Dialectical Behavioral Therapy: A Guide for Muslims

Muslims, as an Ummah, let’s be examples of dialogue. Have our discussions be pleasant and useful. Let’s use mindfulness and awareness of Allah (swt) with everything we do. Be kind but not a pushover. Do not be unfair to obtain fairness by shouting or humiliating one another. Never exaggerate or lie to appear more pious or more intelligent.

Muslims, as an Ummah, let’s be examples of dialogue. Have our discussions be pleasant and useful. Let’s use mindfulness and awareness of Allah (swt) with everything we do. Be kind but not a pushover. Do not be unfair to obtain fairness by shouting or humiliating one another. Never exaggerate or lie to appear more pious or more intelligent.

A T.I.P.P. For You

In the name of Allah (swt), the most beneficent, the most merciful.

Dialectical Behavioral Therapy (DBT) is often a treatment used for Borderline Personality Disorder (BPD). I, being diagnosed and in the past suffering from BPD, had a decade in therapy and at least four of those years were dedicated to learning DBT.

DBT is a different breed. These meetings and sessions are educational skill-building discussions that aim to balance a “too emotional” and “too rational” mindset with a “middle path” term called “wise mind”. The therapeutic terminology used is mindfulness.

My definition for mindfulness is “awareness of each moment and using intentional, deliberate actions influenced by our five senses”. But mindfulness can also be found in our beautiful faith of Islam. Not in a way that is bidda or innovative or that will steer you away of tahweed or our faith being total monotheism. People often merge mindfulness with goddesses and sage and mantras – but it does not have to be like this for Muslims.

In Islam, there is the word muraqabah (the constant knowledge that you are serving Allah (swt) and having the conviction that Allah (swt) is always watching you) so you are mindful of what your thoughts and actions because of this. Muraqabah has four aspects, as Sheikh ‘Abd al-Qadir al Jalani proposes:

1. Knowledge of Allah Almighty.

2. Knowledge of the enemy of Allah, Iblis.

3. Knowledge of your soul’s capacity to suggest evil, and

4. Knowledge of deeds to be done for the sake of Allah.

I am also suggesting:

1. Allah is indeed almighty.

2. We have anxieties and depression and other coinciding disorders and discomforts within us that need to be addressed and reactions need to become manageable.

3. Our souls can reach rock bottom and we can easily become lost into bad coping habits.

4. Being mindful of our thoughts and actions with good intent, prayer, meditation, zikr, istighfar as well as DBT skills (that have already been presented in sunnah) should all be done for the sake of Allah (other benefits will follow inshallah).

Dialectical Behavioral Therapy is a deliberate, intentional, consistent practice. Instant gratification is a misconception that drives people into therapy or attracts people to mindfulness in general. Real progress comes at a much slower pace and the goal is to be able to independently regulate uncomfortable, extreme emotions. There are quite a few DBT skills learned that can halt the sensation that there is an emergency and simmer down the commotion, but the underlying problem must be addressed individually. One of these skills is called TIPP.

T for Temperature

T is for temperature. Panic! Your heart is racing. You can’t catch your breath and you are hyperventilating. You are shaking uncontrollably and you just can’t shift your mind from the overwhelming destructive void of isolation you feel. You are alone but suffocating, claustrophobia creeps though you are in a wide, spacious room. You have choices though your feel powerless. An option to return to safety is to exert your face into very cold water. You can hold an ice cube tightly until it hurts. You can take a cold or hot shower. The goal is to change your temperature drastically and quickly.

When these horrifying thoughts corrupt you, it’s important to regulate. Be mindful, maybe it’s not the best time to speak, yell, send that risky text message. “If you get angry, stay silent”, the Prophet Muhammad sallahu alayhi wa salem said. I think of performing wudu as a spiritual refresher as well.

Here is another hadith the Messenger of Allah said: “anger comes from the devil. The devil was created of fire and fire is extinguished only with water; so when one of you becomes angry, you should perform wudu.”

The Rasulallah (saw) said: “When one of you becomes angry while standing, sit down. If the anger leaves him, well and good: otherwise he should lie down.” We are encouraged to change positions when angry. I’ve heard people say “move a muscle, change a thought”. Luckily lots of muscles are used to hop into the shower. You move many muscles when you exercise as well.

