Dialectical Behavior Therapy (DBT) Part 1
By Michelle Lunger
For mental health awareness month, we highlighted an organization called Break the Hold. Break the Hold has a program with an emphasis on teaching Dialectical Behavior Therapy (DBT), which “is evidence-based training for emotional regulation. DBT uses mindfulness strategies to manage emotions, increasing a person's tolerance to negative emotions.” To follow up with that blog post, we wanted to shed some light about Dialectical Behavioral Therapy.
Who created DBT?
DBT is an evidence-based treatment which was originally developed by Psychologist Dr. Marsha Linehan after her own challenges with her mental health. After being a resident at an inpatient mental health hospital, Linehan dedicated her life to finding ways for those struggling to cope with their mental health challenges. Linehan says, “I honestly didn’t realize at the time that I was dealing with myself,” she said. “But I suppose it’s true that I developed a therapy that provides the things I needed for so many years and never got.”
Who is DBT for?
DBT is especially helpful for those who struggle with intense emotional dysregulation, self-harm, suicidality, mental illness/ mental health conditions or challenges, substance abuse, addiction, and eating disorders. DBT focuses on providing skills for those struggling as a way to cope with whatever they are going through.
What are the Main Components of DBT?
There are 4 main skill areas in DBT which include mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance. Mindfulness helps us to bring our attention to the present moment- without judgment. To acknowledge, accept, and tolerate our emotions. Emotional Regulation helps us to acknowledge and understand our emotions and why we are feeling the way we are feeling. After we do this, we are able to learn how to listen to them and figure out what we need at the moment. Interpersonal Effectiveness helps us strengthen our relationships by learning how to effectively communicate to get our needs met, ask questions, how to advocate for ourselves as well as setting boundaries and more. Lastly, Distress Tolerance helps us reduce suffering by first recognizing difficulties and learning how to accept and better the moment.
What is DBT and what does it mean?
The “D” in DBT:
The “D” in DBT refers to Dialectical Thinking. Dialectical thinking refers to the ability to hold multiple perspectives at once- especially of those that are seemingly contradictory. This form of thinking creates understanding and paves the pathway towards acceptance- which DBT revolves around. To explain this in simpler terms, it is easier to give an example. If you have ever felt two emotions at once then you probably have investigated Dialectical thinking already. Have you ever felt happy and sad at the same time? Or made a decision that you knew was the best, but still felt sad about it? That is an example of dialectics. On one hand you experience one thing, on the other hand you experience another thing but both experiences are valid and true.
To add, Dialectical thinking gives you a new way of thinking and a new perspective and sometimes, even a better one. When we lack dialectical thinking, we may have “tunnel vision” or deal with black and white thinking. For me, when I am struggling with my mental health and dealing with brain fog, it can be hard for me to see the big picture. I only know and see what I experience and it makes me feel alone and isolated from the world. But at the same time, I know that I am not alone and other people are going through similar things. Sometimes it is hard to remember that, but dialectical thinking helps me remember that my experience is not isolated and that I am truly not alone. When we practice dialectical thinking, it will be easier to see things from both sides or more.
The “B” in DBT:
Lastly, DBT reflects on finding the balance between acceptance and change. You can accept your mental illness, but that doesn’t make it go away or necessarily make it any easier. You have to put in the work to make things change if that is what you want. With that, the “B” in DBT stands for behavior. To set and reach our goals we must act. To do that, DBT teaches us how to build “a life worth living” by establishing goals that are reachable and using the DBT skills to achieve them.
Stay tuned for part 2 of this blog post where I share a little bit of my story, my connection to DBT, and my favorite skills!
To learn more about DBT check out these links below:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/
https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy
https://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy
https://adaa.org/about-adaa/press-room/multimedia/what-dialectical-behavior-therapy-dbt
To learn more about Dr. Marsha Linehan check out her memoir, “Building a Life Worth Living” or her DBT skills training manual:
