Ride the Wave: DBT Skill to Navigate Anxiety
Anxiety is a pervasive mental health concern affecting millions of people around the world. From everyday stress, muscle tension, fixation on what could go wrong, and falling into perfectionism, anxiety can significantly impact daily living and your well-being overall. As a professional psychologist, I've witnessed firsthand the exhausting effect of anxiety on peoples’ lives. I've also seen the transformative power of effective coping skills, particularly those grounded in Dialectical Behavior Therapy (DBT). This article looks at one such skill, called Ride the Wave.
Understanding DBT and Anxiety
Dialectical Behavior Therapy, created by Marsha Linehan, is a structured therapeutic approach supported by decades of research. It was originally designed to treat Borderline Personality Disorder, or BPD. Much of the research into how DBT works focuses on how effective it is with regulating the symptoms of BPD. One of the core components of DBT is a focus on managing intense emotions, a feature that is also useful in regulating high anxiety. In the time since DBT was first developed, we found evidence to suggest that DBT is helpful for addressing a wider range of issues, including anxiety.
One study from 2021 examined anxiety symptoms in women with eating disorders. The findings, published in this article “Examining DBT Day Treatment in Treating Mood Dysregulation Expectancy and Anxiety in Women Diagnosed with Eating Disorders,” provide support for the idea that DBT is effective at reducing anxiety. The researchers found that “anxiety scores significantly improved” after the women received DBT treatment, showing a decrease in both the number and severity of anxiety symptoms. In fact, a “large proportion of the sample achieved clinically significant change” in their anxiety symptoms.
How DBT Addresses Anxiety
Here is my take on how DBT works as a treatment for anxiety. The short version is that DBT integrates skills from behavior therapy to create change with skills from mindfulness to practice acceptance of what cannot be changed. By teaching people the skills to regulate emotions, tolerate distress, and make mindful choices, DBT provides a comprehensive structure for dealing with anxiety.
The Role of Mindfulness in Anxiety Management
The foundation of DBT is mindfulness, which involves intentionally focusing on the present moment without judgment. When it comes to dealing with anxiety, mindfulness helps people become aware of their emotions, thoughts, and physical sensations without getting overwhelmed by them. By mastering mindfulness skills, you can build a greater sense of control over your anxiety.
Exploring the Ride the Wave Skill
Ride the Wave is a DBT skill created by Marsha Linehan that was designed to cope with intense emotions like anxiety. The image of riding a wave captures the thought that emotions rise and fall in intensity like waves in the sea. You may know it by the name “Mindfulness of Current Emotions.” It’s a skill close to my heart because in grad school I would drive to Half Moon Bay, a town in California along the Pacific Coast, in order to watch the surfers glide across the powerful waves. The first DBT group I ever led was at Stanford University, a 29 minute drive away from that town. In addition to that, there’s a growing body of research to support the idea that there is a connection between proximity to large bodies of water and mental well-being. This makes the connection between easing anxiety and ocean waves feel crystal clear. By learning to "ride" their waves of intense emotions, people can move through periods of heightened anxiety with greater ease.
Understanding the Concept of Emotional Waves in Anxiety
When anxiety spikes it feels overwhelming. It often shows up as waves of intense fear, muscle tension, or panic. In a true panic attack, those waves get intense enough that you think you might die. Waves of anxiety might be triggered by a specific situation, physical sensation, or even by a specific thought. Using the Ride the Wave skill, we recognize these waves as natural ebbs and flows in emotional experience. It is easier to accept a temporary spike in uncomfortable thoughts or body sensations, than if you imagine you will feel this way permanently. With the knowledge that waves of anxiety come and go, we can begin to adopt a more accepting attitude towards this uncomfortable emotion.
You Cannot Destroy Your Anxiety
Ride the Wave, and indeed all DBT skills, are not going to help you if you want to never feel anxiety again. That quest is impossible. Ride the Wave is not a skill designed for suppressing or avoiding your anxiety. Anxiety, like all of our emotions, is a healthy and necessary part of the human experience. Even though there are times when I wish I didn’t feel it, I have to recognize and share that anxiety is a part of my human system designed to keep me safe. This skill helps me manage it: not destroy it.
Ride the Wave Skill Step-by-Step
Notice your emotion. Name it. Ask yourself, when does it feel the strongest? How strong?
