When I first received my DBT manual in the post, I was more than a bit intimidated: was I really supposed to learn all of the skills in this very large book? Luckily, the group skills training I attended decided not to teach everything (I think this would be an almost impossible task in 20 weeks anyway!), but still gave me a familiarity with most of the concepts of DBT, so I had a solid foundation of knowledge. When, later, I decided to embark on individual therapy, one of the most powerful things my therapist said was that I didn’t even need to use all the skills I had learnt in group. I just needed to build my own DBT toolkit, my own version of the manual, if you like. Not only was this a relief, it also allowed me to personalise my experience of DBT and take ownership of my recovery, in a way that worked for me. So, without further ado, here are my favourite / most used DBT skills:

Check the Facts

For me, Check the Facts is my MVP. It is the only skill I really know all the steps of, without having to consult the manual, and it is the skill I have used the most. It is often listed as the first step in lots of other skills (problem solving, opposite action, pros and cons, to name just a few) and I think this underlines its status as a foundational skill of DBT. Indeed, you cannot problem solve if you don’t know what problem you actually need to solve! Check the Facts is a great stepping stone to using another skill or skills later on, but what I also like about it is its versatility. It can also be used, very effectively, by itself. It forces me to observe the objective facts, just as they are, and as a highly emotional person, that still feels radical. Although it can be a long-winded process, I never regret doing it; it always provides clarity and often, new insight too.

Opposite Action

Opposite Action has been a wonderful skill to help me to start breaking the cycle of avoidance, which, sadly, remains a favourite coping mechanism. I start by using Check the Facts, to ascertain what the actual problem is, and then go through the steps of Opposite Action slowly, culminating in doing the task I’ve been putting off. However, the key with this skill is not simply to just do the difficult task, but to change your body language whilst doing it as well. You have to bodily enact the difference you want to feel, signalling to your brain that you can’t possibly feel fear because your body feels so relaxed and calm. In doing this, I’m reminded that, in controlling my body, I can control my mind, enabling me to do things differently. I’ve found Opposite Action to be a great tool to use on avoidance, but it can be used to shift any emotion that you feel is unjustified or unhelpful in meeting your goals.

Options to Solve Any Problem

Admittedly, this is not exactly a skill, but it is a very useful concept that I find myself coming back to time and again. It states that there are 4 options when dealing with a problem in life: 1) solve the problem; 2) feel better about the problem; 3) tolerate the problem; or 4) stay miserable! By thinking about which of the options I want to aim for, I am guided to particular groups of skills which can help me achieve the desired outcome. For example, tolerating the problem would require distress tolerance and mindfulness skills, whereas feeling better about the problem would point me to emotion regulation. This skill reminds me that I have options for how I wish to respond to a difficult scenario and if I choose to stay miserable, I am more aware of the consequences of that decision. Plus, if one of the four options doesn’t work, I have three more options to try next!

Distract with ACCEPTS

It’s imperative that the skills you use help you in the way you need them to, when you need them. Nowhere is this more important than with Distress Tolerance skills, where your level of emotional overwhelm might be so high that using the wrong or an ineffective skill might actually make things worse. In my experience, everyone has a favourite Distress Tolerance skill: it might be TIPP, STOP, IMPROVE or self soothe. For me, it’s Distract with ACCEPTS. What I particularly like is that there are 7 different options for bringing down the emotion’s intensity in this one skill: doing Activities; Contributing; making helpful Comparisons; cultivating different Emotions; Pushing away the problem; thinking different Thoughts; and experiencing different Sensations. It allows me to pick and choose what I think will be most helpful in that particular moment, but it also gives me lots of options to try, if the first thing I picked doesn’t help as much as I’d hoped. I would often eat a spicy candy when at work where I might not be able to use another, more visible skill, whereas at home, I might engage in a strenuous activity like cleaning to calm me down (which also incorporates the Intense Exercise of TIPP). Pushing away and thinking different Thoughts are also exceptionally useful with nightmares. Ultimately, the goal of this skill is to just bring the distress down to a manageable level, at which point you can use some other skills to get on with your day. And most of the time, I find that Distract with ACCEPTS is really useful in doing just that.

As I’ve got further into my recovery journey, the skills I use most frequently have changed, from mainly Distress Tolerance to now some more Emotion Regulation. I imagine in 5 years’ time that my favourite / most used skills will have changed once again! The great thing about DBT is that there is a skill for pretty much every scenario and for wherever you are in your recovery.