When someone is building DBT skills, there’s a tendency to believe that it is only the individual who is doing the work or making changes.  However, we recognize that family involvement can truly enhance individual DBT outcomes and greatly benefit the family system.  While it can be easy to place blame – the family members are easily criticized for their presumed role in the development of the patient’s maladaptive behaviors; individual’s in DBT are also frequently blamed for the burden their families experience – blame does nothing to promote change. 

So what is the middle path?

Consistent with the DBT model, the more family members increase their interpersonal effectiveness, the more it can facilitate change. I tend to see that some family members feel ‘burned out’, believing they have done all they can do for their child or partner. The dialectic in this is that family interventions are designed to help family members, not only the patient. Similarly, anything one family member can do to help another family member function more effectively will improve interpersonal relationships.

DBT Family Skill: Mindfulness

Mindfulness is the core skill in DBT. There is significant benefit to family members learning basic mindfulness, in particular “relationship mindfulness”.  Relationship mindfulness within the family includes the awareness of one’s emotions and needs and the awareness of one’s child, partner, or other family members. The ability of a family member to stay grounded amidst the rapid shifts of the individuals emotional reactivity within the system is a long-term goal.

The family skill of mindfulness focuses particular attention to: letting go of judgments, transforming anger into primary emotions (sadness, disappointment, anxiety, shame)

Given how destructive both judgments and intense anger are in familial relationships, it is vital to building a dialectical atmosphere.

When working with families’ needs, the gap that I usually see is the inability to bring attention to everyday activities and interactions. Adding mindfulness as a family skill, fosters a ‘being together when you are together’ mantra. This can be used while at the dinner table, going for a walk, or simply during a bedtime routine.

Implementing family mindfulness skills can help reduce negative reactivity, which in turn helps to reduce family disengagement and conflict. Both mindfulness and relationship mindfulness contribute to reducing invalidating family interactions, while increasing overall harmonious family relationships.

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