Working Through Grief With DBT Therapy

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Are you finding it hard to deal with grief? If that is the case, then you may be able to cope with it through dialectical behavior therapy (DBT).

If you were unaware, DBT therapy is part of cognitive behavioral therapy (CBT).

CBT's main principle is that thoughts, feelings, and behaviors are linked. Both CBT and DBT therapy focus on change; if we change our thinking, we can change our feelings.

This article serves as an overview of what grief is, the four DBT therapy modules, and how they can help you grieve. 

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Felicia Gray, MS, LPC

Felicia Gray, MS, LPC

Pueblo, Colorado
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Jenifer Seas, LCSW

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Colorado Springs, Colorado
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Dominique Schweinhardt, MA, LPCC, LPP

Dominique Schweinhardt, MA, LPCC, LPP

Colorado Springs, Colorado
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Emily Murphy, LPC

Emily Murphy, LPC

Colorado
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Jennifer Wilson, LPCC, NCC

Jennifer Wilson, LPCC, NCC

Colorado
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Deja Howard, MSW, SWC

Deja Howard, MSW, SWC

Colorado
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Sarah Lawler, LPCC

Sarah Lawler, LPCC

Colorado Springs, Colorado
(719) 203-7021
Barbra Styles, LPC, LAC

Barbra Styles, LPC, LAC

Colorado Springs, Colorado
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Vanessa Dewitt, LCSW

Vanessa Dewitt, LCSW

Pueblo, Colorado
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Samantha Zavala, LPCC

Samantha Zavala, LPCC

Aurora, Colorado
(719) 345-2424

DBT Skills for Grief We Will Discuss

Dialectical Behavior Therapy (DBT) is a therapeutic approach often used to navigate through the emotional pain and complicated grief associated with loss. 

We practice with approach with grief counseling in Colorado Springs, and anywhere else in Colorado where we are needed, both online and in-person. 

It utilizes several key skills, each designed to help individuals manage difficult emotions and reduce suffering.

  • One popular DBT skill is Accept through Mindfulness. This involves using mindfulness skills to remain present in the moment, observing and accepting things as they are without judgment. Mindfulness helps us to stay connected to the present moment, which can be particularly helpful when dealing with grief and loss.
  • Change through Interpersonal Effectiveness is another core DBT skill. It focuses on nurturing relationships and maintaining self-respect. Interpersonal effectiveness skills can be especially beneficial for family members coping with a loss, as it fosters communication and mutual understanding.
  • Emotion Regulation, a change skill in DBT, involves learning to identify and manage emotion dysregulation. This skill can be very useful for those dealing with the intense emotional flux that can accompany grief, especially in cases of complicated grief such as when a daughter died.
  • Accept through Distress Tolerance. This involves practicing radical acceptance of difficult situations and emotions, instead of trying to change or avoid them. This whole set of DBT skills is often used in treating conditions like Borderline Personality Disorder but is also highly effective in managing most people's grief responses.

These are just a few of the ways DBT can be applied to work through grief counseling. Each skill offers a unique approach to managing the emotional challenges that come with loss, providing a comprehensive toolkit for those navigating this difficult journey. 

What is grief?

When one experiences loss, grief is the emotional response. People go through denial, anger, bargaining, depression, and acceptance, although perhaps not in that order.

Our body, brain, and mind need to go through this homeostatic process to recover from the trauma a loss caused. People have done this throughout evolution.

People grieve because connection and attachment are embedded in them.

Relationships imprint upon us whether or not we like it, and whether or not we are conscious of it.

Accept Through Mindfulness

Grief and mindfulness may seem like two different things. That does not have to be, though.

Someone who is grieving lives in the past, perhaps about feeling guilty about the death of a loved one.

They may live in the future as well, wondering when they will move forward. DBT therapy, and mindfulness specifically, tells us that focusing on the present is important.

We need to accept each moment without judgment. We realize this may sound difficult, and it requires self-compassion.

Imagine how you would treat a friend who comes to you about how she is having trouble grieving.

How would you treat this friend? Now you need to treat yourself the same way.

There is no need to compare yourself to others. You only need to show yourself support.

Grief is complicated, and no two people experience it the same way.

Change Through Interpersonal Effectiveness

This will help you to solve basic grief needs through your interactions with other people.

For this, you can use the DEAR MAN acronym. D means to Describe the situation.

For example, imagine someone told you that they thought you would be over someone's death by now. You can use Describe to tell them "You expressed you thought I need to get over my grief."

E means to Express feelings. "This makes me feel like I have failed and that you don't respect what this loss has meant to me," is what you could say.

With A, you Assert wishes. Something appropriate to say at this stage would be, "If you could refrain from making comments like that, I'd appreciate it."

R means to Reinforce: "I need you to think about how your words will affect me before you use them."

When dealing with people, you want to be Mindful, to be goal-oriented as well as present.

The "A" in "MAN" means to Appear confident. Here it is important to make eye contact instead of looking elsewhere. Do not slouch, whether you are sitting or standing.

N means Negotiate. Be willing to compromise with the other person to both be closer to getting your way.

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More Change Through Emotion Regulation

Emotion regulation skills are a means controlling our emotions.

Although we can never fully control our feelings, this unit gets people to do what they can.

Linehan created this unit to get us to understand our emotions and decrease the frequency of unfavorable ones.

What emotion regulation asks people to do is check the facts. You may feel guilty for not somehow making your brother stay at the hospital after his admission, and then he died.

You need to realize you tried to reason with him, and in the end, it was his choice to leave.

You did what you could.

Another coping tool that emotion regulation teaches is opposite action. This means you act the opposite of what you feel and what your emotions say to do.

Although grief can be helpful for some time, once it gets in the way of one's daily life it will be problematic.

For example, if your best friend keeps inviting you to dinner but you keep turning him down, and you feel lonely, it might be time to accept your friend's invitation. 

Accept Once Again Through Distress Tolerance

When you are grieving, you can not change whatever brought you to your grief.

The pain cannot be erased, and neither can the loss. Distress tolerance teaches radical acceptance to take in situations for what they are.

Even if you are in pain, life is still worth living. Acceptance might feel like it is hard to undertake right now, and that is okay.

One way you can calm yourself down when it feels like your grief might be unbearable is to self-soothe.

Through this, you can calm yourself down. You can use your senses to emotionally and mentally ground yourself.

Remember that you have five senses: sight, hearing, touch, taste, and smell. You might find that raisins are helpful because you can look at their color and ridges, hear what they are like when swallowed, feel their bumpy surfaces, and taste and smell them.

DBT therapy takes time, and it is hard work. We encourage you to keep DBT therapy skills in mind and reach out to a mental health professional about how to implement them.

Conclusion

As we indicated above, you can use the distress tolerance and mindfulness modules for acceptance. 

For change, interpersonal effectiveness and emotion regulation come in handy. 

DBT therapy and CBT are similar. There is one main difference, though: DBT therapy puts emphasis on acceptance. 

If your daily life has become problematic because of grief, we encourage you to see about starting a DBT treatment program.

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April 19th, 2024

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