I for Intense Exercise

The I in the TIPP skills is for “intense exercise”. I suggest a mindful run or fast-paced walk in the fresh air after your wudu. When I feel out of control, I sometimes perform wudu, pray a few rakats, and then go outside for a nice walk to work up a sweat. This will shake out that harmful energy stored inside you.

P for Paced Breathing

The first P in this skill is for Paced breathing. Take only five or six breaths per minute. Make the breath fulfilling by inhaling until you cannot breathe in any more air. Hold the breath for as long as you can and exhale dramatically. Breathe deeply and do this for a long time. It is useful if you just finished exercising as well.

Then you can have your glass of ice-cold water. That isn’t part of the skill. But I think of the sunnah of how our Holy Prophet (saw) used to drink water. Drinking water mindfully can help bring you back to a level head. Say you did wudu, prayed, went for a run, and now your home again. Pour yourself a glass of water. Sit down cozily, drink water slowly, like the Prophet (SAW) did, taking three breaths between each sip.

To add to this calming technique, ask yourself, how does my water taste? Is the glass cold or warm in my hand? Do I smell anything around me that is distinct? What do you see? What do you hear? Connecting to your five senses can be so grounding.

P for Paired Muscle Relaxation

The last letter and stage P stands for paired muscle relaxation. This is when you force out tension in all of your muscles by flexing all of your body at the same time. You can do this sitting or standing.

This TIPP skill is a therapeutic exercise to get you to a mood in which you’re able to function properly and that is fairly easy to do so. You can perform all the skills or just one or two if you are grounded quicker. You can also do these on repeat if it is working slowly. Adjust the skill according to your well being. These are mere suggestions. There is no judgment. If this doesn’t work for you, it’s time to search and discover skills that do work. You cannot fail these skills because they are not a test. So whether this is helpful for you or not, there is hope for you.

We all want to find a way to be the best version of ourselves. Dialectical Behavioral Therapy is proven to successfully get a great percentage of people with Borderline Personality Disorder to recover into a life worth living. Whether or not you have BPD, we all deserve a life worth living.

To be the best person, best Muslim we can be, we must help bring positive experiences for ourselves, our families, our friends, and the Ummah at large. There is a hadith that confirms that the Ummah, our friends, and family are depending on us and we have a responsibility and purpose to be a healthy limb in our communities, where the Prophet (SAW) said: “believers are like one person, if his head aches, the whole body aches with fever and sleepiness.” If the heart and mind are sound, the body is sound and we can all progress further into a brighter future inshallah!

Use F.A.S.T., Not Furious Approach

Most of us expect respect from others without knowing how to respect ourselves. In Dialectical Behavioral Therapy (DBT), there is a skill on how to carefully teach and learn in a confrontation while respecting both parties involved.

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The skill is the acronym “F.A.S.T.”: Be Fair, don’t Apologize, Stick to values, and remain Truthful. This skill is for self-respect effectiveness.

Likewise, our deen (Islamic lifestyle) requires us to respect other people and to respect ourselves. Our Prophet Muhammad, peace and blessings be upon him, exemplified this beautifully. We know this because of ahadith.

The Messenger of Allah (ﷺ) said: “Truth leads to piety and piety leads to Jannah. A man persists in speaking the truth till he is recorded with Allah as a truthful man. Falsehood leads to transgression and transgression leads to the Hell-fire. A man continues to speak falsehood till he is recorded with Allah as a great liar” [Al-Bukhari and Muslim].

This hadith may seem extreme and very black and white. And the ultimatums are certain to be so because we can find the middle way before the afterlife, before we are judged, and before we are condemned to Jahannam (may God save us) or blessed to enter Jannah (insha’allah).

We must continue to find the middle way to lean on the side of the believers: the truthful men and women.

The skill of F.A.S.T. is a balancing act. How do you be fair to both parties without anxiously apologizing and swaying your opinion to please others? Trading your own beliefs for the other party’s to deescalate or impress is untruthful. As Muslims, we do not alter the truth even if the consequence is not which we prefer. Our self-esteem must be independent from people liking us or not, and instead our self-esteem needs to be dependent on Allah (swt) by living by His guidance.

