What is Dialectical Behavior Therapy?
Dialectical behavior therapy (DBT) is a very effective type of psychotherapy that grew out of the field of cognitive behavioral therapy (CBT). DBT expands on the strengths of CBT by incorporating methods and practices from mindfulness meditation.
The word dialectical refers to the concept of synthesizing opposites. As the name implies, DBT works with softening extremes, achieving balance, and finding middle paths between seemingly opposing polarities in the psyche.
DBT is centered primarily around teaching self-regulation and relationship skills to people who need extra help modulating the intensity of their inner experiences. DBT is one of the best modalities available for helping those among us who struggle the most with strong, difficult emotions and self-destructive urges, to learn emotion regulation and the ability to tolerate distress.
DBT has been shown to be effective helping people who suffer from self-harm, addiction, sexual abuse trauma, depression, suicidality, and more. DBT is also the first therapy that has been abundantly proven clinically to help in the treatment of people diagnosed with borderline personality disorder.
DBT is usually delivered in individual sessions combined with participating in a skills training group. The course of DBT treatment is a process in which psychotherapist and client work to practice self-centering mindsets and techniques of acceptance, mindful body awareness, and positive relationship skills.
Through developing a state of inner balance to be the background for the extremes of one’s experience, DBT helps people interrupt destructive patterns through increasing awareness of the connection between triggers, reactive emotions, and counterproductive behavior.
In DBT people learn about, practice, and master several core competencies: 1. mindfulness, 2. acceptance and change, 3. distress tolerance, 4. emotion regulation, and 5. interpersonal effectiveness.
Mindfulness is considered a foundational skill, because it makes it possible to accept and tolerate otherwise strong emotions that come up when we try to change habits, when we are exposed to trauma triggers, and when we are in challenging life situations. Mindfulness includes the ability to pay attention to the present moment, to refrain from labeling and judging one’s experience, experiencing emotions as sensations in the body, and applying wisdom.
There are six mindfulness skills taught DBT, designed to help us experience the state of “wise mind” (wise mind being a unity of both heart and brain). The six skills are divided into two categories, what skills and how skills. The what skills learned in DBT are observe, describe, and participate. The how skills are non-judgmentally, one-mindfully, and effectively.
The benefits of Dialectical Behavior Therapy
Dialectical behavior therapy (DBT) is exceedingly effective at reducing episodes of destructive behavior that bring harm to self and others. DBT shows positive results when it comes to reducing suicidal gestures, binge-eating and other food disorders, substance addiction and relapse, cutting, and emotional volatility. DBT benefits anyone exhibiting these types of behaviors and is one of the most effective methodologies for learning how to cope with the strong negative emotions and self-destructive urges that can make life after trauma so difficult.
DBT also has long-lasting benefits after treatment is complete. Beneficial outcomes of participation in a course of DBT treatment include significant improvements in the following areas:
- Ability to tolerate negative feelings in the moment of having them, through applying methods for improving the moment, soothing one’s upset state, and practicing radical acceptance
- Better decision making, through learning how to neutrally assess whether and how to take action, rather than responding only on the basis of strong negative feelings, intensity, and desperation to change one’s state
- Emotional regulation, through learning how to identify emotions, reduce vulnerability to negative emotions, increase positive emotional experiences in one’s life, and take positive actions
- Relationship skills, including self-respect, assertiveness, and treating others with care
- Improved self-esteem, self-love, and self-compassion
- Reduction of negative emotions like anger and shame
- More effective behavior in life
- Coping skills that can be used in times of significant stress or crisis
- Improved quality of life over all, through better internal experiences and relationships with people
- Learning to accept change graciously
- Better outlook on life and positive mindset
- Effective communication
- Positive experiences in life that validate the changes one has been making
How does DBT help women during Addiction Recovery
Dialectical behavior therapy (DBT) works hand in hand with substance abuse treatment to support women during addiction recovery. As is always the case when treating mental health topics or trauma alongside addiction, it’s important to stabilize and to be sober for the course of treatment, or else addiction interferes with DBT’s effectiveness. That said, engagement in DBT will support sobriety, as the skillsets taught in DBT are very helpful for maintaining sobriety, as well.
DBT in combination with substance abuse treatment helps decrease the physical discomfort associated with withdrawal symptoms and reduces cravings, impulsiveness, urges, and temptations to use.
