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Dialectical Behavior Therapy (DBT) Coach App: Relief comes at your fingertips

Dialectical Behavior Therapy (DBT) Coach App: Relief comes at your fingertips

In early 2020, at age 38, I was diagnosed with Borderline Personality Disorder.

Credit: Stormseeker, Unsplash

The diagnosis came as a relief because I suffered from symptoms that were often confused with depression and anxiety for years, such as suicidal ideation, mood instability, ruminant thoughts, and exaggerated fear of abandonment. However, even with the drug treatment (started in 2010), the pain I felt didn’t seem to stop. The emptiness I felt (and still feel at times), seemed to never end. It was like watching a movie in slow motion, and wondering what you’re doing inside it.

No medicine or therapy was able to alleviate my pain and fear. Until, on my psychiatrist’s recommendation, I started treatment with “Dialectical Behavior Therapy” and suddenly everything started to make more sense. After all, it is an approach aimed at patients with high emotional dysregulation. The only problem is that I developed such a strong bond of dependency with my psychologist. It became increasingly difficult for me to get assistance just once a week in our sessions. That’s when she referred me to the DBT Coach app so that I could learn and practice the skills several times a day, without having to turn to her at every moment of crisis. I am willing to share my experience with the DBT coach app and say how much the tool contributes to my autonomy in problem-solving.

The DBT trainer app is a kind of digital diary, and in it, the patient can record mood, skills, and activities that are carried out during the day. To give you an idea, the daily card check-in starts with the small (but complex) question, “how are you today?” The screen has a small circle with an emoticon in the center, which changes color according to your daily mood. And that’s where it gets interesting: recording humor is not an easy task. There’s a big difference between someone telling you’re not okay just judging by your appearance. On the other hand, when you recognize that you are not ok, it goes beyond appearances: it requires self-knowledge and an understanding of your own emotions. In this sense, the app has already gained my trust because recording mood requires a daily exercise of self-knowledge.

DBT Coach is a tool that invites people to take a daily dive into the ocean of emotions that guide behaviors, attitudes, and skills. And speaking of skills, these are divided in the app (as in DBT) into 4 modules: mindfulness, interpersonal effectiveness, emotion regulation, and tolerance to discomfort. The application suggests that we do a self-assessment of whether each of these skills was helpful when implemented in everyday life. The good thing about having the application at hand is the accessibility to review the lessons applied in DBT. The more I accessed and reviewed skills training videos, the more confident I was in applying them to my daily life.

There is an exercise, for example, called “daily reflection”. For me, it’s one of the richest exercises in the app, as it makes me remember and reflect on situations in which I felt peaceful and open. Putting good experiences into words develops feelings of joy and gratitude, especially in times of so many comparisons on social media. We get so fixated on other people’s lives, whether it be on Facebook or Instagram, that we even forget to appreciate what’s good in our own.

Photo by Zachary DeBottis

It is also worth noting the importance of mindfulness activities in DBT skills training. I learned in my sessions that mindfulness is living intentionally in the present moment, without judgment, doing one thing at a time, with openness and curiosity. In a world so full of stimuli, we have acquired the habit (without realizing it) of eating without tasting, hearing without listening, looking without observing, and living without feeling.

Mindfulness skills exist to remind us that it is not enough to live, it is necessary to experience. It’s like learning to ride a bike! You have to pay attention to your balance, feel the pedals little by little, and adjust your body as you move the handlebars. This is just an example of a mindfulness activity-one skill at a time. DBT coach app also guides the practice in other everyday situations, such as washing the dishes, tasting a piece of chocolate, and listening to the sounds of nature while walking. It’s about observing, describing, and participating, putting words to each experience.

In DBT, we usually talk about the 3 states of mind, termed by Dr. Marsha Linehan, creator of Dialectical Behavior Therapy. According to Linehan, a wise mind is the combination of our emotional and rational minds. Having a wise mind means using the logical part (of the rational mind) and sensitivity (of the emotional mind) in a crisis or problem situation.

In the wise mind exercises, you learn to observe your thinking (instead of acting impulsively); describe the situation that upset you emotionally; learn to use skillful means to solve a problem, rather than doing what you think is right. Practice leads to excellence. From practicing this skill so much, today I can notice the change in my thoughts and emoticons, mainly in the ability to interact with other people.

By the way, here’s another valuable skill worked on in the DBT coach app: interpersonal effectiveness skills.

Interpersonal effectiveness skills are intended to help a person develop self-control, balance, and self-respect. The exercises encourage the patient to discover more effective ways to achieve goals with other people, without being rude or aggressive. A technique widely used for this in DBT is DEAR MAN. It is an acronym for Describe (D), Express (E), Assert (A), Reinforce (R), Mindful (M), Assertive (A), and Negotiate (N).

By scripting (DEARMAN) activity, I was able to understand the difference between describing facts and expressing opinions about a situation. When we express an opinion, it is charged with emotion and feelings. On the other hand, when describing a problem, we limit ourselves to observable facts, without making value judgments. In the activity, it is possible to reflect on how the way we communicate can reduce discussions, and increase mutual understanding. I particularly could see the difference that this skill makes in my relationships, especially with my family. We cannot expect someone to guess what we want or expect from a situation, it is necessary to say it clearly.

In view of all this experience with the app, what I can say is that the exercises significantly contributed to the reduction of my anguish, as well as to the development of my autonomy. With each task completed, I felt more and more confident and less insecure about my feelings, thoughts, and attitudes.

It is important to remember that none of this happened overnight. DBT trainer activities were shared with my psychologist and discussed in our weekly sessions. There are always skills to improve, so making use of the wise mind, balancing reason and emotion, is the key to a more harmonious and peaceful life. That’s why mindfulness skills help a lot, as it’s about getting in touch with what you think and feel, without judgment.

In no way does the DBT coach app replaces psychotherapy, but it does act as a great ally in the therapeutic process. Therapists and patients can review the app’s lessons and work more efficiently on improving skills for a better quality of life. A life worth living.


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