Dialectical Behavior Therapy
What is DBT?
DBT was initially developed by Dr. Marsha Linehan (1993) for the treatment of Borderline Personality Disorder. DBT is a combination of behavioral science, dialectical philosophy, and Zen practice which aims to help people build "a life worth living.
DBT has been consistently shown in clinical research studies to:
- Decrease behavior dysregulation & impulsivity
- Decrease suicide related affect and behavior
- Improve ability to regulate emotions and emotional crises
- Improve interpersonal relationships and decrease chaos in relationships
- Decrease self-destructive and self-defeating behaviors
- Reduce hospitalizations
- Decrease cognitive dysregulation and dissociation
People who benefit from DBT include those with eating disorders, depression, anxiety, PTSD, substance use, mood instability, emotion dysregulation, and relationship difficulties.
A Balance of Acceptance and Change
Dialectics
“The test of a first-rate intelligence is the ability to hold two opposed ideas in the mind at the same time and still retain the ability to function. One should, for example, be able to see that things are hopeless and yet be determined to make them otherwise.” F. Scott Fitzgerald, The Crack-Up (1936)
The term dialectics is based on the philosophical premise that all things are interrelated, two seemingly opposing truths can be true, and the only constant is change.
- There is always more than one way to see a situation, and more than one opinion or idea. And they are all valid.
- Things are not black or white, or right or wrong. Thinking dialectically means being able to see both sides in every situation, even if you disagree.
- It considers a life worth living to have both positive and negative aspects (e.g. happiness, sadness, anger and peace), and all of these aspects are necessary and valuable.
The Central Dialectic, Acceptance vs. Change
Behavioral Strategies
DBT utilizes standard behavioral techniques to induce change. Examples of such strategies include functional analyses of behavior, solution analyses, cognitive modification, and exposure techniques.
Acceptance Strategies
Acceptance strategies are used to strengthen the therapeutic alliance and keep patients in treatment. Examples of these strategies include mindfulness, validation, and self compassion.
Mindfulness Strategies
The general purpose of mindfulness is cultivating awareness of internal and external events. These techniques improve the ability to be grounded and present in the moment.
Validation Strategies
These are meant to improve relationships by communicating empathy and cultivating relational mindfulness.
