Bring DBT DEAR MAN Skills Home for the Holidays

November 21, 2013

DEAR MAN Skills ExplainedThis post is the first of a three-part series about DEAR Skills, adapted from Marsha M. Linehan’s book, Skills Training Manual for Treating Borderline Personality Disorder (1993, The Guilford Press, New York, NY).

The holidays can present challenges to anyone, but for OPI Living and OPI Intensive participants who have been diagnosed with Borderline Personality Disorder (BPD), holiday activities can be exceptionally stressful.

This festive time of year can be full of joy, fun, laughter and celebration with friends, family and loved ones.  But for many, the holidays can easily become intolerably chaotic, evoke intense feelings of sadness, loneliness, anger, regret or feeling out of control, and produce overwhelming amounts of anxiety with potential triggers lurking all around.

With the holiday season right around the corner, it is important for participants with BPD to be especially mindful of practicing Dialectical Behavior Therapy (DBT) skills to keep their “wise minds” in tip-top shape, stay out of “emotion mind” and remain strong in recovery. To prepare for family get-togethers, parties and other social gatherings, using Interpersonal Effectiveness skills is the key to communicate feelings and get needs met.  Remember that more (family members, friends, even strangers) may not necessarily be merrier for you, as this may create the more chances for misunderstandings and miscommunication—so effective interpersonal skills are key!

DEAR MAN is the DBT acronym for Objectives Effectiveness, or skills for getting what you want. This must-have skill for the holiday season can be applied to any situation when you’d like to communicate your feelings, ask for something you want, or set an appropriate boundary to take care of yourself by saying no! Here is an example of applying DEAR MAN skills to a common holiday-time concern for individuals in treatment that can be a tricky situation to address.

D – Describe First, describe the situation you are reacting to. Stick to the facts.

“Participating in mental health treatment is a very private matter. When you talk to others, including extended family members, your friends, co-workers etc., about my treatment without asking me if it is ok to share my private information…”

E – Express Then express how you feel using an “I” statement.

“I feel hurt, betrayed, and mistrustful.”

A – Assert Assert yourself and make your request or say no. Remember others cannot read your mind.

“Please ask me before you talk to anyone about my treatment, including disclosing the fact that I am in treatment.”

R – Reinforce Reinforce how getting what you want will be of benefit ahead of time, or if necessary, explain the consequences of not getting what you want.

“If you respect my boundary and ask my permission before disclosing private information about my treatment to others whom I may not feel comfortable having such personal knowledge, I will feel I can confide in you and continue to share about my progress, which is important to me. If you cannot respect my boundary, I will not feel safe sharing my personal information with you, and will be more selective about what I talk to you about, or may not feel comfortable sharing at all.”

M – (be) Mindful Stay focused on your objective. Don’t allow yourself to be distracted get off topic, or lose sight of your goal in the conversation. Use the “broken record” technique, and repeat what you want over and over. Ignore if the other person tries to change the subject, makes personal attacks, or tries to distract you.

“I know that you are upset with me because I did not do the dishes, and we can talk about that in a few minutes, but I want to resolve this issue first because it is important to me and our relationship.”

A – Appear Confident! Maintain eye contact, stand tall, use an assertive tone of voice. Do not stammer, whisper or apologize.
N – Negotiate Be willing to give to get. Take note that in instances such as this example when setting a boundary, there may not be anything you feel willing to negotiate.

“I am ok with you talking to your therapist, Grandma or your best friend Joan about my treatment, but please ask me before you talk to anyone else.”

Remember if you cannot come to an agreement, use the technique of turning the tables. Ask for the other person to come up with a solution.

“You don’t seem to like my solution to this problem, so how do you think we should handle this?”

The holidays can be stressful at times, for everyone, but if you empower yourself by building mastery in DBT skills, you can maneuver with confidence, safely and soundly, through whatever situations may arise and truly enjoy the magic of the season!

DBT Bonus Tips for Holiday Success

  • Remember to continue self-care and mindfulness practices such as journaling, diary cards, meditation, etc., while home for the holidays…it is easy to forget in the hustle and bustle of holiday madness and this will increase vulnerability to emotion mind!
  • Remember to practice DBT skills out of crisis to strengthen new healthy habits, so that when you really need them, you are able to use them!