Assertiveness: How to Get What You Want (or Say No) Using DBT

People with all sorts of difficulties—ranging from typical, everyday deflation, anxiety, and personality pathology—often struggle with being pro-active, exercising self-control, overcoming passivity, boundary setting, and—in a word—assertiveness.

Assertiveness is a crucial skill that can be developed through therapy and practice. It is fundamental to subjective well-being, happiness, mental health, and self-care. From a clinical perspective, difficulties with assertiveness can be found among individuals with social anxiety and depression as well as in substance use disorders and personality disorders.

What Is Assertiveness?

Assertiveness can be conceptualized as a personality trait, social skill, behavior, or self-regulatory capacity. It refers to behavior that is intentional, self-directed, and pro-active. It refers to behavior that gets one what one wants, establishes interpersonal boundaries, or expresses one’s opinions or feelings in an effective way. Some examples of assertive behavior include raising one’s hand during a classroom discussion—speaking confidently and clearly without excessive maladaptive concerns over criticism or negative feedback.

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Assertiveness ideally involves being comfortable inside one’s own skin, knowing who one is, what one wants, and reaching one’s life goals-short and long-term. Other examples of assertiveness include seeking out a professor during office hours to ask a question about course material, making sure to get class notes from a peer for missed classes, or letting friends know that one is quitting some drug of choice. Assertiveness can take the form of declining to drink alcohol or consume drugs at a party. It can involve picking up the telephone and making a doctor's appointment or calling a friend to make plans. Assertive behavior can include asking someone out on a date, breaking up with a long-time romantic partner because of being in a dysfunctional relationship, or confronting one’s parents for any number of wrongs. Assertiveness involves asking for what one wants or saying no. It underlies self-care and is key to recovery in addiction and personality disorders.

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) is an integrative psychotherapy that combines elements of Buddhism, mindfulness, cognitive therapy, behavioral therapy, and psychodynamic as well as interpersonal therapy. It is manual-based—meaning therapists can follow a pre-determined protocol—and consists of four core modules that are taught to the patient in a didactic manner.

It was developed for the purpose of treating Borderline Personality Disorder (BPD) but in my opinion has wider-ranging applications from managing everyday interpersonal problems to improving self-control, productivity, and the quality of one’s life. It is also commonly used in the treatment of addiction. Interestingly, it’s creator, Marsha Linehan, developed DBT as a way to treat her own borderline personality symptoms, and this therapy has had tremendous success in research studies and clinical settings.

A Brief True Story

In fact, I walked into a Barnes and Noble store last year to see the newest edition of the DBT skills training book displayed prominently on the shelves behind the cash register. Confused about why this book was placed where it was, I asked the cashier what the deal was. She said that books behind the register are the ones most frequently stolen and are kept there for safekeeping.

Interpersonal Effectiveness: DBT Skills Training in Assertiveness, “Dear Man”

One of the areas of focus in DBT is called “interpersonal effectiveness” which includes skills training in a variety of interpersonal problem areas. Included in this domain is an assertiveness script, designed to help people become more assertive—i.e., to get what they want or say no in the context of interpersonal relationships. To help people remember the script, Linehan coined the acronym DEAR MAN, described below:

• Describe [the facts]
• Express [your opinion or feelings]
• Assert [what you want or say no]
• Reinforce [consequences of getting what you want or of you not getting what you want]
• Maintain [your position in face of distraction, criticism, or whatever else by repeating what you want or saying no like a broken record]
• Appear [confident by making and holding eye contact, as well as maintaining an upright posture]
• Negotiate [If the other person still has not caved or accepted your no, consider pulling back what you want a little bit and asking for a little less. If that still doesn’t work, try saying something like, “How can we solve this problem?”

“Dear Man” is not magic, but it can be grounding in connection to helping people navigate uncomfortable social situations effectively. It’s not a panacea but it can help. It’s a skill that needs to be practiced in order to get better. In my opinion, “Dear Man” is one of the better worksheets or handouts designed to help people improve their social skills.

Assertiveness Essential Reads

The Awesome and Sometimes Sinister Power of "The Ask"

Assertive Communication: Required in All OCD Marriages

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It may be particularly useful for shy, passive, sociotropic, interpersonally dependent, clingy, needy, and submissive types of people—but in my view, anyone can benefit from assertiveness skills training. The thought has crossed my mind that "Dear Man" might be very useful in sales or politics, but that is beyond the current scope.