No matter what is thrown at you, you have to be ready with a DBT skill or response, in the moment. You cannot hesitate and you cannot give up.
Make an acceptance-acknowledgement declaration
-for you and your loved one this declaration often opens the door to healing and change
-repeat it over and over if necessary
-remind your loved one that you never intended to do any harm
-apologize
Take your loved one’s emotional temperature
-try to sense what emotion they are feeling
-observe body language, gestures, and facial expressions
Mind-read
-imagine being your loved one by looking at the current situation from their perspective, given their dysregulation and past experiences
-validate and normalize their response
Describe
-describe what you see, what you feel, and what your intuition tells you
Validate
-have courage and validate the emotion you sense your loved one is feeling
-keep your own emotion out of it
-validate their inner capabilities and wisdom
-validation is the key to improving communication
Be fully present in the moment
-during the interaction, stop doing whatever you were doing and focus all your attention on your loved one
-make eye contact
Identify and prevent triggers
-it is time to practice predicting your loved one’s reactions by identifying possible behavioral triggers
-this requires you to mind-read so as to identify possible behavioral triggers in various situations and try to prevent emotional escalations by validating emotions and suggesting alternative behaviors
Script a DEAR CCC
-when you want to ask for something or explain why you cannot do something, plan what you will say in advance by writing out a structured, clear, and concise script using the DEAR CCC format
-this will help you to reduce misinterpretations of simple, uncomplicated situations or neutral statements
-using DEAR CCC as a guide can prevent triggering maladaptive BPD responses and decrease the possibility of misinterpretations, thereby averting stressful, aversive interactions and improving communication
-it is sometimes easier for your loved one to “hear you” when what you are saying is written rather than said face to face
-reading decreases the potential misinterpretations of voice tones and facial expressions
Cheerlead
– encourage your loved one by reminding them that they can do hard things, that they have done hard things in the past, and that they are capable of tolerating distress
-communicate that you believe in your loved one
Develop a scale
-help your loved one to evaluate their experiences, to rate their own emotional intensity or difficulty of their problem
-remind them of how they overcame problems in the past
-WOW stands for wait, observe, and wing it
Be a magnifying glass
-people with BPD do not see the world the way you do because their thinking has a strong negative bias
-call attention to the positive aspects of situations
-by pointing out the overlooked positive in their life you are being their magnifying glass, helping them see the world and their own accomplishments in a more positive life
Find the nugget of truth
-find the truth in whatever it is that your loved one says or feels
-there is usually something valid at the bottom of their feelings or actions, it is your job to find and validate it
-accept that they feel what they feel
Do not encourage fragility
-do not treat your loved one in a patronizing or condescending manner
-that contributes to their feelings of shame
Build competency and self-respect
-to feel competent, a person must succeed at doing something, even if it’s just a small thing
-competency is feeling proud of yourself because you have achieved something you wanted to do
-point out that your loved one deserves to feel really good about themselves because they have achieved a goal they did not think they could achieve
-achieving competency means developing self-esteem
-people with BPD need to feel they have control of their lives, can stand up for themselves, express their own opinions, and say no to demands
-try asking your loved one for advice, say ‘what advice would you give your best friend in this situation?’
Be irreverent
-use humor or make challenging statements, or say things that are irreverent
-it is important to keep your tone of voice light and validating
Learn to live with failure
-if you protect your loved one from experiencing failure, how will they ever learn to overcome it?
-failure is as much a part of life as success
Accentuate the positive
-glass half full or half empty, people with BPD tend to see it as half empty
-persistence is often more important than innate talent, it takes courage to keep going
-courage is not the absence of fear but the ability to keep going in spite of it
Be your loved one’s memory
-when a person with BPD is in emotion mind, they will hold themselves up to the impossible, unrealistic standards, compare themselves to others, and feel as if the world has conspired to cast them as a failure
-because people with BPD seem to have difficulty accessing their own happy memories, provide your loved one with concrete, physical evidence of their positive experiences
Manage contingencies
-anticipate how your loved one might react or feel in a certain situation
-try asking questions about potentially difficult situations that are sure to arise and help them find ways to deal with them ahead of time
Empower your loved one
-almost any new situation in which your loved one feels out of control, judged, compared to others, criticized, incompetent, or embarassed will produce anxiety
-remind them of past achievements in similar difficult situations
Reconcile and synthesize
-both you and the person with BPD must radically accept that each one of you did the best you could and never realized or understood the effect your behaviors and responses had on the other person
-to achieve a synthesis between acceptance and change it is essential that you forgive one another
Accept the premises of BPD
-progress in DBT is a slow, ongoing process
-it requires setting realistic goals and readjusting expectations
-BPD is a chronic disorder, progress is a decrease in the severity of episodes and an increase in the length of time between episodes
-focus on changing yourself so that you can be willing, open, radically genuine, authentic, and compassionate
The BPD Group 