1. Introduction to Interpersonal Skills in DBT
The treatment is based on the biosocial theory, which suggests that the disorder is influenced by a combination of biological factors and an invalidating environment. Emotionally sensitive individuals are more vulnerable and have difficulty coping with life's events. This theory is referred to as "emotion dysregulation" or "affect dyscontrol." (Gerra et al.2021)
The DBT manual gives an overview and reason for the skills, explaining their purpose, focus, and example content. Since DBT targets various forms of dysregulation, the skills cover a wide range of symptoms and problems. This article focuses on individuals with emotion dysregulation as their main issue, sharing how DBT addresses other areas through its comprehensive approach (Zeyrek2020).
1.1. What are Interpersonal Skills?
Interpersonal skills consist of particular concrete behaviors that lead to a desirable outcome. They are used to express or transmit information, to solve problems, cajole, deliberate, harmonize, problem-solve, and so on. Interpersonal skills are developed by coexisting openly and interacting harmoniously and efficiently with others, linked to communicating and working effectively and constructively with people. Good interpersonal skills are the cornerstone for functioning in teams, with the family, community, and partners. However, interpersonal challenges are to be expected, so being able to deal competently is fundamental. It is therefore important that we pay attention to the developing communication skills of the individuals involved in Dialectical Behavior Therapy. These skills involve developing the capacity to listen, the capacity to express oneself, and to learn from experience. The responsible use of language can help to have a productive conversation. Interpersonal skills are developmental and can be influenced because they also depend on the context in which an individual operates.
1.2. The Role of Interpersonal Skills in DBT
Individuals with emotional dysregulation often have difficulty managing interpersonal relationships and their approach to relationships leads to a higher likelihood of negative life events that exacerbate their symptoms, which supports the expansion of the individual's DBT skill set beyond distress tolerance and affect regulation. Treatment is organized around four sets of behaviors considered necessary for full treatment participation: core mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. These skills may be taught individually or in small groups, depending on patient need and preference. DBT is a treatment with demonstrated efficacy in the treatment of BPD, suicidal behavior, and drug abuse.
Interpersonal skills are a critical component of dialectical behavior therapy (DBT) that facilitates the individual's understanding of interactions and relationships, as well as how these interactions and relationships influence functioning. In DBT, interpersonal effectiveness is one of the foundation skills that are thought to help regulate and manage emotions as well as behaviors. The first two modules of the treatment focus on reducing dysfunctional behaviors, such as self-harm and suicidal urges, and behaviors that interfere with the course of therapy.
2. Some Interpersonal Skills in DBT
DEARMAN
DEARMAN is a skill used for effective communication, particularly when you want to assert your needs or say no to a request while maintaining self-respect and the relationship.
Components of DEARMAN:
- Describe: Clearly describe the current situation.
- Express: Express your feelings and opinions about the situation.
- Assert: Assert yourself by asking for what you want or saying no clearly.
- Reinforce: Reward the person ahead of time by explaining the positive effects of getting what you want or need.
- Mindful: Stay focused on your goals and the discussion.
- Appear Confident: Appear effective and competent.
- Negotiate: Be willing to give to get.
Example:
Imagine you need to ask your boss for a day off.
- Describe: "I’ve noticed that I haven’t taken any time off in the past six months."
- Express: "I’m feeling really stressed and overwhelmed with the current workload."
- Assert: "I’d like to request a day off next Friday to recharge."
- Reinforce: "I believe taking this day off will help me come back to work more focused and productive."
- Mindful: (If the boss interrupts) "I understand this might be inconvenient, but it’s important for my well-being."
- Appear Confident: Maintain eye contact, sit up straight, and speak calmly.
- Negotiate: "If Friday doesn’t work, I’m open to taking another day off that suits the team’s schedule better."
FAST
FAST is a skill used to maintain self-respect and integrity during interactions, especially when setting boundaries or standing up for yourself.
Components of FAST:
- Fair: Be fair to yourself and the other person.
- Apologies: Don’t over-apologize. Only apologize when it’s warranted.
- Stick to Values: Stick to your values and what’s important to you.
- Truthful: Be truthful and avoid exaggeration or lies.
Example:
Imagine a friend frequently asks you to lend them money, and you want to set a boundary.
- Fair: "I understand you’re in a tough spot, and I want to help within my means."
- Apologies: "I’m sorry you’re struggling, but I can’t keep lending you money."
- Stick to Values: "I value our friendship, and I also need to stick to my budget."
- Truthful: "The truth is, I can’t afford to lend you money without it affecting my own financial stability."
GIVE
GIVE is a skill used to maintain and improve relationships, emphasizing the importance of kindness and validation.
Components of GIVE:
- Gentle: Be gentle in your approach, avoiding attacks or threats.
- Interested: Show interest by listening and engaging in the conversation.
- Validate: Acknowledge and validate the other person’s feelings and experiences.
- Easy Manner: Be relaxed and use humor when appropriate.
Example:
Imagine you want to discuss a misunderstanding with a close friend.
- Gentle: "I’d like to talk about something that’s been on my mind, and I hope we can approach this conversation calmly."
- Interested: "Can you tell me your perspective on what happened at the party last night?"
- Validate: "I understand why you felt left out when I didn’t introduce you to my colleagues right away. That makes sense to me."
- Easy Manner: Smile, use a light tone, and say, "Let’s find a way to avoid this kind of misunderstanding in the future."
Summary
- DEARMAN: For asserting needs while maintaining respect and the relationship.
- FAST: For maintaining self-respect and integrity in interactions.
- GIVE: For improving and maintaining relationships with kindness and validation.
By practicing these skills, individuals can improve their communication, set healthy boundaries, and foster better relationships. (Mhaoláin and MacNeela2021)
References:
Gerra, M. L., Gerra, M. C., Tadonio, L., Pellegrini, P., Marchesi, C., Mattfeld, E., ... & Ossola, P. (2021). Early parent-child interactions and substance use disorder: An attachment perspective on a biopsychosocial entanglement. Neuroscience & Biobehavioral Reviews, 131, 560-580. unipr.it
Zeyrek Rios, E. Y. (2020). Dialectical behavior therapy in the treatment of borderline personality disorder. Journal of Cognitive Behavioral Psychotherapies and Research, 9(2), 148. jcbpr.org
Panish, D. (2021). Dialectical Behavior Therapy Skills Training for Emotional Problem Solving for Adolescents (Dbt Steps-A) in Urban School Contexts: A Mixed Methods Study. rutgers.edu
Whittles, P. (2020). Multi-Family Group Therapy in Primary Schools: Effectiveness, Processes and Challenges. ucl.ac.uk
Mhaoláin, C. N., & MacNeela, P. (2021). A roadmap to recovery and a life worth living: An interpretative phenomenological analysis of adolescent experiences of dialectical behaviour therapy in child and adolescent mental health services. European Journal for Qualitative Research in Psychotherapy, 11, 87-102. ejqrp.org
This post is for informational purposes only. It should not be considered therapy. This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise provide any clinical opinions. If you think you need immediate assistance, call your local doctor/psychologist or psychiatrist or the SADAG Mental Health Line on 011 234 4837. If necessary, please phone the Suicide Crisis Line on 0800 567 567 or sms 31393.