What is DBT, Dialectical Behavioral Therapy?

DBT was originally designed for treating people with Borderline Personality Disorder (BPD). Now, many people enjoy the benefits of DBT. DBT is also used for people with self-harm behaviors, suicide thoughts, urges to suicide, and suicide attempts. It also helps with binge-eating, depression, suicidal teens, and older clients who get depressed again and again. The goal of the therapy is to create a “life worth living,” such as what the client wants, for example, such as finding a life partner, having children, going back to school, finding the right religion, or changing to a new career. The therapy is based on changing behavior that is based on thoughts. The balance between change and acceptance forms the fundamental dialectic. Dialectics is from a Greek word, meaning a play of ideas bringing together opposites or apparent contradictions and attempting to resolve them to give rise to a truth. Dialectics is about the reconciliation of opposites in an ongoing process of synthesis. For example, what is a thought versus reality in the here and now? It’s about thoughts coming together in balance. The process flows from the balancing of Zen (Eastern) practice with psychological (Western) practice. It blends validation of thoughts into the patient’s wisdom to create the behavior.DBT is an “empirically-supported treatment,” which means it has been researched in clinical trials as a valid therapy method. From a practical perspective, the therapy involves individual therapy one time per week and a weekly DBT skills group. The skills group is 1 ½ hours long. The group members learn mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance. The individual therapist coordinated treatment with the facilitators of the DBT skills group, to keep track of how the treatment is going to help the client reach desired goals.From an intellectual perspective, there are major things to learn, thought DBT involves much more. Those with self-destructive behaviors, and those with learned coping techniques for intense and negative emotions, such as guilt, shame, sadness, fear, and anger, feel the emotions much more intensely than others may. For some, like those with major depression or Generalized Anxiety Disorder (GAD), the medications are not doing what is needed, so the client feels deep emotional suffering.The self-destructive behavior and learned coping techniques can lead to emotional vulnerability. Life can feel unpredictable and all over the place when emotions are intense, quick, and difficult to control. And, those with an invalidating environment, in other words, other people are not treating the person with respect, attention, and understanding, can feel emotional vulnerability.The therapy moves through stages: First, the client moves from being out of control of one’s behavior to being in control. Second, the client moves from being emotionally shut down to experiencing emotions fully. Third, the client builds and ordinary life, solving ordinary life problems. Fourth, the client moves from incompleteness to completeness and connection.