What is dialectical therapy?
Dialectical Behavioral Therapy or DBT was developed from CBT or Cognitive Behavioral Therapy. CBT helps people change their thoughts and modify their feelings. DBT does the same and addresses additional components. Marsha M. Linehan is the founder of DBT. She saw the benefits of CBT, but recognized that she had some deficits and improved them. CBT was great for identifying negative thought patterns and changing them, but it lacked a component on how to handle situations where a person’s emotions were heightened. Linehan wanted to develop a form of mental health treatment that could help people when dealing with emotional pain. This is where the origin of DBT began. City Psychological clinic in London stands #1 in providing the Dialect behavioral therapy in London.
What is DBT?
DBT helps people manage emotional distress. It gives a person a toolkit of skills to help them cope with pain. Some of the things you learn in DBT are mindfulness, tolerance for distress, and the ability to navigate relationships. It helps us in four key areas. When we talk about mindfulness, we accept our feelings in the moment and don’t try to change them. With suffering tolerance, we are able to acknowledge pain and sit with it instead of running away from it. The third area where DBT can help us is emotional regulation. Emotional regulation allows people to understand what they are feeling and ride the wave of emotions: Emotions can feel intense and overwhelming, but when people learn to ride the wave of their emotions,
Finally, DBT teaches interpersonal skills that enable us to communicate better with others. Learning these emotional skills helps us gain assertiveness, stand up for ourselves, respect others, draw boundaries, and maintain stable relationships.
How do we use DBT?
Marsha M. Linehan originally developed DBT to treat people living with borderline personality disorder (BPD). People with BPD often have a low tolerance for emotional pain and have difficulty with emotional regulation. One of the things that individuals with BPD may struggle with is black-and-white thinking, and it can be challenging to navigate relationships when you’re constantly in emotional pain and can’t see things from someone else’s point of view because you’re overwhelmed by your feelings. Marsha M. Linehan saw that they lack the coping skills needed to maintain interpersonal relationships and struggle to live with intense emotions and know how to manage them. DBT is highly effective in treating borderline personality disorder, but it is also helpful in treating other conditions such as bipolar disorder, anxiety, depression, OCD (obsessive compulsive disorder), eating disorders, substance abuse problems, and more. It is helpful for anyone who struggles to regulate their emotions or compulsions in the moment and would benefit from learning how to be more present.
When a person enters DBT, they may struggle to cope with emotional distress. Their pain tolerance could be extremely low. When people have difficulty tolerating emotional pain, they may engage in self-destructive behaviors. For example, some people who live with borderline personality disorder and have a low tolerance for emotional pain engage in self-harm or harmful behaviors to cope with this distress. If this is the case, the most urgent goal is to get the client to a place of safety. If a client is experiencing suicidal thoughts, self-harm, or engaging in other dangerous behaviors, a therapist will first help them get to a place where they are no longer at risk of harming themselves.
Emotional pain tolerance and emotional distress are often the first aspects worked on when one begins to integrate DBT when that is the immediate concern, and things like mindfulness, self-compassion, self-respect, self-awareness, and interpersonal relationships will come a little later. A DBT therapist will help a person learn how to deal with emotions and acknowledge how they feel, without necessarily trying to change it.
DBT group therapy
It is possible to learn DBT skills in individual therapy, but DBT is usually received in group settings. People in DBT groups talk about their challenges with emotional regulation and learn to manage their feelings by hearing from other group members and their experiences. Many people find it helpful to participate in group therapy in addition to seeing a therapist one-on-one. Group therapy sessions are usually led by a certified and trained DBT therapist. Group participants will learn standard DBT components such as mindfulness, emotional regulation, stress tolerance, and effective interpersonal communication skills together. Like individual therapy sessions, a group therapy session often lasts about an hour.
The core beliefs of DBT
Using dialectical thinking, we learn that there are primary and secondary emotions.
Primary emotions are the initial response we have to an event. You are triggered by something that happens to you or around you in your environment.
Secondary emotions are the feelings you have after the primary response. You have a gut reaction to an event and then you have a thought reaction afterwards. You can’t control the first reaction, but the secondary emotions you can work with and manage.
Primary emotions can be natural feelings about something that is happening. For example, when you go through a divorce, you experience sadness, pain, or anger. Secondary emotions are those over which we have more control. We may choose how we respond to these experiences. For example, you may feel angry when you get divorced and have choices about how to deal with that anger. You could call your ex mad and yell at them. You might feel good in the moment, but you’ll probably end up feeling ashamed or guilty afterwards. Another idea is to write in a journal about your anger or talk to a therapist about it. You can accept your primary emotions because they are instinctual and work on how you express secondary ones.
Differentiating between what is effective or ineffective behavior?
You may find yourself engaging in an act that doesn’t attract what you want. That causes you more harm than good. For example, making someone feel guilty for not doing something for you probably won’t help you achieve your goal. It will make you feel bad and shame the other person. This would be inefficient behavior. A useful response would be to ask the person directly for what you want.
Using a non-judgmental approach
DBT is based on a non-judgmental approach. Don’t judge yourself, and your therapist doesn’t judge you. You observe your emotions, experience, process and feel them. Don’t judge yourself for handling them a certain way. You are allowed to feel your feelings. Mindfulness is one of the principles of DBT where you can practice not being judgmental. You may notice that you feel sad because your boyfriend hasn’t called you. You start judging yourself and think, “I shouldn’t be sad. It’s only been a day since I talked to him. Instead of feeling guilty about being sad about not getting a call from your partner, allow yourself to feel sad. These feelings are real. There is no such thing as a “wrong” emotion. You are free to express yourself.
The importance of maintaining a therapeutic relationship
DBT is a unique form of mental health treatment. You learn to manage your emotions and eventually you will be able to do it yourself. Until then, you are in therapy to learn skills. Your therapist is also a DBT teacher. It shows you a skill to use when you feel intense emotions. It teaches you how to be mindfully aware of your feelings, regulate your emotions, maintain positive interpersonal relationships, and manage distress tolerance. When you learn these DBT skills, you will be able to practice them every day and use them in your life.
Why choose DBT?
DBT is not just for people living with borderline personality disorder. It was developed for people who have BPD to help with emotional regulation and maintaining interpersonal relationships, but since its creation, DBT has been used for many different types of mental health problems, including anxiety, depression, eating disorders, and many others. Almost anyone can benefit from learning DBT skills. If you want to regulate your emotions, manage distress or impulses in a more productive way, communicate better in interpersonal relationships, gain a better self-image, or manage the thoughts that come with conditions like depression or anxiety, DBT is an excellent choice for you. Whether you decide to work with a therapist in your area