DBT Skills to Interrupt Dissociation
Applied DBT Skills for TraumaSo my go to strategies for helping to prevent or reduce dissociation for clients is going to be anything from our skills that is going to bring on some intense sensations that will essentially distract them from whatever is the dissociative experience and bring them back into the present moment. So as a first step, I would recommend trying to help them figure out what are the warning signs. What are they aware of, which is often something in their bodies that is a sign that they're about to dissociate or have started to dissociate and really bring them with sort of mindful awareness to start noticing those first signs. Sometimes I've had clients who describe they start to get some tunnel vision or they start to feel really cold, or there's something that they can notice about changes in their physical sensations.
That then is when we want them to jump in right away and start using skills that will bring on some intense sensations to prevent dissociation from starting or from getting worse. There's a couple of general skills that I think about with how to reduce dissociation. And usually, some of my favorite skills for that are around some type of intense sensation. Basically, we have something happening right here, right now that's intense enough, it's going to be hard to stay checked out.
It's going to bring your attention back one way or another. So that can be through any of our senses, anything that is something you're looking at or something that's loud or something that smells or something that you're tasting or touching, any of those things could potentially work to bring you back. So I have a couple of things I brought with me today just to sort of give you some ideas that we can try out, and we can sort of see which ones you think you want to try at home on your own. So the first one is going to be something really cold. So have an ice pack. Do you have something like this at home? Yeah, I do. You do?
So generally, sometimes just holding it, I mean, that's pretty cold, right? Like it's going to be a pretty intense sensation to hold an ice pack in your hand, but probably even more effective is going to be to put it over your eyes, sort of on your face, and to kind of hold it there for we don't want you to be incredibly uncomfortable from the coldness in some way or painful, but long enough to kind of shake you out of it. So do you want to just try it for the practice of it and Yeah, I mean, what's the worst thing that can happen, right? Right. You'll get a cold face. Oh, wow. Yeah. That feel hard to ignore?
Yeah. Yeah. Oof. Got me a little brain freeze, but Yeah, absolutely. Yeah. Do you think that intensity of a sensation, do you think that would be something that would help you to kind of stay here, aware, present, not move off into dissociation? You know, I think so. Because it really does just bring me back. I feel it straight through my eyes, forehead, and then just holding it as well, too.
It makes me feel like I'm in this moment. Yeah, ice is one of my favorites. I think it's just a really intense thing that is kind of quick to grab and will help you. Often that's all that's needed for a lot of people, but we're going to try some other things too. So we've got ice pack as our first option. Seems like a good one.
Sometimes too, like a really intense flavor. We can talk about other options here, but what I have for you is just Thick Tack. Do you wanna take a candy? Sure. And put it under your tongue potentially, usually a little bit more intense there. Sometimes people just carry something like this around with them. Doesn't have to be Tic Tacs. Do you have like a mint that you prefer or some other kind of candy?
Like Altoids are sometimes good or maybe you prefer sour or Warhead or Hotball, things like that. Yeah, yeah. I like more sour. You like sour? So what do you think would work for you? Probably a Warhead. Mhmm. Yeah. Because that's something. Do you usually have either pockets or a bag or something like that? Yeah, usually pockets. You could just carry a few with you out in the world so that you have that handy at the first sort of sign of any of those tunnel vision, things getting quiet, all of that, and reach in your pocket.
Just put that in your mouth? Yeah, I think so. Since it's sweet, don't really That one doesn't really wake you up in the same way as ice or something sour would. Yeah, exactly. Yeah, some other things, if you want to be real adventurous, things like wasabi or hot sauce? Do you like spicy things? Not as much, but Okay. So maybe warheads, a lemon. We're just going to try some things and figure out what works.
Wasabi, if you want to be real brave. Yeah. Yeah. Okay. And then smells are another thing. So I have vinegar in here for you. And the idea, you know, obviously with smells just put it under your nose and have right? Yeah. Wow. Uh-huh. Yeah. That does get me here. Yeah. Exactly. So that would be, again, something when you're sort of starting to feel that kind of like woozy sensation if you put something like that under your nose.
Probably gonna bring you right back. Yeah. Yeah. This one definitely. So vinegar is a good one for Yeah. Yeah. Wow. I'm having urges to tell you to do it again, but you're not dissociating, so I won't. But I think that that looked like it was more powerful Yeah. For sure. Oh, yeah. This one, the ice really gets me in the moment.
The Tic Tac, since it's sweet. Didn't want to do much? Yeah. Okay. But yeah, this Brave soul. Yeah. Alright. Yeah. So I think vinegar is a winner. Yeah. You probably have some at home, some Oh, Definitely. So that gives you some choices. You might have to buy some wasabi and more heads, but otherwise I think you've got an ice pack, you've got vinegar.
Those are also things that we're going to have you do, I'm going have you do here as best we can. So I have an ice pack obviously. I can have that kind of at the ready. If you're going to get yourself some more heads, you just bring them with you if you don't plan to have that. But in general, we're going to be working on in here too, kind of noticing when it's starting and trying to stop it as quickly as we can with whatever works and then keep right on going.
Okay. Alright.