Mindfulness and Interpersonal Effectiveness in DBT

Mindfulness and interpersonal effectiveness are two core components of dialectical behavior therapy (DBT), which is a comprehensive intervention originally developed for the treatment of suicidal behavior and borderline personality disorder (BPD.) Together, they are critical tools in the toolbox of any person. However, they are particularly useful for those struggling with addiction and trauma. 

Mindfulness relates to the relationship you have with yourself. On the other hand, interpersonal effectiveness deals with the relationships you have with others. According to Addiction Science & Clinical Practice, several studies have demonstrated the efficacy of DBT in reducing substance abuse in individuals with a co-occurring borderline personality disorder (BPD). Lantana Recovery offers a full array of DBT programming options. 

Mindfulness

According to Neuroreport, mindfulness facilitates the thickness of the prefrontal cortex. Studies show that the greater the thickness of the prefrontal cortex, the greater its ability to control cravings. For instance, an interpersonal mindfulness program embedded in a psychiatric nursing practicum was found effective. In DBT, mindfulness has a number of important tenets, including the following:

Observe

When you’re being mindful, you want to practice carefully observing your surroundings in a completely nonjudgmental way. You could practice by looking at a rock and noticing its ridges, its shape, and its color. 

Next, practice being grateful for the things you observe around you. Notice how the chair you’re sitting in holds you up, how the ground provides a path for you to walk. Notice how electricity provides light for you to see. Notice the miraculousness of existence itself. 

As you observe the world around you, allow thoughts to pass through you like clouds on a sunny day. This builds your ability to compartmentalize and just “be with” your thoughts rather than being ruled by them. 

Sensory Analysis

Next, engage in a sensory analysis of the world around you. You started with sight. Now, continue with sound, smell, and taste. Allow yourself to wonder what you’re experiencing. 

As urges come, don’t fight them, but rather examine them. View them as boats on a river passing by or train cars on a track. You want to view these urges and identify them, but you don’t want to jump on them. Alternatively, view them as packages on a conveyor belt passing you by and a box to be opened later. 

These urges can include urges to use a substance of choice. Sit with the urge, but don’t act on it. Examine it and let it pass. This is mental weightlifting; the more you examine urges without acting on them, the easier it will become to forgo your substance of choice. 

Describe

Practice describing people. For example, look at a person walking by. Describe their demeanor and their potential story. Practice describing your thoughts and emotions, especially when you have strong ones. 

Know that just because you describe something a certain way doesn’t mean that’s the way it is. For example, if you are afraid of something, that doesn’t mean there is an objective reason to be fearful. Remember to “check the facts” and be able to understand the difference between what you know for certain and what you are interpreting. 

For those struggling with trauma, this step can be doubly important. You want to be able to describe the fears you feel and the reactions you have to them. How does a past event make you feel? Why does it make you feel that way? 

Nonjudgmentalness

You want to stick to the facts as thoughts of judgment cross your mind. There are three different states of mind you can occupy. The first is your “reasonable mind,” which is ruled by logic and is cool, rational, and task-focused. 

The second is your “emotional mind,” which is mood-dependent and emotion-focused. Your “wise mind” represents a middle path, informed by reason and values. This is the frame of mind you want to occupy as you approach life’s challenges. Allow your thoughts to pass without judgment and be ruled by reason and values. 

Interpersonal Effectiveness and DBT

Interpersonal effectiveness skills dovetail with mindfulness. Many people who struggle with their relationship with their own mind struggle with their relationships with others. To be effective in personal relationships, you have to be able to balance short-term and long-term goals. 

First, you should ask yourself what you want to get out of a relationship. Is it important to maintain a particular relationship long-term? What do you have to do to act in a way that maintains your own self-respect? 

For many in recovery, it is important to tread lightly on pre-existing relationships as they have often been taxed by years of dysfunction. Carefully consider how you need to act to maintain the good graces of those around you. 

DEAR MAN in DBT

Dr. Marcia Linehan, the creator of DBT, uses the acronym DEAR MAN to encapsulate a core DBT strategy of interpersonal effectiveness when trying to get something from another person. 

• Describe: Describe your situation, just in terms of the facts. Remember to be nonjudgmental in your approach and stick only to what you know. Instead of saying, “You did something stupid,” say, “You spent money without asking.”
• Express: Express exactly how the situation described made you feel. Remember that the other person can’t read your mind. Be open. 
• Assert: Be assertive, clear, and confident in the way you make your ask. Don’t be angry or too forceful. However, be willing to stand on your own two feet, look the other person in the eye, and make the ask. 
• Reinforce: You want to reinforce your ask by outlining the positive effects of getting what you want or the negative consequences of not getting it. 
• (Be) mindful: Remember to stay mindful when you are making your ask. That means using your wise mind, which focuses on reason and values. 
• Appear confident: Have enough self-respect for the reasoned and thoughtful way you approach the situation to be confident about how you are asking. Be sure to use good eye contact and tone of voice. 
• Negotiate: Be willing to change or reduce your request if necessary if it doesn’t undermine your underlying goal.

Bottom Line

“The use of mindfulness meditation as a treatment for mental health problems has been of interest to clinicians and researchers” (Mindfulness as taught in Dialectical Behaviour Therapy: A scoping review, Eeles & Walker, 2022) for years. Lantana Recovery understands the importance of DBT skills in living healthy lives for those who struggle with addiction. That’s why Lantana Recovery provides a wealth of DBT programming options for those interested in participating. The mindfulness module emphasizes the importance of observing, describing, and participating in the world. If your relationships with not only your mind but also those around you have been negatively impacted by addiction, interpersonal effectiveness skills can be a crucial lifeline.