Reducing Suicidal Thoughts with DBT Skills

Men's Group Therapy Session

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DBT Skills Can Detour Emotional Distress and Thoughts of Suicide

A young man named Will Lippincott who works in publishing in New York almost gave up and took his own life. He had tried every treatment he could find for depression for 30 years without lasting success. To him, his death seemed inevitable.

Lippincott wrote in an article in The New York Times: “I fit the demographic profile of the American suicide – white, male and entering middle age with a history of depression. Suicide runs in families, research tells us, and it ran in mine. My father killed himself at age 49. A generation before, an aunt of his took her life, and before her, there were others.”

The one thing Lippincott didn’t want to do was inflict more suffering on his family. So he gave life one more try. He went to an in-patient program at the Menninger Clinic in House and was enrolled in a Dialectical Behavior Therapy skills group.

He knew he had behaviors he wanted to change – depression, anger, impulsively spending money and isolating himself. Those behaviors left him with debt, regret and broken relationships.

In the DBT group, Lippincott began to see a light at the end of a dark tunnel of mental health problems that had tormented him for decades.

His life began to change.

“DBT provided me with a rubric for figuring out what was causing my anxiety, anger or sadness, and new options for how to behave in light of it,” said Lippincott. “Once a week, for the last two-and-a-half years, I’ve attended a DBT group and learned a set of skills that have been nothing short of transformative.”

What is DBT?

Dialectical Behavior Therapy was created by Marsha Linehan in the 1980s, originally as a therapy for those at-risk of suicide. It has proven very effective for treatment of suicidal behaviors. DBT has also become an extremely successful treatment for borderline personality disorder.

DBT is a compassionate type of behavioral therapy intended to help people move toward having a life that feels meaningful and worth living. Distress, emotional pain, interpersonal difficulties and behavioral problems such as over-eating, not eating, using substances, self-injuring, losing control and withdrawing can make it difficult to function normally and lead a life that feels meaningful and worthwhile.

DBT targets the issues that cause distress and teaches skills to deal with them without having to resort to self-defeating behaviors. Understanding and practicing four basic sets of skills is the foundation of DBT. Those four skills are mindfulness, distress tolerance, interpersonal effectiveness and emotion regulation.

Lippincott gives examples of how he used strategies from the DBT module of distress tolerance to make slow and consistent changes that moved him past considering suicide and improved his ability to function in daily life.

“I followed the strategy of distracting myself with highly specific tasks just long enough, usually for two or three minutes, to lower the intensity of the fear before it overwhelmed me,” he said. “Because I can’t rely on my memory when anxiety swells, I’d carry lists on an index card or on my phone.”

One strategy was to pull out a piece of paper and write down all 50 states and their capitals. Another was to snap the rubber band on his wrist. At work, strategies included making subtle changes in posture like bunching his toes, or half-smiling to activate facial muscles, or slowing his breathing.

Who Can be Helped with DBT?

Adults with suicidal behaviors, Borderline Personality Disorder and substance abuse issues have been shown to benefit from DBT. There are also increasingly positive results from using DBT with adolescents.

People with Borderline Personality Disorder experience intense emotions that can lead to actions such as self-injury, anger outbursts or abrupt ending of important relationships.

Lippincott describes how he went from nearly taking his own life to how the Skills of DBT help him deal with stressful situations in everyday life.

“Mindfulness challenges me to accept emotions and situations as they are, not as I want them to be,” said Lippincott. “I’ve learned how to ‘observe and describe,’ to state the nature of a problem with facts, not judgments, so I can determine how best to solve it.

“Prepping in advance for tough conversations and avoiding over-apologizing are key skills,” he said. “The interpersonal effectiveness training helps me ask for what I need in relationships and to manage conflict positively, and to do both while preserving my self-respect.”

Coping and Hope that Comes with DBT

“Now I am able and willing to fully participate in life, ready to experience its joy and pain equally, as I reach for my long-term goals,” said Lippincott.

His message to others struggling with often overwhelming mental health issues is:

“Depression is treatable and suicide is preventable. I, too, once firmly believed that I was broken beyond repair, but I was wrong. Don’t lose hope. You are not alone.”

Read more about the DBT Skills Group at Boston Evening Therapy led by Adam Carmel, PhD.

References

Lippincott, Will, “No Longer Wanting to Die,” New York Times, May 15, 2016

The Center for Dialectical and Cognitive Behavioral Therapies, “Dialectical Behavior Therapy in a Nutshell,” 2003.

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