DBT - Should I End This Relationship?

DBT - Ending Relationships - Interpersonal Effectiveness Handout 13¹

Are you in crisis or distress?

These guidelines also work for groups. “Should I stay in this group?”

I’ve added some of my notes as footnotes, since I struggle to understand what Marsha means with some of these words.

Decide to end relationships in WISE MIND, never in emotion mind.

Destructive Relationships

Destroy or completely spoil these personal qualities

• The relationship itself²
• Your enjoyment of your body³
• Felt safety, especially emotional⁴
• Self-Compassion⁵ & Self-Image⁶
• Self-Respect & Integrity⁷
• Happiness⁸
• Peace of Mind⁹
• Your ability to care for the other person¹⁰

Interfering Relationships

Interfere with these parts of your life

• Pursuing goals¹¹
• Enjoyment¹²
• Hobbies¹³
• Relationships with others¹⁴
• Welfare of others you love¹⁵

If a relationship is important and interfering, you can try Problem Solving to repair it.

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1. Decide to end relationships in Wise Mind, never in emotion mind.

2. If the relationship is important and not destructive, and there is reason to hope it can be improved, try Problem Solving to repair a difficult relationship.

3. Cope Ahead to troubleshoot and practice ending the relationship ahead of time.

4. Be direct: Use the DEAR MAN, GIVE, and FAST interpersonal effectiveness skills.

5. Practice opposite action for love when you find you love the wrong person.

6. Practice safety first!
   Before leaving a highly abusive or life-threatening relationship, call a local domestic violence hotline or the toll-free National Domestic Violence Hotline (1-800-799-7233) for help with safety planning and a referral to a qualified professional. See also the International Directory of Domestic Violence Agencies.

More Articles

What is Codependency - Very Well Mind
Needs Inventory - Center for Nonviolent Communication

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1. This article is based on:
   DBT Skills Training Handouts and Worksheets, Second Edition.
   Dr. Marsha Linehan.
   Interpersonal Effectiveness Handout 13 pg. 145 ↩︎

2. Healthy relating is: give and take, both sides practicing forgiveness, validation, change, and acceptance. ↩︎

3. This includes: physical abuse, sexual abuse, having space to yourself, a safe place to sleep, and food to eat. ↩︎

4. This includes emotional abuse such as: negation, projection, gaslighting, invalidation, name calling, and financial abuse. ↩︎

5. There are partners who will love you for who you are, not who they want you to be. Part of this journey is also giving yourself compassion. Someone who takes away your ability to like yourself is destructive. ↩︎

6. This includes your hobbies, choice of career, friends, and lifestyle. ↩︎

7. One of the goals of DBT is to arrive at a “A life worth living.” Not enduring, or putting up with stuff. The goal is to enjoy this. Part of self-esteem and self-integrity is self-respect. Starting to understand who you are (or at least who you want to be), working towards that, and having people in your life who can support you. Anyone reading this has probably endured enough. ↩︎

8. Happiness as a felt experience in the body. The kind you might get walking in nature, being with a friend or family member, or doing something you enjoy. ↩︎

9. You have a right to a relationship without drama, where you can sleep at night, have reasonable expectations what they might do. ↩︎

10. This is related to attachment theory. Hopefully the person you are caring for is open to you trying to care for them – this includes their willingness to get help, treatment, and therapy. ↩︎

11. It’s OK to have your own goals. It’s hard to acknowledge that a goal you want may not be a goal someone else wants for you. If this conflict is strong enough, the relationship should be ended. ↩︎

12. You are allowed to exist and take up space. You don’t need to save everyone. You can have hobbies, and be idle. You can smell the flowers, but you need to give yourself the space to do that. Co-dependency goes here. ↩︎

13. You are allowed to have things you enjoy, even if others aren’t interested. Your hobbies and interests can be as random and niche as you’d like. What would you like doing? ↩︎

14. You are allowed your own friends. ↩︎

15. As found family becomes more common, it’s important to find people who are also OK with your found family and friends. ↩︎

Dissociation Treatment Targets

This is the minimum set of skills necessary to downregulate dissociation. These are found on page 146 of Christine Forner’s book.

