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DBT Therapy & Dialectical Dilemmas

This week we are talking all about dialectical dilemmas & our topic is: Apparent Competence. We have covered dialectical dilemmas before with our discussion on active passivity, self-invalidation, inhibited grieving and unrelenting crisis.

For a refresher –

Dialectical dilemmas are defined as extreme conflicting emotional states that a individual may present with in treatment. We all at one point or another may have faced a dialectical dilemma. The focus of Dialectical Behavior Therapy treatment is to find the synthesis of these two opposing ideas.

What is Apparent Competence?

Apparent Competence essentially is appearing to be able to cope with situations and problems on the outside, but internally experiencing extreme distress and emotional dysregulation.

We can all relate to having to feign competence at one point or another, especially in NYC; however, apparent competence can be really hurtful and unadaptive.

Kelly Koerner (2012) explained it best in her book “Doing Dialectical Behavior Therapy: A practical Guide” when she stated that “apparent confidence is deadly.” (pg 11)

It isolates individuals from their support system.

Either the support system has no idea that the individual is suffering, or the instability and inconsistency of the competence makes others feel they are being manipulated.

When there is a disconnection between what we are expressing as well as communicating to yourself and others, the people around us and ourselves may be unable to accurately assess the help that we need until it’s too late and everything EXPLODES!

Individuals who engage in apparent competence generally avoid being vulnerable and do not feel comfortable asking for help.

Apparent Competence leads to burn out and isolation.

Keeping up the act is exhausting. The root of the problem, emotional dysregulation, is not being dealt with effectively either. So the skill the individual possesses in one place or situation is not generalizable to other experiences, even if they’re the same.

How to cultivate balance, honest communication and expression utilizing DBT therapy:

Avoid Avoiding

The first step is to avoid avoiding. Try to get comfortable with being uncomfortable. Apparent Competence is rooted in avoiding being emotionally vulnerable and asking for help.

Activate Wise mind

Make sure that you’re activating your wise mind and are not making decisions or emotions and thoughts in extremes. Walking the middle path and finding balance is important when working through dialectical dilemmas.

Emotion Regulation: Identifying and clarifying the emotions

Identify the emotion you’re feeling. Ask yourself “what am I feeling right now?” “What emotion did this event bring up for me?” Clarify which emotions are primary or secondary. Clarify why you’re feeling the way you are. Acknowledge your emotions and sit with them.

“I’m feeling angry because…”

“This made me feel angry because…”

“I would feel better next time if…”

Mindfulness

Be nonjudgmental and accepting of the emotions you have just identified, clarified and acknowledged. Tell yourself

“It’s okay that I’m feeling this way…”

“I’m feeling…”

“I’m feeling afraid of being vulnerable and open…”

“I am not weak for feeling…”

Communicate effectively and Ask for help

Learning how we can effectively communicate our needs and wants to our support system is extremely important when combating Apparent Competence. It enables us to better ask for help and allow others to help us. Our friends, family and health providers don’t and can’t know that we’re struggling if we are actively hiding or appearing competent. Think about what you will tell them, how can you explain your feelings without placing blame. Think about how you can ask for help and what your support system can do for you.

“I am feeling depressed and….”

“Can you help me with this task because….”

“I am having difficulty and need support with…”



Think different, do more, worry less.

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