All you need to know about Dialectical Behavioral Therapy DBT

A Quick Guide

Dialectical Behavioral Therapy (DBT) is a type of psychotherapy developed by psychologist Marsha M. Linehan. It was initially designed to treat individuals with borderline personality disorder (BPD) but has since been adapted for other mental health conditions characterized by emotional dysregulation and difficulties in interpersonal relationships. In this article, we will discuss what DBT is, its stages, how it works, its uses along with its pros and cons

What is Dialectical Behavioral Therapy DBT?

Dialectical Behavior Therapy DBT teaches patients new ways to deal with distressing feelings and reduce conflict in interpersonal relationships. DBT is influenced by dialectics, a philosophy that emphasizes balancing opposites, as its name suggests. The therapist continuously encourages the patient to find a middle ground between two seemingly incompatible viewpoints, avoiding all-or-nothing, black-or-white thinking, and promoting balance. DBT encourages a both-and perspective as opposed to an either-or one in support of this balance. DBT’s fundamental dialectic is one of acceptance and change.

DBT specializes in teaching therapeutic techniques in four critical areas. First, mindfulness aims to enhance a person’s capacity for accepting and being present in the moment. Second, rather than attempting to run away from negative feelings, distress tolerance is designed to help people handle them better. Thirdly, emotional regulation refers to methods for controlling and altering strong emotions that negatively affect a person’s life. Fourth, interpersonal effectiveness is the ability to interact with others in a manner that is assertive, upholds one’s self-respect, and helps strengthen bonds with others. Let us try to understand these four aspects a bit more.

Mindfulness

The improvement of mindfulness abilities is a significant benefit of DBT. You can live in the present and concentrate on the here and now with the help of mindfulness. This assists you in developing a nonjudgmental awareness of what is happening inside of you that is your thinking, emotions, sensations, and drives, and what is happening outside of you that is whatever you see, hear, smell, and touch.

When you are experiencing emotional distress, mindfulness techniques can assist you to slow down and concentrate on adopting better coping mechanisms. The method can also assist you in maintaining your composure and preventing impulsive actions and cycles of negative thoughts and emotions.

Learn more about Mindfulness In DBT: Cultivating Inner Peace & Emotional Resilience

Emotional Regulation

You can deal with intense emotions more successfully if you have good emotional control. You will be able to recognize, name, and alter your emotions with the help of the techniques you learn. It lessens your emotional sensitivity and enables you to have more pleasant emotional interactions when you are able to identify and manage strong emotions such as anger.

Distress Tolerance

Your ability to tolerate stress will help you accept yourself and your circumstances. DBT provides a variety of crisis management methods, such as:

• Distraction.
• Improving the current situation.
• Self-soothing.
• Weighing the advantages and disadvantages of not putting up with distress.

Techniques for coping with distress help you get ready for strong emotions and give you the tools you need to deal with them in a way that will benefit you in the long run.

Interpersonal Effectiveness

Your ability to articulate your requirements and say “no” in a relationship and still maintain a nice, healthy connection depends on your interpersonal effectiveness. You will develop the ability to respect yourself as well as others, listen and communicate better, and handle difficult people.

Stages of DBT

Dialectical Behavior Therapy typically involves these 4 stages:

Stage 1

The most severe and self-destructive behaviors are addressed first at the start of treatment. This may involve problems like self-harm or suicidal tendencies.

Stage 2

Next, the focus of treatment shifts to problems that have an impact on a person’s quality of life, like their capacity for managing their emotions, interpersonal effectiveness, and capability to tolerate distress.

Stage 3

The attention now shifts to problems with self-worth and social interactions.

Stage 4

At this stage, treatment focuses on assisting patients in making the most of their lives, including identifying strategies for improving happiness, strengthening relationships, and pursuing their life goals.

How does it work?

The main objective of therapists who practice Dialectical Behavior Therapy DBT is to establish a balance between the advantages of change and the validation (acceptance) of who you are as well as your problems. Your therapist will work with you to develop fresh techniques for better emotion control.

Dialectical Behavior Therapy’s structure can differ slightly from therapist to therapist, but in general, it entails these 4 types of sessions:

• DBT pre-assessment
• Individual counseling
• Skills training in groups
• Telephone crisis coaching

Pre-assessment for DBT

Before beginning DBT, your therapist could offer an assessment. Through questions and an explanation of how the approach functions, they will ascertain whether it is a good fit for you. They will ask you to stick to the course of treatment if you determine that DBT is the best therapy for you.

Individual counseling

It includes once-a-week therapy sessions. Every session lasts between 40 to 60 minutes. The goals of individual DBT therapy sessions include the following:

• To assist you in overcoming the challenges preventing your development, such as mental health issues or interpersonal problems, in order to help you achieve your goals and enhance the quality of your life.
• To assist you in replacing harmful behaviors with new skills.
• To decrease any self-harming and suicidal tendencies, if any, in order to keep you safe.
• To prevent behaviors that interfere with effective therapy.

