This form of therapy changes lives for people with BPD. Here are the skills that can help you too.
THESE DIALECTICAL BEHAVIOR THERAPY (DBT) PRINCIPLES CAN HELP ANYONE COPE WITH DIFFICULT EMOTIONS.
By Jackie Menjivar
(Pawel Czerwinski / Unsplash)
We’ve come a long way in our understanding of borderline personality disorder (BPD). It took decades to even recognize BPD as a distinct diagnosis, and it was once thought to be untreatable. Through research and advocacy, we know so much more about this mental health condition and how to treat it.
The main thing that defines BPD is instability. That can show up in unstable moods, behavior, thoughts, relationships, and self-image. You may struggle with intense emotions, impulsive behavior, and a shaky sense of self.
Dialectical Behavior Therapy (DBT) was created specifically to help people with BPD. It teaches you the skills to identify, process, and manage intense emotions and the behaviors that go along with them. DBT is usually done through one-on-one therapy, group training sessions, and over-the-phone crisis coaching.
While you need professional support for proper DBT treatment, there are still skills you can learn and practice on your own to help manage your emotions. These are some of the basics.
Mindfulness
Mindfulness is about being aware of your thoughts, feelings, and behavior. It’s about focusing on the present moment without reliving the past or imagining the future. It also means that you aren't judging the things you’re thinking and feeling. For people living with BPD, practicing mindfulness helps you stay in the moment and react to what’s happening now, rather than getting stuck or spiraling.
IN THE MOMENT: MEDITATE ON HOW YOU’RE FEELING
The next time you’re having an emotionally charged moment, take these steps.
Find a quiet space, and get comfy. It doesn’t matter if you want to sit or lay down — just make yourself cozy.
Focus on your breath. Breathe normally and observe the way your breath rises and falls. Notice the air moving through your nose and your belly rising and falling. In and out.
Do a body scan. From head to toe, take stock of what’s happening physically. Does your head hurt? Is your heart beating fast? Is your stomach growling?
Investigate. Once you feel physically grounded, it’s time to figure out what’s going on mentally. How do I feel? What are the facts of the situation? How am I responding to that situation?
Remember, you aren’t trying to change your feelings, and you aren’t judging your feelings. You’re just trying to identify them. It’s the difference between: “I’m all alone, and nobody likes me. This hurts so bad, and I don’t know when it’ll stop,” and “My friends are all busy today, so I’m feeling lonely. It makes me sad that I’m not spending time with them right now.”
Like any other skill, mindfulness takes practice. Use these exercises to build up yours.
JOURNAL TO UNDERSTAND
Practice observing and describing without judgment. Write about something you did today, like going for a walk or cleaning your room. What did you see, hear, smell, and touch? What did you feel as you were doing it? Don’t make any judgments (“My room shouldn’t have been that messy”). Just describe the experience.
Once you get comfortable doing this with simple subjects, you can learn to do the same with more emotionally intense situations.
PRACTICE BEING IN THE MOMENT
Practice doing things with awareness. Eat a meal without Netflix in the background or scrolling on your phone. Focus on every bite — texture, taste, temperature, etc. Go for a walk and really take in what’s around you. Read the street signs, watch the cars go by, and smell the flowers along the way.
Keep your mind in the moment. Don’t let your thoughts wander to something that happened earlier or to what you’re going to do after. Get in the habit of experiencing the present fully.
Distress Tolerance
Distress tolerance means learning to cope with intense emotions and handle crises. People living with BPD can build up resilience to deal with those difficult feelings on their own instead of relying on other people for reassurance. It’s about accepting and getting through the pain.
IN THE MOMENT: DISTRACT AND SELF-SOOTHE
Distract yourself until your painful feelings pass — and we promise you, they will pass. Just make sure you’re doing it in a safe way. For example:
Do an activity. Think hobbies (knitting, painting, playing guitar), chores (cleaning up, doing laundry, washing dishes), and physical activities (going for a walk, dancing, doing yoga).