The core mindfulness practices coached in DBT help women identify and avoid triggers that lead to substance use. DBT skills also help support goals of substance abuse treatment through reducing the severity of emotional distress and improving the ability to tolerate extreme experiences without being triggered to self-destructive action as a way of seeking relief.
Finally, DBT helps women to create, communicate, and enforce boundaries that are required for maintaining abstinence after leaving the treatment setting. Improved relationship skills are an enormous help in contexts where family, community, love and work life challenges are encountered.
In general, DBT supports the ability to choose to take positive actions and experience the ability to change. Even after completing treatment, DBT can be an ongoing resource for learning how to live life comfortably enough without substances, even in the face of strong emotions and life challenges, as well as past self-destructive tendencies or impulsive or damaging behaviors.
Villa Kali Ma offers Dialectical Behavior Therapy (DBT) as a part of our treatment programs, because of its effectiveness and our strong belief in mindfulness as a safe, secure path to holistic wellbeing.
When to Seek Help
If you are worried about suicide, please err on the side of caution and seek help immediately. If you are in a current crisis, you can speak with someone at the National Suicide Prevention Lifeline at any hour by calling 1 – 800 – 273 – 8255 (1-800-273-TALK). You can also go to an emergency room or call 911.
Outside of an immediate crisis, it is still critically important to seek professional help whenever destructive behavior is at play, as in the case of suicide attempts, cutting, eating disorders, self-harm, and substance abuse. While these gestures are ways of communicating pain, they are also dangerous and damaging. Ideally they are treated seriously and addressed right away.
Dialectical Behavior Therapy (DBT) is an evidence-based practice known to be effective in providing help for people suffering in the above ways. DBT is generally very highly recommended for those who have a hard time managing and modulating their emotions, so if you or your loved one are given to strong, distressing feelings and outbursts, such as severe anger and/or desperation, or problematic, dramatic impulsive behavior, DBT can be very helpful to make living in your skin more doable.
Finally, if you or your loved one suffer from any of the following conditions, DBT is likely going to be very helpful for you:
- Borderline personality disorder (BPD)
- Post-traumatic stress disorder (PTSD)
- Survivor of sexual abuse or another form of significant childhood trauma
- Self-harm, including cutting
- Suicidal behavior
- Substance abuse
- Eating disorders, especially bulimia
- Serious Depression and/or Anxiety
If you have questions about DBT Therapy offered as a part of our holistic addictions treatment program for women at Villa Kali Ma, a member of our admissions team will be happy to discuss the topic with you, so don’t hesitate to reach out to us. 1 – 760 – 814 – 8214
Dialectical Behavior Therapy options
Dialectical Behavior Therapy (DBT) is typically facilitated by a therapist, counselor, psychiatrist, psychologist, or social worker.
Choosing a DBT therapist can take some time but is well worth the extra effort to make sure you feel the person is right for you personally. To find a DBT therapist, search for practitioners in your local area or in your state’s psychological association. Some practitioners work online.
DBT may involve a pre-assessment, individual therapy, skills training groups, and crisis coaching over telephone.
You can expect a therapist who specializes in DBT to validate your feelings, help you accept yourself and your challenges, and to support you to change your self-destructive behaviors into positive ones. Your therapist will also actively coach you on how to apply skills that will help you improve your emotional world.
Individual DBT therapy is delivered in weekly sessions. These weekly sessions might be dedicated to the following goals:
- Keep you safe from any self-harming, destructive or suicidal behaviors
- Introduce you to new coping skills that effectively replace harmful behaviors
- Help you practice mindsets that create balance and peace internally
Group DBT skills training is delivered in a classroom-like setting, where you can learn about the core DBT skills together with other people. In DBT Skills Training Groups you will practice skills that relate to mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. All of these skills help you live life more easily.
Finally, it’s important to know that your intense emotions and your destructive behaviors are normal reactions, understandable given what you experience inside your skin and they are not your fault. You did not consciously choose to be harmed or damaged.
It is your responsibility to learn to heal them, for the simple reason that only you will be able to make the needed changes to have a different experience. So fair or not it’s an inside job, but know this: recovering is absolutely possible with support. Many have done so before you, and you can do it, too.