If the balancing act is uncomfortable to us, we must aim for equilibrium by saving the heaviness of the emotions and using language to describe the emotions without excessive crying or cursing or shouting or causing heartache. Imagine your anger or sadness being two feet away from you rather than raging rampantly inside your heart and mind.

We can say something as simple as “I seek refuge with Allah from Satan”. This could bring us back to a calm, cool, and collected mindset. Use this hadith as an example:

“While I was sitting in the company of the Prophet, two men abused each other and the face of one of them became red with anger, and his jugular veins swelled (i.e. he became furious). On that the Prophet said, ‘I know a word, the saying of which will cause him to relax, if he does say it. If he says: ‘I seek Refuge with Allah from Satan’ then all is anger will go away.’ Some body said to him [the man who was angry], ‘The Prophet has said, ‘Seek refuge with Allah from Satan.’ The angry man said, ‘Am I mad?’”

And so the men came back to a clear state not plagued with hostility.

We can add more skills that temporarily puts aside emotions. This will ease the fears of the F.A.S.T. skill. We later address the oppositions after the interaction by putting your anxiety in a bottle and let it float far, far, away down a smooth streaming river until it washes away into the ocean.

The best way to put aside anxiety is to accept that anxiety exists and is there, and then move forward by knowing you have control to put it away and take it out when it’s most useful to you. With a wise mind, be gentle to yourself and minimize the situation by rationalizing. Hype yourself up by twisting your lack of confidence to: “It’s just a mere conversation!”, “I can do this. He is human with human emotions just like me. We are the same.”, or “He’s not better or worse than me.”

You can also do exercises such as the T.I.P.P. skill we talked about previously:

Change your Temperature with wudu using cold water or take a steamy shower and do ghusl.

Intense Exercise through burnout on cardio and shake the anxiety out of your fingertips! Pray many rakat to feel physical exhaustion and spiritual peace.

Pace your breathing; exaggerating the inhale and exhale may work wonders. Say “subhanallah”, “alhumdullilah”, “Allah akbar”, “La ilaha illalah”, and mark one bead on your tasbeeh per breath.

Paired Muscle Relaxation through flexing, stretching, and bending, and focus on the pressure of every joint and willingly let go of the tension.

I know. You’re sinking into the couch, ignoring the responsibility of a conversation you need to have with your father, friend, or boss. You’re uncomfortable and wish this aggravating situation would disappear. No matter how useful it feels to sit in fear, avoidance is breaking the balance. This is the divine balance that I’m talking about. The balance we can achieve if we are all proactive.

As creatures who are supposed to move forward, staying stagnant is moving backwards.

This is when I’d like to look at the Quran for guidance and motivation to at the very least, shift the mindset:

“Indeed, Allah orders justice and good conduct and giving to relatives and forbids immorality and bad conduct and oppression. He admonishes you that perhaps you will be reminded,” (Quran, Surah Nahl, Ayat 90).

We are pro-justice as Muslims. We have to exemplify justice even if it’s a hard thing to do. We must have the best character by conducting ourselves with proper manners in our discussions. We do not oppress, and nor do we bow down to another human being, paving the way for them to walk all over us. This is literally the F.A.S.T. Skill. I remind you:

Fairness, Don’t Apologize (if you know you are not wrong), Stick to values, and remain Truthful.

We practice our deen with intention. We practice the “Straight Path” in a mindful way. Remember the word “muraqabah”? (the constant knowledge that you are serving Allah (swt) and having the conviction that Allah (swt) is always watching you so you are mindful of what your thoughts and actions because of this). This means not tampering with the style of living designed for us. A design that is divine.

We are not to be controlled by disturbing emotions or defensive logic, but taking a step back from the two and finding out they can work together to solve the puzzle.

Muslims, as an Ummah, let’s be examples of dialogue. Have our discussions be pleasant and useful. Let’s use mindfulness and awareness of Allah (swt) with everything we do. Be kind but not a pushover. Do not be unfair to obtain fairness by shouting or humiliating one another. Never exaggerate or lie to appear more pious or more intelligent. This means taking responsibility, too, and not to minimize where we fell short.

We are Muslims, we strive to be the best in character. This is one attribute we value in ourselves as a community. Let improve upon ourselves and confront necessary conversations amongst each other with respect.