Dialectical Behavioral Therapy (DBT)
“We cannot stop the waves, and we can learn to surf.”
– Joseph Goldstein
Dialectical Behavioral Therapy (DBT) was developed by Dr. Marsha Linehan to help treat Borderline Personality Disorder and intense suicidal ideation. Through the years, it has been proven through multiple studies to treat a wide range of mental and emotional health struggles, including depression, addiction, impulse disorders, personality disorders and suicidal thought patterns.
Dialectics are experiences that while in conflict, both have truth. You may ask yourself, how will this benefit me? We are all constantly balancing dialectics our lives. Whether we are right or wrong, too much or not enough, good or bad, always or never, etc. DBT is a skills and awareness based therapeutic approach that helps to reduce judgment of self and others, while focusing on improving our ability to be present in reality as it is. The primary dialectic that DBT works to synthesize is the balance of acceptance and change in our lives.
What Dr. Linehan found in her research was that when people solely focused on acceptance as their goal, they risked becoming dissatisfied and suffered with the agony of their lives being minimally different. When they focused solely on change, they so frequently felt invalidated and incapable that their suffering was also increased.
She structured DBT in a way that helped individuals learn skills to effectively balance efforts to accept reality as it is, while working to change reality to reduce destructive behaviors and create a more desired existence.
DBT has four primary modules of skills that address most components of our lives.
Core Mindfulness – Skills that enhance our ability to be fully present in a moment and develop greater self-awareness.
Distress Tolerance – Skills that improve our ability to tolerate painful circumstances effectively without making them worse.
Emotional Regulation – Skills that enrich our ability identify emotions, reduce our vulnerability to suffering and change emotions that you want to change.
Interpersonal Effectiveness – Skills that focus on your ability to improve your relationships through validation and speaking needs effectively.
DBT has four stage targets of treatment, which include:
Stage 1: Reducing or eliminating life threatening and therapy interfering behaviors.
Stage 2: Improving emotional regulation and reducing emotional responses to trauma/traumatic invalidation.
Stage 3: Improving quality of life through problem solving, increased self-respect, responsibility, cultivating effective relationships
Stage 4: Creating a life worth living through greater capacity for joy and existential fulfillment.
DBT is provided through four distinct types of treatment: Skills training
Skills Training focuses on enhancing a person’s capacity to function effectively by teaching new behaviors and generalizing these behaviors to many different environments. Basically, if you never learned to swim, you can’t judge yourself for being afraid of the ocean. You just need to learn to swim!
Individual therapy focuses on improving and maintaining motivation, and learning how to apply new skills to specific challenges in your life. Individual therapy also helps to explore the secondary targets and beliefs /myths that interfere with healthy behaviors and functioning.
Phone coaching targets improving your ability to apply skills in the moment, when needed. Yes, I will be available to you outside of normal therapy time to help coach you though difficult moments when needed. These are generally short and highly effective to improve use of newly learned behaviors.
Consultation I will need support too. Consultation meetings are designed to support you by helping me conceptualize our work and to ensure I am not missing any important factors that could help you. The group consultation helps me remain the best therapist I can be for you and compliant with the principles of DBT.
For more detailed information about DBT, please click the link below.
https://behavioraltech.org/resources/faqs/dialectical-behavior-therapy-dbt/