Dialectical Behaviour Therapy: Mindfulness - The "What & How" Skills

United Kingdom

The Core Dialectics highlighted the difficulties associated with non-dialectical approaches, and the usefulness of a synthesis between opposing positions. It is however one thing to understand the value of a dialectical approach, and quite another to be able to implement it. Many clinicians might suggest to their clients the benefits of “sitting with feelings,” yet clients need more direct assistance in learning what this means, how to do this, and what the benefits could be.


The Mindfulness Skills develop the capacity to guide the focus of one’s attention. It is more of an active capacity to attend, integrate, and inhibit action, than to aspire to rest or relaxation. Mindfulness Skills are like the reigns we put around the wild horse of our emotions to guide the forceful nature of the beast safely in useful directions. 


In all forms of acceptance and change an awareness of both the current reality, and the focus of attention to learn and apply new skills are required. Therefore the Mindfulness Skills are the first skills taught in DBT, and are also reviewed and repeated between all new skills sets. 


Marsha Linehan recognised that traditional forms of Mindfulness that focus on achieving stillness by traditional meditation can often be an aversive experience for both dysregulated and traumatised clients. She developed a more practical and tolerable set of goals. These are the “What to Do”, and “How to Do it “ Skills as presented in this Module. 


In addition to the attentional control offered by these Mindful Skills, they also offer ways to “plug back in” as an antidote to disconnection and emptiness. While many of the skills focus on the downregulation of an agitated and over-aroused Emotion Mind, the Mindfulness Skills are needed for the capacity to move from an overly Rational Mind into a more empathically connected Wise Mind.

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