Introduction
Impulse control disorders are characterized by an inability to resist the urge to perform an action that is harmful to oneself or others. This is where Dialectical Behavior Therapy (DBT) steps in, offering a unique approach known as Alternate Rebellion, which is part of the Distress Tolerance skills training. In this psychoeducational article, we’ll explore the concept of Alternate Rebellion, its significance in DBT, and how it can be effectively utilized in therapy settings.
Understanding Impulse Control Disorders
Before diving into Alternate Rebellion, it is crucial to understand the nature of impulse control disorders. These disorders manifest as actions that are often aggressive, self-damaging, or disruptive. Common examples include trichotillomania (hair-pulling disorder), kleptomania (compulsive stealing), and pyromania (fire-setting behavior).
DBT and Distress Tolerance
Dialectical Behavior Therapy, developed by Marsha M. Linehan in the late 1980s, is a cognitive-behavioral treatment that emphasizes balancing acceptance and change. It is particularly effective in treating Borderline Personality Disorder and other conditions involving intense emotions and impulsive behaviors.
Distress Tolerance, a key component of DBT, involves skills to tolerate and survive crises without making them worse. It’s about accepting the current situation and finding ways to endure and bear the pain of harsh realities without resorting to harmful behaviors.
Alternate Rebellion: Concept and Application
Alternate Rebellion is a technique within Distress Tolerance designed to manage impulsive behaviors effectively. It’s based on the premise that many harmful impulsive actions are forms of rebellion or a way to assert control.
The Theory Behind Alternate Rebellion
The core idea is to replace a harmful impulsive action with a less harmful, but still rebellious, action. This substitution satisfies the urge to rebel or assert control without the negative consequences associated with the original impulsive behavior.
Implementing Alternate Rebellion
- Identify the Impulse: Recognize and acknowledge the harmful impulsive behavior that you want to change. It’s important to be aware of what triggers this behavior and the feelings associated with it.
- Choose an Alternate Action: Select a rebellious action that is safer and less damaging. This action should still provide a sense of control or release but without the negative outcomes.
- Practice Mindfulness: Stay present and mindful when the urge arises. Observing your thoughts and feelings without judgment can help in managing the impulse effectively.
- Execute the Alternate Action: Engage in the chosen rebellious action instead of the harmful impulse. This step requires commitment and practice.
- Reflect on the Outcome: After performing the alternate action, reflect on how it felt. Did it satisfy the urge to rebel? Was it less harmful than the original behavior?
Examples of Alternate Rebellion
- Snapping a rubber band on your wrist provides a physical sensation without causing long-term harm.
- Rearranging items in a store satisfies the urge to act out of line without the legal and moral consequences of stealing.
- Giving an honest response instead of a polite one prevents you from suppressing anger, frustration, contempt, disappointment, or wise advice.
- Speaking out rather than staying quiet prevents the feelings derived from low self-esteem and diminished confidence, lack of agency, or denied autonomy.
- Dress in a counter-cultural style if you feel like your identity is a projected facade.
- Challenge statements when you disagree
- Choose mediocrity rather than drama
- Quit things that are not effective
- Follow your passion rather than your expectation
- Wallow in creativity
- Give yourself time to play
- Explore
- Say no to family when they ask for a favor
- Leave the light on all day
- Get a tattoo
- Change your color preference of clothing
- Do things out of order
- Do things out of character
- Seek your own interests
- Don’t cook
- Write a letter to the editor
- Run instead of walking
- Get a radical hair cut
- Turn up the volume
- Roll down all the windows in your car
- Play a different style of music
- Leave things out of place
- Shout or scream alone
- Dye your hair
- Wear clothes that don’t fit right
- Vocally advocate for an issue you care deeply about
- Sleep late on Saturday
- Dress up for a casual event or down for a fancy event
- Get your ears pierced
- Buy something impractical
- Break out of roles expected of you
The Role of a Therapist
In a therapeutic setting, the counselor plays a vital role in guiding the client through the process of identifying harmful impulses, selecting appropriate alternate rebellious actions, and reflecting on the outcomes. The therapist’s support is crucial in helping the client navigate this journey safely, with empathy, validation, patience, attunement, and understanding.
Conclusion
Alternate Rebellion in DBT offers a novel way to manage impulsive behaviors. By substituting harmful actions with less damaging ones, individuals learn to satisfy their need for rebellion in a controlled and safe manner. This technique, along with other DBT strategies, can lead to significant improvements in impulse control and overall mental health.
References
- Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
- Chapman, A. L., Gratz, K. L., & Tull, M. T. (2011). The Dialectical Behavior Therapy Skills Workbook for Anxiety. New Harbinger Publications.
- Robins, C. J., & Chapman, A. L. (2004). Dialectical behavior therapy: Current indications and unique elements. Psychiatry (Edgmont), 1(9), 62–68.
This article provides a comprehensive overview of Alternate Rebellion, a skill within the DBT framework, aimed at addressing impulse control disorders. By understanding and applying this technique, clients can learn to manage their impulses in a healthy and effective way, contributing to their overall well-being and mental health.