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Dialectical Behavior Therapy (DBT), developed by Dr. Marsha Linehan, is a comprehensive cognitive-behavioral treatment that emphasizes the psychosocial aspects of therapy, particularly for individuals with Borderline Personality Disorder (BPD) and emotional dysregulation issues. An integral part of DBT is the concept of mindfulness, divided into “What” and “How” skills. While the “What” skills focus on what to do to be mindful, the “How” skills describe how to practice these actions mindfully. This article delves into the “How” skills of mindfulness in DBT, exploring their significance, application, and impact on therapeutic processes.
Understanding the "How" Skills in DBT
The “How” skills in DBT are essentially guidelines on how to approach any action mindfully. They are crucial for ensuring that the mindfulness practice is effective and transformative. These skills include three key components: Nonjudgmentally, One-mindfully, and Effectively.
The Three "How" Skills Explained
1. Nonjudgmentally
This skill involves experiencing the present moment without labeling it as good or bad. It’s about accepting things as they are without criticism or evaluation.
2. One-mindfully
This skill encourages individuals to do one thing at a time, focusing entirely on the present activity without distraction.
3. Effectively
This is about doing what works. It means being mindful of the goal at hand and acting in a way that is most likely to achieve that goal.
"Mindfulness skills are central to DBT; they are the foundation for all the other skills taught in therapy, including the capabilities for emotion regulation, distress tolerance, and interpersonal effectiveness."
The Importance of "How" Skills in DBT
The “How” skills are crucial in DBT as they provide a practical framework for applying mindfulness skills. They help individuals to:
Act with Awareness
By being nonjudgmental and one-mindful, individuals can become more aware of their actions, thoughts, and emotions.
Reduce Suffering
Accepting reality as it is without judgment can reduce the suffering that comes from resisting or denying the present moment.
Achieve Goals More Effectively
The effectiveness skill helps individuals to focus on what needs to be done to achieve specific outcomes, leading to more productive behaviors.
Applying the "How" Skills in Everyday Life
Incorporating the “How” skills into daily life involves a conscious effort to approach activities and interactions mindfully. Here’s how:
Practice Nonjudgmental Stance
Try to notice judgmental thoughts and let them go, focusing instead on observing and describing facts.
Focus on One Task at a Time
Whether you’re eating, working, or talking to someone, give your full attention to that one activity.
Act Effectively
Consider the most effective way to approach a situation, focusing on what will work best rather than what you think should work or what you want to work.
The "How" Skills and Coping Strategies
In DBT, the “How” skills are also vital for developing effective coping strategies. They help individuals respond to distressing situations more mindfully and less impulsively.
Challenges in Practicing the "How" Skills
For many, especially those accustomed to multitasking or engaging in automatic judgment, practicing the “How” skills can be challenging. It requires mindfulness, self-awareness, and the willingness to change habitual responses.
The Impact of the "How" Skills on Therapy
Incorporating the “How” skills in therapy sessions enhances the effectiveness of DBT. Therapists often focus on these skills to help clients develop a mindful approach to their thoughts, emotions, and actions, facilitating overall therapeutic progress.
Expert Opinions on the "How" Skills
DBT experts emphasize the transformative power of the “How” skills. Dr. Linehan notes, “Mindfulness skills are central to DBT; they are the foundation for all the other skills taught in therapy, including the capabilities for emotion regulation, distress tolerance, and interpersonal effectiveness” (Linehan, 2015)1.
Conclusion
The “How” skills in DBT provide a practical and accessible framework for practicing mindfulness in everyday life. These skills are not only therapeutic tools but also essential life skills that foster a more mindful, present, and balanced existence. For individuals struggling with emotional regulation, the “How” skills offer a way to engage with their inner and outer worlds more effectively and mindfully. Mindfulness skills are central to DBT; they are the foundation for all the other skills taught in therapy, including the capabilities for emotion regulation, distress tolerance, and interpersonal effectiveness
"How" Skills Book Recommendations
Here is a collection of the best books on the market related to “how” skills:
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Your Thoughts about the "How" Skills
It’s highly recommended that you jot down any ideas or reflections that come to mind regarding “how” skills, including related behaviours, emotions, situations, or other associations you may make. This way, you can refer back to them on your Dashboard or Reflect pop-ups, compare them with your current behaviours, and make any necessary adjustments to keep evolving. Learn more about this feature and how it can benefit you.
References
- Linehan, M. M. (2015). DBT Skills Training Handouts and Worksheets, Second Edition. Guilford Press.
