Sometimes this just involves just a little understanding and support while the person works through their problems. You may just need to give them time to talk or space to work on things. However, when things are more complex support needs get more complex. You may feel that whatever you do isn’t good enough, or that you try to help but it seems to make things worse. Maybe you’ve even given up trying.

DBT has long understood that a person’s broader environment matters. Family, friends, work, school, all play crucial roles in complex emotional problems. The biosocial model explains how a person’s environment can interact/transact with their emotional sensitivity in a way that shapes and reinforces particular patterns of responding to emotions. It’s very important here to say that this is not about blame. In our experience people with the kind of emotional problems that DBT is designed for can come from a range of different family backgrounds from very loving, supportive and caring families, as well as families that are rejecting, harsh or where there is high levels of conflict.

If you look in chat rooms, on YouTube, at blogs and other social media you will find people discussing whether to involve family members by disclosing difficulties. One common discussion is about whether to tell parents about self-harm or other problem behaviours. You find lots of advice from people to not tell parents or loved ones. This advice is driven by bad experiences or fears that parents can’t be trusted; that things might change for the worse afterwards; that loved ones will get angry; or that other people may be told or get involved. These fears all centre around invalidation. The person fears that telling someone will be an invalidating experience. Invalidation and the fear of being invalidated can increase a person’s distress and make it harder to accept support. As such, learning how to validate is crucial.

Support and carers people can also experience emotional difficulties themselves. They tend to experience higher levels of anxiety, depression and  sleep problems. This can then impact on the support person’s work, family life, leisure activities, which then feeds anxiety etc. This makes complete sense of course, and yet support people and carers often do not get help themselves. They may not feel they have the time; they may feel that they should be focusing on the person they are trying to help; they may feel guilty about focusing on their needs or think they are not as important. However, it is very important to understand that you will be more effective if you get help and support, and in the end being effective in providing help and support is what really matters.