You’ll probably be asked by your therapist to keep a diary in order to monitor your feelings and activities and to look for patterns of behavior. You’ll bring this journal to your appointments so you and your therapist can discuss what you should focus on in each session.

DBT Skills training in groups

Your therapist will provide you with skills training in a group setting during these sessions. This is different from group therapy, which involves talking about your issues with others. Consider it more along the lines of a classroom-style teaching and learning experience.

Telephone crisis coaching

DBT frequently uses telephone crisis coaching to assist you in your day-to-day activities. This implies that you can call your therapist for support at specific times in between sessions. Here are a couple of situations where you might want to give your therapist a call:

• When you require assistance with a sudden crisis, such as the desire to harm yourself.
• When you’re attempting to apply the DBT techniques you’ve learned but need a bit more guidance.

Furthermore, your therapist will establish clear guidelines for when you can call, such as only within a certain window of time in the day. Although crisis coaching is available when needed. The calls are typically quick, therefore they shouldn’t be used in place of individual or group sessions.

When is DBT used?

Dr. Marsha Linehan and her colleagues developed DBT in the late 1980s after observing that Cognitive Behavioral Therapy CBT alone did not perform as well as planned in Borderline Personality Disorder BPD patients. To cater to the particular requirements of these people, Dr. Linehan and her team incorporated approaches and created a treatment. DBT was developed to address issues associated with Borderline Personality Disorder, including:

• Either suicidal thoughts or attempts
• Extreme mood changes
• Feeling hopeless or hollow inside
• Feelings of self-hatred or low self-esteem
• Impulsive or risk-taking behavior
• Intense emotions
• Relational instability
• Self-harm

Even though it was developed with BPD in mind, it is a treatment option that therapists currently provide for various mental illnesses. These consist of:

• Anxiety
• Attention Deficit Hyperactivity Disorder ADHD
• Depression
• Eating disorders such as Bulimia Nervosa and Binge Eating Disorder
• Emotional instability
• Issues with drugs or alcohol
• Post Traumatic Stress Disorder PTSD

How long will you require Dialectical Behavioral Therapy?

The typical duration of Dialectical Behavior Therapy DBT is between six to twelve months. However, because every person is different and because mental health issues are complicated, you shouldn’t anticipate being entirely free of symptoms or having problematic behaviors after a year of DBT.

Many therapists think that it can frequently take several years to treat Borderline Personality Disorder BPD in particular. Don’t let the time it might take to improve your quality of life and ability to manage your emotions discourage you. The fact that you are looking for assistance is essential. Any progress is great.

Pros and Cons of DBT

Numerous studies have shown that Dialectical Behavior Therapy DBT is effective in treating patients’ mental health issues. Particularly for those with borderline personality disorder, DBT has the following effects:

• Fewer days spent in the hospital as an inpatient
• Less abuse of alcohol and drugs
• Less anger and self-harming behavior
• Reduced depressive symptoms

DBT can be highly challenging and isn’t for everyone. You have a better chance of success with DBT if you:

• Are dedicated to making improvements for the better.
• Are prepared to concentrate more on your present and the future than your past.
• Are prepared to dedicate your complete attention to therapy and homework.
• Feel prepared to participate in some sessions in a group setting.

Can You Practice Dialectical Behavioral Therapy By Yourself?

DBT is complicated, and you shouldn’t typically attempt it on your own without the assistance of an experienced therapist. To help you learn new coping mechanisms, there are certain activities you can do on your own. For instance, you can use mindfulness, breathing techniques, and progressive muscle relaxation to enhance your capacity to handle distress.

It’s crucial to keep in mind that this shouldn’t be utilized in place of expert advice. It’s always better to seek the assistance of a licensed mental health expert if you’re experiencing mental health issues.

What to Look for in a Dialectical Behavior Therapist

In order for group skills training to be effective, DBT assumes that therapist behavior and work with clients must be taken into consideration just as much as client behavior and experience. As a result, any DBT program should include treatment for the providers, and therapists should use the techniques themselves. They must be familiar with DBT and basic behavior therapy approaches. 

Find a mental health practitioner who has had specialized DBT training and experience. Standards for clinician certification have been created by the non-profit Linehan Board of Certification. Finding a therapist with whom you feel comfortable dealing is also crucial.

Keep in mind

Attending all of your planned DBT individual treatment appointments and group skill-training sessions is crucial.

Call your therapist if you’re in a crisis, such as when you’re considering suicide. Dial 988 to reach the National Suicide Prevention Lifeline if your therapist isn’t available. Every day of the week, someone will be accessible to speak with you. You can also dial 911 or visit the closest emergency room.

Outlook

Dialectical Behavior Therapy DBT is a successful treatment for those who struggle with extremely strong, negative emotions. Finding the ideal DBT therapist for you may be challenging and time-consuming, but it’s crucial to keep looking. The sooner you can begin therapy and commit to it, the sooner your quality of life will improve.

We hope you found this article helpful in learning about Dialectical Behavioral Therapy DBT along with how it works, its pros and cons, and more.