Phase One

• Learning how to ground and uses grounding techniques
• Learning emotional safety skills
• Practicing Internal Communication between parts
• Practicing Regulating Fear
  • Insight into when being scared happens (when dissociation is possible)
  • Getting out of the fear response
  • Understand the difference between the past and present in regard to the fear response
• Feel feelings without dissociation
• Emote feelings without dissociation
• Distinguish between procedurally learned experiences and new experiences
• Able to take a mental pause
• Basic empathy
• Basic self attunement

References

Dissociation, Mindfulness, and Creative Meditations: Trauma-Informed Practices to Facilitate Growth - Christine C. Forner
Dissociation FAQ - International Society for the Study of Trauma and Dissociation
Guidelines for Treating Dissociative Identity Disorder in Adults (2011) - International Society for the Study of Trauma and Dissociation
Understanding Integration - Sidran Institute
Dissociative Experiences Scale - II (DES-II) - For printing and laminating
Dissociative Experiences Scale - II (DES-II) - Online version
Integration Measure (IM) - For printing, borrowed from M. Rose Barlow’s Thesis.

v1.3
Last Edit: 24-June-2022
redirect: sitwithariadne.com/dissociation-treatment-targets
redirect: sitwithariadne.com/des-ii
redirect: sitwithariadne.com/im

How I Pronounce My Name

How to Pronounce Ariadne, by Ariadne. (YouTube Link)

An American pronunciation for my name is four syllables, these set of sounds:

Are - Are you going?
Reee -- Look in the reeds.
Odd -- Even and odd numbers.

Knee -- I took an arrow to the knee.

are-ee-Odd-knee.

Emphasis on the third syllable.

The Narcissist's Prayer

The Narcissist prayer works by gaslighting, or overwriting someone else’s reality. Two people believe different things – the Narcissist is very forceful about their version of events and when confronted becomes the victim.

That didn’t happen.
And if it did, it wasn’t that bad.
And if it was, that’s not a big deal.
And if it is, that’s not my fault.
And if it was, I didn’t mean it.
And if I did, you deserved it.

It’s worth committing to memory each line of the prayer to be aware of toxic micro-interactions.

That didn't happen.                   (1 - Negate)  
And if it did, it wasn't that bad.    (2 - Minimize)  
And if it was, that's not a big deal. (3 - Project)  
And if it is, that's not my fault.    (4 - That's How The World is)  
And if it was, I didn't mean it.      (5 - Claim Pure Intentions)  
And if I did, you deserved it.        (6 - DARVO)

Short Definition of Narcissism with Examples

The Nature Example - Two People, Two Childhoods

cw: child neglect, narcissism, NPD.

Quinn enjoys nature. Quinn spent a lot of time outside since early childhood. Quinn has easy access to the feelings nature gives them: peace, safety, comfort, connection. When Quinn was growing up, Quinn’s parents validated Quinn’s feelings often going on hiking and camping trips and repeatedly telling Quinn that Quinn’s feelings were important. Quinn’s parents weren’t really into camping or hiking, themselves, but they made time for Quinn to pursue their interests. Quinn has felt these feelings, clearly, for years and has a lot of practice. When someone says nature is stupid … Quinn’s internal feelings don’t change. Quinn understands, “This person hates nature, but that’s OK, it doesn’t change how I feel about it.”

Morgan hates nature. When asked why Morgan responds by mentioning a famous conservative YouTuber who hates the national parks system and promotes drilling in ANWR. Early in Morgan’s life, going to school they talked to other kids who got to go to parks and decided they wanted to go. When Morgan asked their parents, their parents became angry telling Morgan to go play videogames. Morgan asked one more time, but this time Morgan’s dad screamed at them to leave them alone. Morgan’s brain, trying to optimize for staying in the family and not being exiled now buries the desire under a new emotion, shame. Years have passed. Since shame is a deeply painful experience, when Morgan was exposed to the famous YouTuber they latched on immediately, with a ready made excuse why enjoying nature isn’t important or worth doing.

The core of narcissism is avoiding shame at all costs by trying to do what others value. Morgan is validated by the Famous YouTuber and is now part of a community which helps them avoid shame, by substituting it for anger. Human seek social validation … some us, like Quinn, get it unconditionally and others, like Morgan, get it with conditions attached. The greater the conditions attached, the more distant from ourselves we become, until our internal world looks more like a mask to be put on than a person.