Help other people. You can do formal volunteering at your local food pantry or animal shelter. Or you can just do things for your friends and family, like offering to walk their dog or writing them a heartfelt note.
Tap into an opposite emotion. Watch a scary movie, laugh along to a funny YouTube video, or listen to some upbeat music.
Use physical sensation. Get your mind off the mental by focusing on the physical. Hold an ice cube, take a hot shower, or drink warm tea.
You can also try self-soothing. These are things you do that make you feel good or bring you comfort. When in doubt, engage your senses.
See: cute cat videos, your favorite TV show, a collection of art you love.
Hear: birds chirping, waves crashing, your pick-me-up playlist.
Smell: a lit candle, blooming flowers, freshly laundered clothing.
Taste: a nice meal, a refreshing smoothie, a stick of mint gum.
Feel: a fuzzy sweater, a warm bath, a piece of modeling clay.
PREPARE YOUR DISTRESS TOLERANCE TOOLKIT
Find the things that make you feel better. Write down the activities that work for you so that you can remember them when you need them. Prepare anything you might need ahead of time, like a YouTube playlist of funny videos or the recipe for your favorite dessert. You can even put together a literal kit — fill a box up with candles, bath bombs, notes from friends, or anything else you might want handy during a difficult time.
Emotional Regulation
Emotional regulation helps you to understand and manage your emotions. It can make a huge difference for people living with BPD who often face really overwhelming and constantly changing emotions.
IN THE MOMENT: UNDERSTAND, CHALLENGE, FEEL, AND ACT
UNDERSTAND YOUR FEELINGS
These are some things to keep in mind when you’re thinking about your emotions and how to deal with them.
Feelings aren’t inherently good or bad. Everyone has emotions. Some are painful, and some are joyful, but they’re all just signals that our bodies give us.
Feelings can serve a purpose. Sometimes our emotions get us to act. If you're in a dangerous situation, fear motivates you to get to safety. If you’re facing injustice, anger motivates you to stand up for yourself.
You are not your feelings. Emotions are things you experience, not things that define you. Recognize that you may feel sad right now, but that doesn’t make you a sad person.
Feelings aren’t facts. The way you’re feeling is very real, but the reality behind that feeling may not be. (More on that below.)
CHALLENGE YOUR INTERPRETATION
Emotions don’t just come out of nowhere. Usually, it starts with something happening in your environment or in your thoughts. Feelings are prompted by your interpretation of that event, not the event itself. For example, you see your friends hanging out without you — you interpret that to mean that they don’t like you, and you feel sadness.
As you use your mindfulness skills to assess the situation and what you’re feeling, look out for where you might be jumping to conclusions. Challenge your interpretation. Is it realistic? What other explanations could there be?
FEEL IT AND RELEASE IT
Feel your feelings and then move on. Accept your painful feelings, and let yourself feel them. Don’t make them any bigger by replaying a hurtful situation or telling yourself that the pain won’t go away. Let it wash over you, and then when you’re ready, think about what comes next.
ACT THE OPPOSITE
Like we said before, sometimes feelings prompt us to act. When it comes to those negative emotions, your first impulse may not be the healthiest. Instead, act the opposite of how you’re feeling. For example:
You feel sad, so you want to withdraw from your friends. Instead, make plans with them.
You feel angry, so you want to yell. Instead, go to a comedy show and laugh it off.
You feel anxious, so you want to hide in your room. Instead, go out for a walk and give someone a compliment along the way.
TRACK YOUR EMOTIONS
Keep a journal of the most intense emotion you feel each day. What event triggered it? How did you interpret that event? How did the emotion motivate you to act? You may start to notice bigger patterns or trends in your emotions that you miss in the day-to-day.
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Practicing these skills on your own isn’t a replacement for DBT, but it is a place to start managing your symptoms and building your resilience.
To learn more, read stories from people living with BPD at The Mighty, and visit the National Education Alliance for Borderline Personality Disorder for educational courses and resources.