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Mindfulness Skills in Dialectical Behavior Therapy

Christy Matta, M.A.

How often do you do things in an automatic way without thinking?  The truth is that most people spend much of their time operating in "automatic pilot" mode.  We get up and drift through our morning routines with little thought or attention to what we are actually doing.  If you've ever arrived at work without remembering the drive or showered and can't recall washing your hair, you've been on automatic pilot.  The problem with living on automatic pilot, is that our reactions to events, people, and stress also tend to be automatic.  That recurrent fight with your spouse or repeating problem at work is likely a result of operating and responding on automatic pilot.

woman meditating on the beachHowever, with regular practice we are capable of being present moment-to-moment.  With mindful participation automatic reactions are replaced with greater observation and perception. The more accurate information gained from our enhanced perceptions allows us to respond effectively, which leads to improved competence and sense of control.

Mindfulness skills are central to DBT.  They are the first skills taught and are repeated, throughout the skills modules.  The concept of mindful awareness originated in early Buddhist practice, but as taught in DBT is a non-religious, practical skills module focused on achieving a balance between emotionality and reasonable rational thought.  DBT teaches six mindfulness skills aimed at enhancing awareness of everyday life. The assumption, in DBT, is that responding to life's events wisely requires acting with awareness.

Emotion Mind, Reasonable Mind and Wise Mind

In DBT, the mind is conceptualized as existing in three states.  In "emotion mind" a person's thinking and behavior are controlled primarily his or her emotional state.  Reasonable and logical thinking is difficult, at best and facts are distorted to conform to the current emotional state.  In "reasonable mind" situations are approached rationally and logically, with focus on facts and planning, with no consideration of emotion.  "Wise mind" is the integration of "emotion mind" and "reasonable mind."  It is both the overlap of emotion and reason, as well as an intuitive knowing that goes beyond simple emotion or logic.

What Skills

DBT views lack of awareness as a primary contributor to impulsive and mood dependent behavior.  The three "what skills" are designed to teach how to observe, describe and participate in life with awareness.  To learn a new skill, like playing an instrument or driving a car, you must pay close attention as you practice.  In order to change habitual actions and reactions, you must learn to pay attention to what is happening around and inside of you. 

How Skills

The "how skills" describe how you participate with awareness.  These skills highlight the importance of participating without judging, focusing on what works and being fully present in the moment, rather than focused on past worries or future planning. 

Mindfulness, like any new skill, takes practice and attention.  In DBT it is considered an essential core skill and necessary for fully learning skills in the other three skills modules.

Linehann M. M. (1993). Skills Training Manual for Treating Borderline Personality Disorder. New York:  The Guilford Press.