In this example Quinn and Morgan have the same starting conditions, but very different kinds of validation.

(1) That Didn’t Happen - Negate

Quinn: You stepped on my foot.

Morgan: I didn’t.

Morgan learned early in life the easy way out is to invalidate people. Morgan was invalidated early and often, so now … they are doing what they’ve learned to others. Lying to Morgan is a better outcome then feeling shame.

Quinn (to themselves): Maybe I imagined it?

Quinn (to themselves): Maybe they didn’t notice.

(2) And If It Did, It Wasn’t That Bad - Minimize

Quinn: No, you did step on my foot.

Morgan: It looks fine.

Morgan doesn’t understand the problem. The foot looks fine. Morgan doesn’t have a strong sense of Quinn’s internal world, not really having one themselves. Minimizing what happened comes easily, and avoids shame.

Quinn (to themselves): This hurts, but maybe it’s not so bad?

Quinn (to themselves): Morgan is pretty confident I’m OK, I’ll be OK.

(3) And If It was, That’s Not a Big Deal - Project

Quinn: Um … it does hurt, it hurts a lot.

Morgan: It happens, people’s feet get stepped on all the time.

When Morgan was growing up, they heard this line used … a lot. Something would happen and Morgan’s parents would go “That’s how the world is.” No one in Morgan’s family took responsibility for things … now Morgan doesn’t.

Quinn (to themselves): (Still in pain) I guess this is OK.

(4) And if it is, that’s not my fault - That’s How The World is

Quinn: Morgan, this really hurts!

Morgan: It isn’t my fault, I’m clumsy.

At this point Quinn knows how this whole exchange is supposed to go. Morgan is supposed to validate Quinn’s intangible reality, harm has happened. How Morgan sees it is … this is how the world works. Morgan’s parents have told them they are clumsy hundreds of times. Morgan is just clumsy, there isn’t any changing this.

Quinn (to themselves): Why can’t Morgan just say they are sorry?

(5) And if it was, I didn’t mean it - Claim Pure Intentions

Quinn: I get it, you are clumsy. Are you sorry?

Morgan: I didn’t intend to step on you.

Morgan has admitted to being clumsy. Now the shame is going full-tilt, because Morgan has partly admitted to being involved and making a mistake. Morgan would rather not be friends, period, vs feel that level of shame. Morgan says since they didn’t mean to hurt Quinn, the harm doesn’t count.

Quinn (to themselves): … But you still hurt me. Please acknowledge you hurt me. Please acknowledge you care.

(6) And if I did, you deserved it - DARVO

Quinn: What? You stepped on me, say you are sorry.

Morgan: … You were in my way. Why are you making such a big deal out of this? Stop attacking me! Calm down.

This is the end of the script. From here it can repeat, but what it usually turns into is JADE (Justify, Argue, Defend, Explain) as Quinn and Morgan go around endlessly trying to get the other to agree to how to see the event. Quinn wants validation, Morgan doesn’t want to feel shame.

Quinn (to themselves): Maybe I’m not being clear enough … Let me try again.

References

Dr. Ramani - YouTube
Dr. Ramani - Narcissistic relationships and the trap of the “almost win”
Dr. Ramani - What does it mean when a narcissist says “I love you”?
Narcissist Support
Darvo - Southpark

DBT Reality Acceptance Skills

This is a DBT Reality Acceptance flowchart. It uses the skills from Marsha Linehan's book

These skills are meant to be learned in a DBT skills class, or one-on-one with a therapist (DBT is an entire therapy modality); however, if you have access to neither, the materials are below to explain what each of the skills are.

The chart is meant to serve as a printable shorthand to help re-train behavior to ease day-to-day emotional turmoil.

DBT Reality Acceptance - LucidChart (Can be made into a PDF, printed, duplicated and modified CC-BY 4.0)

References

Reality Acceptance Skills - PDF (Starts at page 11)
Radical Acceptance - Tara Brock

redirect: sitwithariadne.com/dbt-reality-acceptance

v1.1 - Last edit 8-July-2024
This work is dedicated to the Public Domain via CC0 1.0