Many people who have experienced trauma in their childhoods struggle to manage intense feelings of anger, anxiety, and deep sadness. These emotions may lead to isolation, angry outbursts, feeling paralyzed, overwhelmed, avoidance of important goals and relationships, self-harm and suicidal thoughts. DBT emotion regulation skills can help with these intense feelings experienced by those living with PTSD.
Dialectical Behaviour Therapy (DBT therapy) was created by Dr. Marsha Linehan in the 1980’s to help people with emotion regulation issues. DBT therapy is a third wave cognitive behaviour therapy that integrates mindfulness and acceptance practices with behaviour change. Comprehensive DBT therapy is composed of DBT Skill group, weekly individual therapy, and phone coaching .
DBT therapy has an extensive research base to treat a variety of conditions including: Borderline Personality Disorder, Substance Use, PTSD, Major Depression, ADHD, Bipolar Disorder, Binge Eating, and Bulimia (https://behavioraltech.org/evidence/).
Here are a few DBT emotion regulation skills that you can use in your daily life that are especially helpful for those who have experienced trauma.
Radical Acceptance:
Radical Acceptance means accepting reality as it is and was a term coined by Marsha Linehan the founder of DBT therapy. However the concept of radical acceptance is gleaned from Dr. Linehan’s study and practice of Buddhist philosophy.
In DBT therapy, radical acceptance means to stop fighting the reality (unpleasant emotions, facts) and to turn towards the reality (often painful) instead of away or denying that it exists.
The skills of radical acceptance means noticing when we are fighting reality, and instead intentionally turning toward the reality and the painful emotions over and over again (this is called Turning the Mind). In practicing Radical Acceptance we come to terms with life as it is and are now able to see the situation clearly and problem solve what we do have control over.
For those who have experienced trauma this may mean acknowledging the losses and changed life circumstances of the trauma on your life. For example, if you have been in a car accident and have had a brain injury it is vital to acknowledge your changed capacity for activities and reduced energy so you do not overextend yourself, burn out or worse take it out on those who love you. It can be painful to acknowledge that life has changed and that you do not have the same physical and/or that you used to have prior to such an accident. For clients I have worked with they find they can be happier and more content when they stop fighting against the limits of their body or mind and stop putting expectations on themselves to function at a pre-PTSD level.
Check the Facts:
“Check the Facts” is a skill in DBT emotion regulation skills that involves naming the emotion you are experiencing and asking if the emotion and its intensity fits the facts of the situation. To check the facts we examine our assumptions, and judgements, and check to see if those line up with the facts- this skill also involves seeing the situation from alternative points of view.
To go a step further Check the Facts asks you to assess if there is a threat you are assuming and assess the probability that it will happen, as well if it does happen it invites you to imagine coping well with the worst case scenario. Check the facts in DBT therapy is a change strategy that in itself can regulate your emotions.
Often when people with PTSD experience a trigger that evokes a strong emotion their trauma brain starts to tell them a story that tries to prevent the trauma for happening again. For example if you have experienced being cheated on or lied to in a relationship, any subsequent relationship you may find yourself triggered and jump to conclusions and believe that your new partner will let you down like others have in the past. If you notice your emotion seems more intense than the situation warrants you can use the check the facts skill and ask yourself if your interpretation of this event lines up with the facts. Doing this in itself can help reduce your emotional distress.
Opposite Action:
If after checking the facts, the emotion does not fit the facts then we invite the client to check in and consider whether it is effective to act on the emotion. If it is not effective to act on the original emotion we invite clients to use “Opposite Action” to regulate the emotion. Note, in doing this we are not trying to suppress the original emotion, but we are communicating to the brain by our actions to help the brain come to the conclusion that the threat is not warranted and the emotion may decrease as a result.
In opposite action we identify the emotion and action urge of the original emotion and “act” opposite to this urge. For example, if you are feeling angry and your urge is to lash out or get angry, an opposite action would be to avoid or be gentle or a little nice with the person you are angry with. Doing “Opposite Action” is a powerful skill to help with emotion regulation in DBT therapy.
The Value of DBT Therapy
I encourage you to try these 3 DBT Emotion Regulation Skills in your daily life to begin to shift and change your emotions and trauma responses. There are many valuable skills in DBT therapy that can help those who have experienced trauma, in addition to the three skills we have shared in this article.
If you would like to learn more please reach out to a DBT trained therapist. We run Trauma-Informed DBT Groups, provide in-person counselling in Vancouver and online counselling in BC, Ontario or Alberta today.
April Griffin MSW RSW RCC is the founder and director of Emotion Wise Counselling (www.emotionwise.ca) in Vancouver BC and she specializes in providing DBT therapy and EMDR therapy to treat Complex Trauma and PTSD.
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