Dialectical Behavior Therapy is an evidence and skills based treatment to help those with Borderline Personality Disorder, Mood disorders, Eating Disorders, Addiction, Self-Harm, Suicidal Ideation and other mental health disorders. Created by Marsha Linehan, an American Psychologist and Author in the 1970s, the treatment combines cognitive restructuring with mindfulness, acceptance, and behavioral shaping. DBT is broken down into four modules:

• Mindfulness
• Emotion Regulation
• Distress Tolerance
• Interpersonal Effectiveness

What is Interpersonal Effectiveness?

Interpersonal Effectiveness is one of the DBT modules. Some goals of interpersonal effectiveness include getting people to meet your needs, saying no, setting boundaries, getting others to do those things you want them to do, to get others to take your opinions seriously, to maintain your self-respect and to maintain the relationship. The main objective is to strengthen current relationships, build new and nourishing relationships, and end those relationships that are deemed unhealthy, unbalanced, or even toxic. It is important to create and maintain balance in relationships, and balance change with acceptance.

Interpersonal effective skills are not naturally attained. The skills need to be learned, so practicing DBT skills is imperative to build and nourish satisfying relationships. There are three types of goals:

• Objective Effectiveness: obtain something you want or saying no
• Relationship Effectiveness: maintain or improve a relationship
• Self-Respect Effectiveness: maintain or improving your self-respect

In most circumstances, you’ll have more than one goal in a situation, and sometimes all three are important. If the other person is important to you, you’ll want to maintain the relationship while obtaining something you want or saying no. And you’ll probably want to keep your self-respect in the process. The skills for each goal can be used simultaneously.

Here are three skills that are the building blocks in this module.

What is DEARMAN?

Dearman is an interpersonal effectiveness skill. The acronym stands for:

• Describe the current situation.
• Express your feelings
• Assert yourself
• Reinforce
• Stay Mindful
• Appear Confident
• Negotiate

The first step in this skill is to describe the situation aloud to the other person. It is important to only state the facts, that means not staying any judgements or opinions about the situation.

The second step is to express your feelings using “I statements.” Other people cannot read your mind and this gives you an opportunity to express in an open and honest and open way how you feel.

Assert is when you ask for what you need or want or say no. It is important to be clear and direct so your assertion is not misinterpreted.

Reinforce the positive outcomes if your request is met and/or the negative consequences if they accept your no. Reinforcing will increase the likelihood that people will respond more positively.

Staying mindful means to stay on task and to reiterate your request repeatedly. The other person may try to get you off track or even become hostile and it is vital that you stay mindful of your goal.

During the interaction try and appear confident which includes using a confident tone of voice, standing up tall and making eye contact, and avoid unsure language such as “I am not sure.”

While it is important to appear confident, it is important to stay flexible. Sometimes we need to be willing to get, to offer alternative solutions, and to turn the table to receive alternative solutions from the other person.

What is GIVE?

Give is an interpersonal effectiveness skill. The acronym stands for:

• (be ) Gentle
• (act) Interested
• Validate
• Easy Manner

Be kind and respectful. Treat others like you would like to be treated. Stay away from attacks, making judgments, or using “should” statements. Honor delaying the conversation or changing the location of the conversation.

Acting interested means listening, maintaining eye contact, no interruptions and honoring their wish to postpone the conversation. You do not feel heard if the other person is distracted, doing something else during the conversation and not giving you undivided attention.

Validating means showing the other person that you understand what they have said. Validation can be shown through words or actions such as a head nod, saying “I hear you,” and using gentle body language. Try to find the truth in what the person is saying.

Easy manner means smiling, being friendly, and over-all being easy-going. Try to accept and listen to their response or boundary in a calm and gentle manner.

What is FAST?

Fast is an interpersonal effectiveness skill. The acronym stands for:

• (be) Fair
• (no) Apologies
• Stick to your Values
• Truthful

Be fair when you’re describing the situation and stating your objectives and goals. Consider the other person’s wants and needs along with your own. Avoid judgments and opinions and stick to the facts. Also be fair to yourself.

Don’t apologize when you don’t have to. Apologizing can imply that you are doing something wrong and over time it can minimize our self-respect. Asserting yourself, asking for what you need and want, and saying no are not reasons to apologize. Neither is the way you feel or having a different point of view from the other person. You can apologize when you have made a mistake or caused hurt.

Do not agree with something that does not fit your values or morals. Do not compromise them to please the other person or to avoid conflict. Confidently honor your values.

Being honest is vital in increasing our self-respect. Sticking to the facts helps to reduce exaggerating or stretching the truth. Try not to act helpless when you are not, even if you are feeling fearful and uncertain,

DBT skills only start to work when we practice them. Practice these skills in group therapy, with your therapist, a friend, even your pet! Write out effective scripts and read them aloud so you feel more prepared during the actual conversation. Practice makes progress.

Warmly,

Meredith O’Brien, LCSW