By Deni Cifuentes
Dialectical Behavior Therapy (DBT) is a behavioral intervention developed by Marsha Linehan in the late 1970’s that stems from Cognitive Behavior Therapy (CBT). While initially its intended treatment group was limited to patients experiencing chronic suicidal ideation as an effect of Borderline Personality Disorder, it has since been adapted to treat a range of disorders in patients who exhibit self-destructive behaviors and have been unresponsive to past treatments. DBT is distinguished by its structured modular design that places emphasis on key components of self awareness and desired change: mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance. While its target audience continues to be chronically suicidal patients, I’ve often wondered whether this treatment was worth incorporating into the everyday lives of the undiagnosed.
Let’s look at the acronym often used in DBT: D.E.A.R. M.A.N.
Describe, Express, Assert, Reinforce, Mindful, Appear confident, Negotiate
Although this acronym is specific to this evidence-based approach, it may come in handy when facing uncomfortable situations. Making requests is an interpersonal effectiveness skill many don’t feel comfortable doing. Falling victim to a discouraged mindset in which you assume a negative outcome can turn avoidance into a costly habit. Although use of this acronym does not guarantee results in your favor, it does grant you consideration of your words and a response, an opportunity created by careful planning on your behalf.
Do you find you’re the type of person that just can’t say no? How do you politely refuse an additional assignment, one that’s not quite your obligation, although it feels as if it may as well be included in the contract? How might this feeling translate into your personal life?
Take this scenario: your friend Tom recently broke up with his girlfriend after discovering she had cheated on him. Tom has gotten into the habit of calling you nightly, still clearly distressed as a result of his loss. Your first class is scheduled early in the morning, and while you care for your friend, lack of sleep has caused you to underperform during sunlit hours and you can’t continue to hold these nightly phone calls. How can you talk to your friend during this sensitive time in his life? Let’s go through each letter of the acronym and see how it can be helpful.
D is for Describe. Describe the situation, explain how your change in routine has affected your daily life: “These nightly phone calls are causing me to fall asleep during class.”
E is for Express. Express your opinions on the matter and your emotional stance: it’s not me, it’s you, or rather, what the situation has done to you, and be clear that it hasn’t affected my feelings toward you. “I understand that this is a very difficult time for you. I want to be there as your friend. However, I cannot continue to talk to you late at night for long periods of time. It has made it difficult for me to carry out my responsibilities.”
A is for Assertive. Be assertive; you need your rest. “I need my full eight hours of sleep.”
R is for Reinforce. Reinforce your feelings: “I understand that you are going through a hard time right now.
M is for Mindful. Be mindful with your words and your friend’s reaction to them. The intent isn’t to hurt your friend, but to stand your ground.
A is for Appear confident.
N is for Negotiate. Negotiate a plan that suits you both. “Can we talk during our lunch breaks instead of late at night? Do you want to schedule a time for us to go out to dinner and talk?”
Let’s look at one other acronym: P.L.E.A.S.E.:
treat Physical illness, Eat, Altering drugs, Sleep, Exercise
This acronym appears under emotion regulation, and it aims to reduce unpleasant emotions by pushing you to tend to your basic needs. We tend to forget sleep isn’t a luxury that can all but fully be chipped out of our daily routine, exercise boosts your energy and mood, and being hangry and on non prescribed medication will only put a damper on your performance and mood.
I recall a daily chant recited each morning during middle school summer camp that would end in an enthusiastic “Hydrate or die!” and send this out to students, especially: let’s imagine we’re once again quickly approaching the beginning of the end. Of course, I’m referring to the week of final exams, a time highly anticipated by local coffee shops and fast food shops reach their prime and when libraries are the most full they have been all year. I can certainly attest to this problem; alongside the usual lack of sleep, be it from late night sessions or nerves, for years I’ve had this habit of drinking massive amounts of water while typing assignments (I don’t know, maybe it’s a long term side effect of camp) and would- and do- forget about meals if not scheduled into a busy day. The key word in these situations is “forget”. You may feel normal after your extended study period, but your body may be plotting its revenge for the day of your exam. Take a break, go for a long walk, eat and survive.