Stacy Pershall

Stacy Pershall M.F.A.

Being Patient

The Modules of Dialectical Behavior Therapy: Interpersonal Effectiveness

In which a Strange Girl uses DBT in everyday life

Posted Jun 11, 2012

I promised when I started this blog to write about the four modules of DBT, and I had intended to do them in order, but I’ve been procrastinating on a post on the first module, Mindfulness, for several months.  It’s the hardest one for me, the one on which I least feel like an authority, but it’s first, and I’m one of those people who needs an outline. 

But in a conversation with my fellow DBT dork Amanda Smith of My Dialectical Life, I realized that the module I needed most was Interpersonal Effectiveness  -- which is, technically, the last. As I say in my book, the reason I couldn’t deal with the world was that I couldn’t deal with individual people.  I was a slime mold of abandonment issues when I walked into DBT (seriously, Google slime molds; they’re cool and I promise the metaphor works.)

Marsha Linehan is a big fan of acronyms, like DBT.  She gives you mnemonic devices for remembering the skills, which makes it easier to remember them when you’re in crisis.  The acronym for the Interpersonal Effectiveness skills is DEAR MAN.

A summary of the DEAR skills in the navigation of a disagreement: “Describe the problem to the other person without judgment, stating only the facts as you see them. Tell the person how those facts make you feel, and ask for what you need without throwing a fit.  Explain how giving you what you’re asking for benefits them.” 

The MAN skills are: “Stay mindful while you discuss the situation.  Don’t apologize for your stance or your needs through your words, actions, or body language. Listen to the other person’s needs too, and negotiate without getting off the subject.”

So essentially, it’s very simple and very complicated at once, which is exactly the kind of dialectic Lady Marsha’s always on about.  It’s the duality in all situations of which you must be mindful if you’re ever going to stop with the black-and-white thinking.  It will always be hard, but will eventually become automatic.  Here’s an example.

Six months ago, I left New York City after 12 years and moved in with one of my oldest and dearest friends in Northern Virginia, just outside Washington, DC.  He offered to let me live in his house and write my next book and pay whatever rent I could afford, which obviously makes him a fabulous person.  (We’ll call him Francis, because he needs an alias and I’m listening to The Pixies.)

Francis and I had a disagreement this morning centered around the following: while his house is big and suburban and has a washer and dryer and backyard and central air and makes me feel like a princess, it is a decidedly grungy royalty.  My sweet prince Francis, one of my favorite men on the planet, has given me the closest thing he can offer to a castle, and it’s a grubby duplex through which many, many other men and/or traveling musicians have passed.  There’s a layer of Burning Man dust here at least three roommates thick.

I don't think of myself as being particularly neat, but apparently six months is the breaking point at which I get all gender-conformative and switch into A GIRL LIVES HERE NOW AND I NEED TO SCRUB EVERYTHING WITH A TOOTHBRUSH mode. So last night I took every single item off the kitchen counters, scrubbed them with a toothbrush, and piled up all the random stuff next to the recycling bins, which are inside next to the front door; I did not, as Francis said, “plan to throw away all his appliances,” though I can see how it might have looked that way. 

What I had actually planned to do was a Hoarders-style intervention, because I’ve seen too many shows about hoarders and interventions.  You know, the kind where the interventionist/professional organizer confronts the person with one of their piles of stuff and says, “Let’s go through this one thing at a time, and you can keep every single bit if you want to.”  The difference being, of course, that the hoarders on those shows have generally asked for help, and the organizers generally mean it about letting them keep things.

When Francis came home, I met him with a gleeful, “Look!  I cleaned the kitchen!”

His response, besides the part about throwing away his appliances, was, "This is my house! This is my stuff! This is the longest I've ever lived anywhere!  Put it all back like it was!”

I told him I only wanted to go through the pile. I held out a couple of items and said, “Where should this broken toaster oven go?  Where should this rancid, filth-encrusted bottle of what I think began life as an artisanal cooking oil go?”  In retrospect, I see that these were leading questions.

Francis let me chuck the broken appliances, but his response to the other items in the pile was, "If it REALLY BOTHERS YOU for that to be on the counter, I'll put it somewhere else," Discouraged that I wasn’t generating the kind of epiphany the lady on Hoarders can generate in forty-two minutes, I said something along the lines of,  “Look, all I'm asking is, could the water-damaged penguin notepad maybe go someplace other than on top of the broken toaster oven?" But I managed to call upon my DEAR MAN skills and successfully negotiate the pile.

Francis and I are, as I write this, spending a few hours apart.  He’s locked in his office working, and I just finished scrubbing the shower grout with one of those oxy-cleansers with a name like Kaboom or Shazam or Whammo. While scrubbing, I contemplated Francis’ Official Issues, the ones I know about because we’ve been friends for 11 years. I get where he was coming from, but I also insist upon the validity and logic of my own stance.  In other words, boundaries. 

I know that people with Asperger's may have trouble reading social cues, like facial expressions, whereas I think people with BPD tend to be the exact opposite. We're hyperaware of those things. But where we (or at least I) tend to have the most trouble is knowing how to express our needs and listen to the needs of others. When you have no boundaries, it’s too dangerous to see human interaction as anything other than black and white. Only one of you can be right, which means the other has to be wrong. If you admit the other person is right, they're COMPLETELY right, which means you have to spend days punishing yourself for being completely worthless. If you think you're right, you get so angry at the other person that you often say something horrible to push them away, which means you have to spend days punishing yourself because someone left you.

But when you accept that in most disagreements, both people are partly right and a partly wrong, it eliminates the need for either of you to be punished. I now have very concrete steps for how to navigate disagreements, and I trust that Marsha Linehan had my best interests in mind when she came up with them. As a result, even though having someone be mad at me is still really uncomfortable, I feel absolved enough of  shame that I no longer need to hurt myself. I don't expect to come out of arguments mortally wounded anymore, which makes them a lot less scary. It's all just an opportunity to develop more compassion for other human beings.

I’m sorry, Francis, and I love you.  You tune your guitar to dangerous tensions to play Dave Wakeling songs for me, and I am eternally grateful to you for that risk to your vision.  Finding compassion for you is easy; I hope you’re upstairs thinking the same of me.

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