Dr. Marsha Linehan, the creator of DBT, explains there many infinite painful and distressing events which occur in our lives, and yet there are a limited number of responses available to us. She categorized these responses into four groups. I present these options to clients (and myself) when there are difficulties moving forward on a particular problem. Maybe we’ve been juggling options around for some time and haven’t been able to settle on what to do, or maybe there’s some willfulness arising, preventing forward movement toward resolving this issue.
Regardless of the circumstances, these four solutions require us to start by accepting the fact that no matter what we do, we’re making a decision on how to handle the problem. As the enlightened band Rush states in their song Freewill, “If you choose not to decide, you still have made a choice.”
The four solutions to any problem
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Solve the problem
This solution seems to be the most straightforward. If you have a problem, solve it. If your boss is reducing your hours, ask for more hours or get a new job. If you’re afraid of flying, engage in exposure therapy or simply avoid flying.
For larger and more complex problems such as discrimination, solving the problem includes identifying power structures that allow unfair treatment to continue and taking action to radically change them.
This solution offers changes in the environment. Skills such as Walking the Middle Path from Interpersonal Effectiveness and Problem Solving from Emotion Regulation are useful here. Unfortunately, some problems such as racism and homophobia are not quickly or easily solved, requiring us to manage and tolerate painful realities while we continue to push for equitable treatment for all.
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Feel better about the problem
When solving the problem is not possible or preferable, we can work to manage the difficult emotions related to the issue. For instance, a person who is afraid of flying might handle those feelings by developing self-compassion for themselves or joining an aerophobia support group. When managing discrimination, the emotions that arise can be extremely devastating. Handling those emotions might include finding a place of safety among supportive people or developing ways to shield yourself from discrimination such as a mantra (“I am not alone” or “I decide my worth”).
In DBT, skills in the Mindfulness and Emotion Regulation modules will be helpful for managing difficult feelings.
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Tolerate the problem
When we can’t solve the problem or change how we feel about it, we can still relieve some distress by learning to tolerate the problem. By radically accepting the problem and the difficult emotions that arise from it, we reduce the suffering we experience. If you’re afraid of flying and you’ve been unsuccessful at solving the problem or managing your fear, you might accept that you won’t be someone who takes long distance vacations or business trips. Of course this is painful, and yet accepting this reality allows you to make different decisions such as making day trips to local attractions or having a job that allows you to work from home. When facing discrimination, tolerating the problem means accepting that some structures are designed to prevent minorities from succeeding.
PLEASE NOTE: Accepting this reality does NOT mean you are approving of discrimination or unable to change unjust policies. It simply means recognizing that discrimination exists which can enable us to be more mindful and strategic in how we address it.
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Stay miserable
When I first read about these solutions, I thought this option was included as part of comic relief and irreverence. Then, I thought of all the times when I’ve chosen to stay miserable and not use skills. For instance, when I procrastinate on something, I’m not using any skills and I’m definitely staying miserable. There’s nothing wrong or shameful about choosing this option, everyone does it. And yet, it’s important to note that this solution does not require skills and is most often ineffective. Not wrong, ineffective.
In our fear of flying example, the individual wouldn’t accept their fear and would continue to be extremely distressed without hope or insight into how to change it. When facing discrimination, staying miserable involves allowing those in power decide our worth, ignoring instances of discrimination towards ourselves or others, habitually numbing emotions, and believing we cannot make a difference to make our world a better place.
Using skills is very difficult, especially when we’ve had years of practicing other behaviors. If you’re looking for ways to use the first three options, our therapists at CCDBT can help you develop the skills you need to move forward on problems you might be stuck on. Please consider reaching out to us to schedule an appointment.