Dialectical Behavior Therapy : Interpersonal Effectiveness Overview

In DBT, the second skill module presented is interpersonal effectiveness. These skills help to enhance our ability to communicate effectively. In order to understand the importance of these skills, situations to evaluate for interpersonal effectiveness are presented; attending to relationships, balancing priorities and demands in life, balancing the wants-to-shoulds ratio in life and relationships, and building mastery and self-respect. Attending to relationships ensures that we keep in contact and deal with mild relationship stressors to keep our support system in tact. In balancing priorities and demands, we want to make sure that we are not living without intention and doing what we think others expect of us. By balancing wants and shoulds, we have to make sure that we balance things that are pleasurable with things that are responsible. Finally, by building mastery and self-respect, we keep ourselves in an emotional place to be skillful and assertive. Building mastery is doing things that make us feel competent and confident. Two major aspects of interpersonal effectiveness are asking for things and learning to say no and resist pressure.

There are three goals of interpersonal effectiveness; objective effectiveness, relationship effectiveness, and self-respect effectiveness. The idea is that different situations present different challenges. In certain situations, we need to get a tangible outcome. For example, in objective effectiveness we may need to ask for a raise and that goal may be non-negotiable. On the other hand, the goal in a different situation may be to preserve the relationship. For example, if our best friend borrowed a CD, most likely the relationship is more important to preserve than getting a material item back. Although, there can be two goals present at the same time if the CD being returned and the relationship are important. These examples are presented to get us to slow down and identify what is the goal in the current situation, and what type of interpersonal effectiveness skill(s) we want to employ. Often all three goals are important, but we must prioritize.

Factors that reduce interpersonal effectiveness are also presented. Skill deficits, worry thoughts, emotional reactions, indecision, environment, and interplay of factors can all lead to decreased interpersonal effectiveness.

An acronym for objective effectiveness is DEAR MAN to help remember key elements of the skill. D- is for describe the situation that we are reacting to in factual statements avoiding judgment. It is good to give examples. E is for express feelings and opinions about the situation clearly. We cannot expect people to read our minds. A is for asserting our wishes by asking directly and specifically for what we want and do not want. Do not include should statements. R is for reinforcing when people comply with our requests or boundaries. M is for mindfulness to our objectives in the situation by using broken record technique (repeat over and over the same request and stay on message) and ignoring distracting events from the other person (diversions, verbal attacks, etc). A is for appearing confident by tone of voice and physical manner with eye contact. N is for negotiating by understanding what is permissible to accept and not. Be prepared to give and get in the situation.

The acronym for relationship effectiveness is GIVE. G- is for be gentle in your approach to the other person by not threatening (manipulating) or attacking verbally. I- is for acting interested in the other person by listening to their point of view, opinion, and reasoning. Being patient and not interrupting are also part of the skill. V- is for validating or acknowledging the other person and their situation, stance, and feelings. Last E- is for using an easy manner by being humorous, laid back, resist urges to manipulate or bully and decrease intensity.

For self-respect effectiveness the acronym is FAST. F- is for being fair to yourself and the other person. A- is for no apologies when they are not definitely appropriate as we often say sorry needlessly and weaken our argument and effectiveness. S- is for stick to your values and integrity without being swayed to another person’s ideas just because opinions differ. T- is for being truthful by not exaggerating, being dishonest or acting helpless.

Overall DEAR MAN GIVE FAST is a way to utilize the interpersonal effectiveness skills and remember them. These skills help to master situations more skillfully and thus enhance our ability to get our needs met and create a life where we feel effective. Communication is difficult for many, so having concrete factors to consider when approaching a situation can help decrease emotional intensity and enhance mastery.

Reference:

Linehan, M. (1993). Skills Training Manual for Treating Borderline Personality Disorder. Guilford: New York.

- By Tara Arnold, Ph.D., LCSW