Could DBT Help Me?
Just as everyone experiences distress in life, everyone copes with the distress in some manner. Some responses are healthier than others, and some are potentially harmful or even destructive.
Sometimes the things a person does to cope with feelings of distress are impulsive behaviors/reactions that offer immediate relief in the moment but can actually make things worse in the long run. This may mean that there is an unproductive reaction that ranges from a volatile display of emotion to an almost complete shut down and withdrawal. Wherever you fall in the reaction spectrum, DBT skills can help you develop new skills to improve general functioning levels.
DBT skill building focuses on four areas:
- Emotional Regulation – Coping skills to address emotional experiences
- Distress Tolerance Skills – Techniques for handling the emotions triggered by distressing circumstances, including those that cannot be immediately resolved
- Interpersonal Effectiveness – Maintaining positive relationships with others, asking for what they need, and establishing appropriate boundaries with others.
- Mindfulness Skills – Seeing different viewpoints and staying present.
DBT at PeoplePsych
DBT’s focus is on teaching coping and life skills to address the emotional issues, in an environment of validation and acceptance. PeoplePsych therapists incorporate DBT in their therapeutic work in different ways.
Some clients seek and benefit from a structured DBT intervention where sessions focus on a particular problematic behavior or event that occurred between sessions. In this case the problematic behavior is discussed in detail during the session, including what led up to the event, alternative responses and what the prevented the you from reacting in a healthier way.
However, most of our clients benefit from PeoplePsych therapists simply incorporating the DBT skills into their ongoing clinical work. This perspective encourages continued deep clinical work while ensuring that simultaneous efforts are being made to address the present experiences and relationships. Just as in the more structured DBT work, the focus is on teaching clients to better handle their emotional responses in real time.
What is DBT?
Dialectical Behavioral Therapy (DBT) is a modified type of cognitive behavioral therapy (CBT) developed by Marsha Linehan Ph.D. Today DBT skils are effectively used to augment psychotherapy for a multiple of clinical presentations including anxiety, autism spectrum disorders (Aspergers syndrome), neurodiversity, ADHD, BPD, PTSD, and trauma recovery. Although the modality has more recently been found to effect profound change for people with a variety diagnoses, DBT was initially developed to directly target those psychotherapy clients who had a history of suicidal thoughts and behaviors, self-injured, and struggled with extreme difficulty in managing their emotions, many of whom have borderline personality disorder (BPD).
The central theme of DBT is that change can only happen once there is acceptance. DBT differs from other cognitive/behavioral treatments in that it:
- Focuses on acceptance and validation of the behavior
- Emphasizes treating the behaviors that interfere with therapy
- Emphasizes the therapeutic relationship
- Focuses on the dialectical process – The engagement of the client and therapist in a dialogue to promote change.
DBT is based upon the following theoretical assumptions:
- Due to biological factors and invalidating (as experienced by the individual) environments in childhood and adolescence, an inability to regulate emotional responses develops.
- The level of emotional arousal increases extremely quickly, peaks at a high level, and takes longer to return to “normal” or baseline levels. This is experienced as mood swings (hyperarousal).
- The negative behaviors demonstrated, are learned efforts at coping with intense and negative emotions, and that no other effective means of coping have been learned.