What is Dialectical Behavioral Therapy and How Can It Help?

Dialectical behavior therapy (DBT) is an increasingly popular form of therapy that is being used to treat people with a variety and struggles and diagnoses. But what exactly is DBT and how does it differ from other treatments?

What is DBT?

DBT is a cognitive-behavioral treatment approach that focuses on the psychosocial aspects of therapy for people with self-harm behaviors such as cutting, substance abuse, suicidal thoughts and suicide attempts. The unique aspect of DBT comes from the “dialectical” aspect as DBT brings together two opposites in therapy: acceptance and change.

DBT helps a person identify their strengths and builds on them so that they can feel better about his or her self and their life. It also helps them to identify thoughts, beliefs and assumptions that make life harder so that they can learn different ways of thinking.

Components of DBT

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There are four set of behavioral skills that are taught in DBT: mindfulness (the practice of being fully aware and present in the moment), distress tolerance (feeling negative emotions such as stress without reacting impulsively), interpersonal effectiveness (navigating conflict and interacting assertively) and emotion regulation (recognizing, labeling and adjusting emotions).

These skills are learned through the four stages of DBT. Stage I focuses on moving from being out of control of one’s behavior to being in control; Stage II focuses on moving from being emotionally shut down to experiencing emotions fully; Stage III focuses on building an ordinary life and solving ordinary problems; and Stage IV focuses on moving from incompleteness to completeness and connection.

The Evolution of DBT

DBT was originally developed in the late 1980’s by psychologist Marsha M. Linehan to help better treat patients with borderline personality disorder (BPD). People who are diagnosed with BPD often experience extreme emotional swings and many feel as though they are unable to cope with their sudden, intense surges of emotion. Dr. Linehan used to treat people with BPD with cognitive-behavior therapy (CBT) treatments, but found that CBT was not very effective at helping people with BPD.

People with BPD often reacted negatively to CBT because they felt that there was too much focus on change. As a result, Dr. Linehan created DBT to couple the focus on change with a focus on acceptance and found that this was much more helpful in treating people with BPD. Since it’s inception, DBT has evolved into a treatment that can be used to help people with multiple different disorders.

Is DBT Effective?

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As a comprehensive treatment, DBT helps people who are struggling with self-destructive behavior by increasing one’s motivation to change by providing positive reinforcement and  teaching new coping skills that generalize to one’s everyday environment. Research has found that DBT is effective in reducing suicidal behavior, self-injury, psychiatric hospitalization, treatment dropout, substance abuse, anger and depression while also improving social and global functioning.

Many people who have not responded well to therapy and treatment find that DBT helps them work through their problems so they can get their lives back on track. Ask your doctor for a referral to a therapist who practices DBT if you think that this treatment may be helpful for you.

Feature Image: Daniel Bowman