Notice the urge to block it. Notice if the desire to be rid of it shows up.
Notice what thoughts it brings. Notice the thought that it is too powerful, or the worry that you will be stuck in it forever. When you feel this way, what are your thoughts?
Notice your body sensations. Get into your physical body. What exactly are your feeling and where exactly are you feeling it?
Experience these urges, thoughts, and body sensations as long as you can, without having to act on any of them. Observe how long it takes for one wave to ease, for the next wave to rise, and then the next.
Ride the Wave Case Study
The question that I get asked the most is, what if I get overpowered? What if the emotion is too strong? The fear is that the wave of emotion will overpower them, and they’ll get carried out to sea. With one client who comes to mind, they shared that for them, the longer they practice Ride the Wave the stronger their anxiety seems to grow. They felt utterly helpless. For them, the physical sensations they experienced during Ride the Wave were feeling hot in their neck and face, feeling something stuck in their throat, and fast, shallow breathing. Having that combination of sensations felt unbearable to them. Even so, they were still willing to Ride the Wave of these sensations in the room with me.
When we tried the skill together in session, I noticed each time I asked them what was going on in their body, they would tense up, as if they were doing something wrong or did not have the “correct” answer. Although the original anxiety they wanted to reduce was about work performance, as we rode the wave together they experienced thoughts of being completely out of control.
The trick for this client was to stay in the practice long enough for the anxiety to come down on its own. As unbearable as it felt in the moment, the only way for that wave of anxiety to ebb was to stay with it. I’m so proud of the way they stuck with describing the physical sensations, and experiencing them as fully as they could. They noticed their thoughts, they noticed their body, it seemed that they came close to total awareness of what was happening to them as they rode the wave. Gradually, drop by drop, they voiced that the heat in their face and the clog in their throat were easing a bit. And then a bit more. They stuck with those sensations long enough to know when they were starting to fade. That was enough. Once they became aware of the sensation starting to ease a little, they felt their breathing slow down. I reminded them about the waves coming and going. A little arrogantly I tried to point out that they were clearly capable of withstanding what at first felt unbearable, for long enough that it was possible for the emotion to release. I say arrogantly, because in that moment they had proved it to themselves. They didn’t need validation from me at that moment- they had proof enough of their own power in managing their anxiety.
Techniques for Managing Anxiety in the Moment
The main strategy that I use for myself when I’m struggling to Ride the Wave is to stay with the anxiety for long enough. With a particularly strong anxiety wave, it feels unending and permanent. I use Ride the Wave to stay with it anyway, and gradually prove to myself yet again that as all-consuming as anxiety feels in the moment, there will come another moment. And it will eventually ease.
If I give up halfway through, I teach myself that the anxiety truly is overpowering and unbearable, when it turns out that if I could have stayed noticing it for a little longer I might have been able to see it come down.
Some effective techniques to help you stay with it for longer include grounding techniques like feeling your feet in your socks, deep breathing exercises, practicing self-compassion, or progressive muscle relaxation. Essentially, use whatever tools you have to keep yourself in that present moment, so that you can tolerate the waves of anxiety long enough for them to abate.
Staying mindful and observing what is going on in your body can be helpful too. Techniques such as mindful breathing, body scans, and sensory grounding help people stay present and connected to the reality of their body, rather than getting carried away with anxious thoughts or worries.
Like any skill, mastering Ride the Wave takes practice and perseverance. By incorporating DBT skills like Ride the Wave into your daily routine, you can reduce the impact of anxiety on your life over time. Consistency is very much the key. Please remember that incremental progress is worth celebrating. Finally, getting support from therapists and peer groups can be immeasurably helpful in maintaining momentum in DBT practice, and overcoming roadblocks in using skills like Ride the Wave. Therapists trained in DBT can provide feedback, encouragement, and guidance tailored to your specific situation.
Conclusion
To wrap it up, Ride the Wave is a foundational tool in the DBT toolbox that offers hope for people coming to terms with anxiety. By navigating the waves of emotional intensity with mindfulness and self-compassion, you can reclaim control over your mind. Remember, mastering this skill does take repetition and practice, and there is help out there available to you. If you’re interested in getting that guidance and feedback through DBT therapy, you can schedule a free consult call here. So, take a deep breath, embrace the waves of anxiety, and ride through them with courage. You've got this.