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Four dialectical behavior therapy skills for college students

Art by Jo Moses

In 1967, a woman who would later become one of the United States’ most trailblazing psychologists moved into a Chicago YMCA following a mental health low. Tallying over two years across several stays in a psychiatric facility for severe mental illness (what she would later come to understand as borderline personality disorder (BPD), a condition marked by profound emotional dysregulation), 24-year-old Marsha Linehan was ready to begin her journey to healing. As a teenager, Linehan had been subjected to what were, at the time, leading treatments for people dealing with serious emotional instability and self-harm. These therapies included electroshock, isolation and heavy hypnotic drugs. It would take years of schooling for Linehan to become a psychologist, but at 24 years old, she unknowingly possessed the basis for her life’s work: her own lived experience as a misunderstood young woman with mental illness.

While working as a receptionist and living at the YMCA, Linehan enrolled in night classes at Loyola University Chicago. As a Roman Catholic, she would frequently retreat to a chapel on-campus to pray.

“One night I was kneeling in there, looking up at the cross, and the whole place became gold — and suddenly I felt something coming toward me,” she said. “It was this shimmering experience, and I just ran back to my room and said, ‘I love myself.’ It was the first time I remember talking to myself in the first person. I felt transformed.”

This pivotal moment would stay with Linehan for years to come. After working her way up from night classes to a doctoral degree in psychology at Loyola, she realized that her patients with BPD needed something else in addition to their regular cognitive behavioral therapy. The deep existential unrest they lived with each day seemed to be particularly powerful, and they needed acceptance of themselves and their struggles to come from within, so she invented dialectical behavioral therapy (DBT). DBT is a fusion of cognitive behavioral therapy and Buddhist principles of mindfulness that proved groundbreaking. It consists of four modules: core mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Research has shown that DBT is effective at facilitating emotion regulation, improving mood and increasing interpersonal effectiveness — most significantly among those with BPD, but in individuals with various other conditions as well. Though most research on DBT has centered around treating those with mental illness, the grounding and practical skills it offers can be tried by any college student navigating a world of academic and social stress. Here are just a few.

Mindfulness: Wise Mind

Wise mind aims to balance emotion and reason, helping one maintain a regulated psychological state. It validates both the emotional and logical aspects of a situation so both are recognized but neither is overpowered by the other. Wise Mind can be used by first recognizing and affirming the emotions one is feeling without judgment. For example, you could note that you feel sad, angry, happy, jealous or another emotion without telling yourself that emotion is wrong. After recognizing the emotion, state the facts. What happened? What do you know, logically, to be true? Seeing the emotional and rational sides of an event at at the same time can help in obtaining clarity in how to proceed with a situation.

One example of wise mind in action is: a student is sad they got a poor grade on a recent test and they are berating themself for it. They first recognize their sadness as a real emotion they are experiencing. When they’ve named their sadness, they also note that, logically, the reason they got a poor grade was that they procrastinated and struggled with the material. The student can then have compassion for themself for struggling while recognizing what they could do differently next time to get a better grade. The student forgives themself and decides to improve their time-management skills and make an appointment with the tutoring center.

Interpersonal effectiveness: F.A.S.T

F.A.S.T is a mode of action for handling interpersonal conflict. The acronym stands for “be Fair,” “be Assertive,” “Stick to values” and “be Truthful.” Remembering F.A.S.T helps people effectively come to a compromise while advocating for their needs and being sensitive to the needs of others.

For example, two roommates, Virginia and Alexa, cannot agree on the volume and timing of music played in their room. Virginia loves to listen to music at all times, but Alexa can’t stand any noise while she studies. Alexa is annoyed by Virginia’s blaring of the band girl in red when she is trying to focus on a math worksheet. Alexa uses F.A.S.T to approach Virginia about her music habits. She acknowledges that Virginia has the right to play the music she wants sometimes since she lives in the room, too (be fair), but that silence while she studies is a necessity to her (be assertive). Instead of yelling at Virginia or confiscating her speaker (stick to values), Alexis honestly proposes that she would like it if Virginia would wear headphones or listen somewhere else while she is studying (be truthful).

Emotion Regulation: Build Mastery

Building mastery may seem like a simple premise, but it is a powerful one. In DBT, building mastery refers to participating in things one enjoys and bettering skills in order to build a sense of accomplishment and satisfaction. Amid life’s stress, or, especially in the case of someone with BPD and emotional dysregulation, the sense of identity and purpose that comes from routinely working hard at something important can be grounding. To build mastery, focus on your strengths and what you are passionate about and set goals from there.

Say a student loves to sing for themself and belts out to REO Speedwagon in the shower every morning. In a leap of faith, the student decides to join the school choir and learn music theory and vocal technique. They gain confidence in their singing abilities and build community in a choir, which boosts their confidence and provides an escape from stress.

Distress Tolerance: Radical Acceptance

Radical acceptance, based on Buddhist philosophy, is the practice of accepting that something is happening and freeing oneself of emotional attachment to the sense of control over that situation. One can practice radical acceptance and still dislike the situation they are in; it only refers to relinquishing control where control is impossible and directing energy towards what will truly help at the moment.

When faced with a challenging situation, one can use mantras similar to these:

“This is what it is. I cannot change it.”

“This, too, will pass.”

“I accept this situation and proceed best I can.”

DBT’s effectiveness and Linehan’s story are reminders that one’s personal experiences and struggles can be transformed into something that makes a difference in the lives of others. To learn more about DBT, check out The Linehan Institute.