What is Dialectical Behaviour Therapy (DBT)?
Perhaps one of the lesser-known therapies, dialectical behaviour therapy is a type of talking therapy which is based on cognitive behavioural therapy, also known as CBT.
However, dialectical behaviour therapy is specially adapted for people who feel very intense emotions and focuses on accepting who you are. Cognitive behavioural therapy touches on this too but focuses more on helping you to change unhelpful ways of thinking and behaving.
Mind.org explains that “Dialectical means trying to understand how two things that seem opposite could both be true. For example, accepting yourself and changing your behaviour might feel contradictory, but DBT teaches that it’s possible for you to achieve both these goals together”.
DBT was developed by Dr. Marsha Linehan and colleagues in the late 1980’s when they realised that CBT alone wasn’t as effective as they expected when tested on patients with borderline personality disorder (BPD).
So, whilst dialectical behaviour therapy was originally created to treat borderline personality disorder, it’s been adapted over the years to successfully treat other mental health conditions such as eating disorders, post-traumatic stress disorders (PTSD), depression, and substance use disorders.
Dialectical behaviour therapy teaches you essential skills to help decrease suicidal and self-injurious behaviour, in addition to improving your overall quality of life and helping you to manage your emotions.
Dialectical behaviour therapy helps to treat these disorders by helping you to understand and accept your difficult feelings, by helping you to feel comfortable enough to make positive changes in your life, and by helping you to learn skills to manage your difficult feelings in a more productive way.
What are the different Dialectical Behaviour Therapy (DBT) treatment options?
Within dialectical behaviour therapy sessions, your chosen therapist will likely use a balance of acceptance and change techniques.
Firstly, acceptance techniques are just as they sound. This method focuses on making sense of why you’re behaving the way you are with potential drug or alcohol misuse or self-harm.
This technique aims to help you understand yourself as a person and what may have started this unwanted behaviour as a way to cope with your overwhelming, intense emotions.
Another dialectical behaviour therapy technique is change techniques. Slightly different to the acceptance technique, the change method focuses on replacing behaviours that put you at risk, with behaviours that are helpful to you.
Whilst using this technique, your therapist may challenge your unhelpful thoughts or encourage you to find a different way to deal with your emotions.
By using a combination of the two primary techniques, you’re likely to achieve a more balanced and effective approach to your treatment.
Despite the fantastic results we’ve seen dialectical behaviour therapy produce, it’s not likely to be effective if you’re not committed to making a positive change in yourself.
You must be ready to focus on your present and your future, rather than dwelling on your past. It’s important that you feel ready to work hard at your therapy and are prepared to participate in group sessions.
If you’re dedicated to achieving all of the above, then you’re ready to take on dialectical behaviour therapy and make it successful for you.
How does Dialectical Behaviour Therapy work?
As DBT has evolved over the years, it’s become an evidence-based psychotherapy which is typically used in three therapeutic settings. The first setting is within a group where patients learn behavioural skills by completing assignments at home and role-playing new ways of interacting with other people.
We can appreciate that working within a group can seem very daunting to some people, however, it can be extremely useful in achieving an efficient recovery which is why we encourage this method so heavily.
Another setting is individual therapy where a therapist will help you to adapt your learned behavioural skills to your own personal challenges in life.
The third setting is phone coaching where you can call your therapist in between sessions to receive additional guidance on how to cope with a difficult situation you’re currently experiencing.
You can experience dialectical behaviour therapy within all three of these settings if they’re suitable to helping you achieve your recovery goals.
Throughout each of these settings, there are common themes and characteristics which appear across all three. The foundations of dialectical behavioural therapy are acceptance and change (referring to the techniques we mentioned earlier) where you’ll be taught to accept your circumstances and make positive changes to your behaviours.
DBT also demonstrates how to communicate effectively and work well within a team with your group or therapist.
You’ll learn new skills and how to enhance your capabilities whilst focusing on changing beliefs, behaviours, thoughts, and actions that aren’t helpful.
All of our dialectical behaviour therapy therapists encourage each of their patients to recognise their own strengths, latch on to that positivity and use them as they move forward towards recovery.
Verywellmind.com describes four main strategies which are used when delivering dialectical behaviour therapy. These are mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation.
Possibly the most important strategy used in DBT is mindfulness as this helps you to focus on the present rather than paying any attention to the past.
Practising mindfulness helps you to connect with your feelings, sensations, and thoughts which are happening in the moment. It can be very useful when focusing on applying healthy coping skills whilst trying to stay calm.
Distress tolerance helps you to prepare for your intense emotions by learning the art of distraction, self-soothing, thinking of the pros and cons of not tolerating distress, and improving the moment.
Interpersonal effectiveness teaches you how to listen and communicate more effectively by being more assertive whilst respecting yourself and others.
Finally, emotion regulation will allow you to recognise and cope with intense emotions, thus reducing your emotional vulnerability and giving you the ability to understand your moods more effectively.