DBT for Private Practice
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SPECIFIC PATHS
Supreme concern Practice
Example: To love my Touch her more often. Provide compliments
wife more fully daily. Notice what she is doing for me more
often. Help with everyday chores so she
knows that what’s important to her is
important to me also. Provide recreation time
with her at least three times per week. Allow
time for conversation daily. Talk about
feelings (not just chores). Set goals and talk
about dreams together. Pay attention when she
talks. Tell her she is important to me. Show
interest in her pain (not just try to take it
away). Make time for eye contact. Find ways
she can stimulate me. Find ways to attend to
the relationship itself (not just completing
daily chores). Take what she says seriously
(don’t dismiss her).
© Thomas Marra/New Harbinger Publications 2005
725206834.
Energy
When I touch her, do it gently and with
feeling. Tell her what I feel when I touch her
(the warmth, the smoothness of her skin). Tell
her things about her I appreciate. I shouldn’t
have to make them up. When I help her
around the house, I won’t resent it. I’ll help
with care and interest for what we both get out
of doing it. When playing, I’ll try to have fun
(not do it out of duty) and express the fun I’m
having verbally and behaviorally. When
talking to her, I’ll listen (not just think about
how I’ll respond), give eye contact, express
interest, affirm her perspective as valid even if
it does not accord with my own opinion (I’ll
look for the grain of truth to what she is
saying before I tell her my perspective). I’ll
ask her about her feelings before I talk about
my own. When I express my feelings I’ll
focus on the positive more than the negative,
and I’ll try to inspire in myself loving feelings
even when I’m feeling irritable, tired, or
numb.
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Now, take the same supreme concerns you listed above, and write them in the first column below. (Don’t
choose new ones, but continue to work with your original choices). For each concern, list methods or means
you can use to concentrate, why you are doing this for yourself (not for others), and why it’s important to you.

Supreme Concentration I (me, not others) Why important

concern
Example: To Be careful not to By loving my wife more fully, I will My kids will be happier to have
love my wife practice this while feel more comfortable at home, I’ll less conflict in the house. I’ll be
more fully. doing something else. look forward to coming home, there enacting something I highly value.
will be less conflict in my life, and My behavior will be more
I’ll feel my feelings more often. I’ll consistent with my values.
feel connected to others. I’ll have
better companionship. I’ll feel more
stimulated at home.

© Thomas Marra/New Harbinger Publications 2005

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Again, write down your supreme concerns (the same ones you listed before). Now write what you might be
able to think about that will encourage you to have faith, courage, patience, and humility, and in the last column
what will help you to move your attention back and forth between what you’re doing and what you are feeling.

The purpose of refocusing your attention between the task you’re practicing and yourself is to help you
integrate the experience. By moving your attention from task to self you more easily recognize why you’re
doing this exercise in the first place: to change your feelings, your experience, and your perspective on life’s
events. When you pay exclusive attention to the task, you may miss important changes in your feelings simply
because you are not attending to them. When you pay exclusive attention to your feelings, you may not allow
the task itself to influence you simply because you’re not being mindful of the interaction between task and
experience. In the last column of the following worksheet shift your focus of attention between self and task
often, asking yourself questions that promote attention to the interaction between your body, your feelings, your
thoughts, and the tasks or behaviors you are engaging in.

Supreme concerns What will encourage me to have faith,
courage, patience, and humility?
Example: To love my I’m not doing this to get my wife to approve of
wife more fully. me, I’m doing this to create more meaning in
my home life. Her response to my practicing,
my behaviors, is not what this is all about. It
may take a long time to undo the insensitivity
I’ve shown in the past. It may take me a long
time to reconstitute the respectful person I
truly believe is me. I’ve developed bad habits,
and my replacement of these with good habits
will take time and effort. I’m not perfect. But
I’ll be the me I want to be by practicing.
Refocus attention between task (what I’m
practicing) and self
How do I feel when I’m being gentle and
observant? How do I feel when I’m listening
rather than responding? What does it feel like
to express love rather than focusing on the
love I’m getting? What makes it hard for me to
be attentive? I must allocate time to do these
things. I have to think about my goals and my
values. Focus on what it is I have to do.

© Thomas Marra/New Harbinger Publications 2005

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© Thomas Marra/New Harbinger Publications 2005

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