Our last blog in the “Building a Life Worth Living” series focused on Core Mindfulness skills. In this blog we will continue to explore DBT skills by taking a closer look at Interpersonal Effectiveness skills.
Eating disorders frequently involve strong emotions, such as guilt, shame, anger, and fear, and these emotions often play a role in the isolation and secrecy that regularly accompany eating disorders. The particularly cruel paradox is that recovery from an eating disorder almost always requires the interpersonal support of others, yet eating disorders often strain or distance interpersonal relationships.
The Interpersonal Effectiveness skills of DBT help to address the interpersonal challenges that often accompany eating disorders.
The Interpersonal Effectiveness DBT module addresses a number of topics, including factors that interfere with interpersonal effectiveness, myths about interpersonal effectiveness, goals in interpersonal situations, factors to consider when approaching interpersonal interactions, and building and ending relationships. However, today’s blog will focus on three specific skills focused on asking for help or saying no, maintaining and improving relationships, and preserving self-respect.
DEAR MAN is an acronym that represents the different components of making an effective request of another person, or tactfully saying no when a request is made of you. The elements of the DEAR MAN skill are as follows:
· Describe – describe the situation at hand, focusing on the facts
· Express – express your feelings and/or opinions using “I” statements
· Assert – ask for what you need or say no directly
· Reinforce – explain the benefits of the person granting your request or accepting you saying no (e.g. how granting your request will help the other person, express appreciation of the other person)
· (Stay) Mindful – do not get distracted or sidetracked while making your request or saying no
· Appear Confident – be aware of and modify your eye contact, posture, and voice tone, as needed, to convey confidence
· Negotiate – be willing to give to get
Let’s translate this acronym into a concrete example: Imagine that you found out that your family planned a large reunion over Labor Day, however you are scheduled to work. DEAR MAN could be used to guide how you want to structure asking a coworker to help with coverage. For example, “Sarah, I just found out that my family will be holding our first reunion in five years over Labor Day, and I am scheduled to work at that time (Describe). I am so excited and happy about the possibility of seeing family members that I haven’t seen in years (Express), and I was wondering if you would be willing to cover my shift that day? (Assert) I hear that they are offering time and a half on that day, and I know that working on holidays isn’t always preferred, so I would be happy to take your shift on another holiday coming up (Reinforce).” In the event that Sarah wasn’t initially willing to take your holiday shift, you could try to use the “Negotiate” by adding other benefits to your proposal (e.g. covering two holidays), or by asking her what might make her willing to honor your request.
GIVE is an acronym that represents things to consider when interacting with another person with whom maintaining or improving a relationship is paramount. The components of GIVE can be seen below:
· (Be) Gentle – be respectful, don’t threaten or attack, and communicate in a friendly and calm manner
· (Act) Interested – pay attention to the other person, including using attentive body language, and refrain from interrupting
· Validate – show that you understand the other person’s situation, feelings, and/or opinions
· (Use an) Easy Manner – use calm and nonthreatening language and posture, and incorporate humor, if appropriate
Returning to the example above, you may notice elements of the dialogue that are consistent with the GIVE skill, such as gentle language (e.g. “I was wondering if you would be willing…” instead of “I want you to…”) and the use of validation (e.g. “I know that working on holidays isn’t always preferred…”).
Finally, FAST is an acronym that represents approaches to consider when interacting with another person and you want to leave the interaction having maintained your self-respect. The components of FAST are as follows:
· (Be) Fair – be fair to yourself and to the other person
· No Apologies – apologize when appropriate, and don’t apologize for being true to your values, tactfully expressing an opinion, and so forth
· Stick to Values – do what is right for you by acting consistently with your values
· (Be) Truthful – do not lie, make excuses, or act helpless
Revisiting the previous example one last time, you may be able to imagine ways in which this conversation could become inconsistent with the FAST skill. For example, if you apologized for asking if your coworker could cover your shift, or lied about your family reunion to increase the likelihood that your coworker would cover a holiday, these actions would not align with the FAST skill.
As with the Core Mindfulness skills, I’d like to close today’s blog with some ideas of activities you can try that utilize skills from the Interpersonal Effectiveness module:
· Think of a request of another person that you have been avoiding making, or think of a request someone has made of you that you have avoided turning down. Write out a script of how you could make this request, or turn the request being made of you down, applying concepts from DEAR MAN.
· Spend some time giving your full attention listening to a family member or friend, with a particular focus on validation. Reflect on what you noticed about your conversation after your conversation is complete.
· Review the FAST skill and pick one part of the skill with which you struggle. Spend one day practicing that specific skill during your interpersonal interactions, when appropriate.
Be on the lookout for Part 5 in our “Building a Life Worth Living” series, which will take a closer look at the DBT Emotion Regulation skills.
Written by Alyssa Kalata, Ph.D.
Associate Clinical Director, Veritas Collaborative