An individual diagnosed with Borderline Personality Disorder experiences severe mood swings, irritability, problems controlling anger, fear of abandonment along with many other emotional difficulties. Unfortunately, this mental health issue cannot be resolved by medication alone. It takes hard work on the part of the patient that requires a commitment to learning and practicing the skills taught in Dialectical Behavior Therapy (DBT). This particular therapy teaches a person that two different ideas can both be true at the same time and that there is always more than one way to look at a situation.
As a DBT therapist and a chair of New York Psychotherapy Network, I often have to answer questions about this therapeutic modality. In essence, DBT is about four categories of skills to help individuals learn to control their emotions and manage interpersonal relationships effectively. The first set of skills are centered around Core Mindfulness, which is learning to live in the moment, letting go of distractions, and controlling your mind. The second set of skills focus on Interpersonal Effectiveness. These skills help a person learn to communicate more effectively with other people which will lead to more stable and positive relationships. The third set of skills teaches Emotional Regulation. Because emotional dysregulation is one of the most troublesome aspects of having Borderline Personality Disorder, this skill set is essential to learning to keep emotions in balance and change undesirable emotions and actions. Lastly, Distress Tolerance Skills are taught to help keep a person safe during a crisis and lead them away from engaging in risky or harmful behaviors.
While working with a therapist is certainly a preferred option, there are Dialectical Behavior Therapy applications available on smartphones and tablets, and these applications can help BPD patients as they are working on skills to mitigate their problems. One of the main components of DBT is keeping track of moods, emotions, and skills on a daily basis. DBT Coach developed by Swasth is one of the more popular applications available for people learning and practicing DBT. This app includes an easy to understand interface that displays all features included in the application in tab format. The app works especially well for training mindfulness skills. In a critical situation, the user can open the app and tap on the ‘Crisis’ tab, and be taken right to a personalized page outlining the steps to cope with a potentially serious situation. This application is not only helpful while participating in regular DBT sessions with a therapist, but it is also helpful for those individuals who have completed DBT and are continuing to practice the skills during their everyday life.
The DBT Diary Card and Skills Coach application, developed by Durham DBT, contains not only a DBT Reference tool but also allows the user to keep detailed records of moods and skills used to regulate emotions. A standard tool used during DBT therapy sessions is the Diary Card. With this app, the Diary Card is completely entered into the application eliminating the need for the traditional DBT binder filled with paper diary cards. All the skills taught in DBT are listed in the app along with pre-filled behaviors and emotions making it easy to identify and use the tools displayed at your fingertips. Another particularly useful feature of the DBT Diary Card and Skills Coach app is the ability to graph moods, emotions, and feelings and see them displayed over time. This gives a patient and their therapist the ability to track trends or event triggers as therapy progresses. An email feature is included so the Diary Card can be sent directly to a therapist on a manual or automatic basis.
A third application available for Borderline patients is Simple DBT Skills Diary Card. The key feature of this application is designed to assist the user with potentially unhealthy urges that are often associated with emotional dysregulation. Examples are over-eating, self-harm, using illegal drugs, over-medicating, or drinking alcohol. This app can be customized to include urges that may not be specific to all patients. The user can specify what type of urge they are having, how intensely they are experiencing the urge, what emotion they are feeling, and what skills they used to cope with the urge. This app also contains the capability to email PDF diary reports using specified date ranges to a therapist.
Dialectical Behavior Therapy can be learned and practiced by anyone who wants to have better control of their emotional reactions. DBT is most effective if conducted in person with a licensed therapist, but self-help books are available online or at your local bookstore. There are even classes developed by DBT therapists available online. With the addition of smartphone and tablet applications, it is easier than ever to learn, practice, and gain control of unwanted emotional mood swings and learn healthy, positive skills for coping in an often complicated and unpredictable world.