Have You Finished Your Homework Yet?
The DBT Homework Assignment Workbook: 50 Worksheets Based on Dialectical Behaviour Therapy
By Elyse Pipitone and Angela M Doel
What’s the aim of the book?
DBT is a practice as much as a theory, and so the idea here is that clients will use these worksheets between sessions to work on their DBT skills. A DBT therapist can also look at the completed worksheets to track the client’s progress.
Checking out the book
As mentioned elsewhere, I’m not currently in DBT therapy, though I am having therapy (should this be ‘trying to make use of therapy’?) elsewhere. But I feel I understand enough of the basics of DBT to test out this book.
The worksheets are divided into the 4 core skills of DBT -
Mindfulness techniques.
Distress tolerance.
Emotion regulation skills.
Interpersonal effectiveness skills.
I took a quick look at the Contents page, and was drawn to “Are you difficult to get along with?” (answer, yes, sometimes, but I used to be much worse).
This worksheet is in the Interpersonal Skills section, and has statements such as
‘Most people are untrustworthy’.
Now, on a bad day, I might judge almost everyone to be a faithless swine, but do I really believe this? No.
What about this statement -
‘I am much more interesting and important than other people.’
Well, given I live alone, I need to be interesting to myself, but it’s really me in relation to another, or the world, that takes my attention. So, it’s a no here too, but it’s definitely a yes to -
‘I feel threatened when my partner/friend/family member spends time with others and gives them attention.’
This sort of feeling has bothered me a lot in the past. When the foundations of whatever relationship I was worried about losing were already shaky, bother would turn into a kind of depressive agony. I’m still very vulnerable to what is called preoccupied attachment, and it can be disabling. It’s a main, and unresolved theme of my current therapy. In normal life ( I hesitate to say real life because I reject the idea that therapy doesn’t have its wholly real elements), I’ve found the only solution for me is to be very careful who I spend time with (i.e. avoid game players, and the ambivalently attached.)
Whilst I’m on the subject of attachment, a book which I’ve found very helpful ( I just wish I’d read it earlier) is -
Attached: Are you Anxious, Avoidant or Secure? How the science of adult attachment can help you find - and keep – love.
by Amir Levine and Rachel Heller
I’ve recommended this book to lots of people I know, and they’ve all found it very useful. It can really help to work out what we’re doing in relationships, and what others might be doing too.
Back to the worksheet. The next step is to consider how behaviours I recognise might affect my relationships, and whether I can start to take steps to change these behaviours. The sheet then moves on to introduce a schema that can be used to improve relationships. It's called the GIVE model, and I have to say that I didn't experience much GIVE growing up, or at school, or in the workplace. And I lacked these skills myself.
The GIVE model is -
G - Be Gentle in your interactions with others.
I - Show Interest in others.
V - Validation. Try to indicate understanding of the other (without judging).
E - Use an Easy manner with others.
Over the last couple of years, I have been actively trying to use more GIVE in my interactions with others. I don’t think it’s brought me any closer to people (sometimes I feel overly reasonable using GIVE), but it hasn’t alienated anyone either. Which means that no one has asked me to leave my new home - Hastings - yet. I’m pretty sure that by retiring my characteristic abrasiveness, I've also stopped loads of bad interactions from even starting.
I also liked ‘Creating a Better Day’ in the Distress Tolerance section. Here the focus is to identify activities which are meaningful and enjoyable, and to schedule at least one of these into your day, every day. These might be activities that encourage thinking, or are funny, or comforting, or whatever. Having identified the activities, the task then is to plug them into your days, record doing them, and note down your distress levels before and after completing the activities.
The focus here is on building structure into a day, reducing difficult feelings by doing pleasurable activities, and also creating a reward cycle so that we become aware of the link between positive activities and improved mood.
I have certainly used this tool to manage my mood. If I'm honest, very little of what I do each day (gym, writing, colouring, reading) gives me profound happiness. I’ve only really experienced that feeling in a safe relationship, and I certainly don’t feel safe these days. But my routine activities and projects do leave me feeling purposeful, organised, creative and fitter, and that’s enough for me right now. It’s also way more than I used to have.
It’s worth noting that some books on depression (I recommend Margaret Wehernberg’s The 10 Best-Ever Depression Management Techniques) also stress the importance of activity and structure. The emphasis here is less on creating a better day (though that may be the outcome), and more on doing something (healthy) rather than nothing, to get the depressed body moving.
Overall, these DBT worksheets are a useful resource. They’re not recommended for someone in crisis – they would probably overwhelm rather than help - but for other times, when you want to get a grip of a situation or a feeling, this set is worth checking out. I also found them free to download, though that might change, I guess.