What is DBT?
Dialectical Behavioral Therapy (DBT) is a therapeutic approach that combines elements of Cognitive Behavioral Therapy (CBT) with concepts from Eastern philosophy, such as dialectics and mindfulness. While CBT places a strong emphasis on facilitating change, DBT not only fosters change by modifying thoughts, emotions, and behaviors, but also enables individuals to accept the aspects of life that cannot be altered.
DBT focuses on helping individuals develop skills to regulate their emotions, tolerate distress, improve interpersonal effectiveness, and cultivate mindfulness. It aims to strike a balance between acceptance and change by teaching individuals to accept their current situation while also working towards making positive changes in their lives. DBT often involves individual therapy sessions and skills training groups, where individuals learn and practice specific coping skills.
History of Dialectical Behavioral Therapy
DBT was initially developed by psychologist Dr. Marsha M. Linehan to help individuals struggling with borderline personality disorder (BPD) manage intense emotions and improve interpersonal relationships. However, due to the effectiveness of DBT, its application has expanded far beyond BPD.
Today, DBT is widely used and has been scientifically proven to help with...
1. Mood disorders: DBT has been found beneficial in treating depression, bipolar disorder, and other mood disorders. The skills taught in DBT, such as emotion regulation and distress tolerance, can help individuals manage their emotions more effectively and reduce the severity and frequency of mood swings.
2. Anxiety disorders: DBT can be effective in managing anxiety disorders by teaching individuals skills to tolerate distress, regulate their emotions, and challenge anxious thoughts. It helps individuals develop a greater sense of control over their anxiety and improve their overall well-being.
3. Substance use disorders: DBT has been adapted for use in treating substance use disorders. By integrating strategies from DBT with substance use disorder treatment, individuals can learn coping skills to manage cravings, regulate their emotions without relying on substances, and develop alternative, healthier behaviors.
4. Eating disorders: DBT has shown promise in the treatment of eating disorders, such as bulimia nervosa and binge eating disorder. It helps individuals address emotional triggers, develop healthier relationships with food and their bodies, and enhance self-acceptance.
5. Trauma-related disorders: DBT can be used as part of a comprehensive treatment approach for individuals with post-traumatic stress disorder (PTSD) or complex trauma. By combining DBT with trauma-focused therapies, individuals can learn skills to manage the distressing effects of trauma, regulate emotions, and improve their overall functioning.
The versatility of DBT lies in its comprehensive framework, which integrates components of mindfulness, acceptance, behavior change, and skills training. By addressing emotional dysregulation, interpersonal difficulties, and self-destructive behaviors, DBT has proven valuable in helping individuals with various mental health conditions lead more fulfilling lives.
DBT's Four Modules
DBT consists of four key modules. These modules serve as the foundation of DBT and provide individuals with essential, practical skills to improve their overall well-being.
The modules are typically taught in a structured and systematic manner during DBT Skills Group therapy programs and individual psychotherapy sessions. Each module is designed to complement the others, creating a comprehensive approach to help individuals manage their emotions, improve relationships, and cope with distressing situations more effectively.
Here are the four modules of DBT:
Mindfulness:
Have you ever felt like life is whizzing away?… It's not uncommon to feel caught up in the whirlwind of responsibilities, changes, and the passage of time. Children grow up, friends move away, we are getting older; it is so easy to be focused on distractions, the past, or the future, that we actually miss many positive things in our life. The core mindfulness skills help us to increase control over our minds by increasing our ability to focus our attention, improve our ability to detach from thoughts, and decrease impulsivity. They teach us how to observe and experience reality as it is, to be less judgmental, and to live in the moment with effectiveness.
Mindfulness is a foundational module in DBT that emphasizes the practice of being fully present in the current moment. It involves observing and describing experiences, both internally and externally, without getting caught up in judgments or attempts to change them. Mindfulness skills help individuals develop awareness, increase their ability to tolerate distressing emotions, and engage in effective decision-making.
Distress Tolerance:
This module focuses on helping individuals build skills to tolerate distressing situations without resorting to self-destructive or impulsive behaviors. Distress tolerance skills teach us to tolerate painful emotions and urges, and survive overwhelming situations without making matters worse. They also teach us to reduce suffering by accepting and fully living life.
Distress tolerance skills include self-soothing techniques, distraction strategies, improving the moment, and radical acceptance. By learning to tolerate distress without engaging in harmful behaviors, individuals can gradually reduce impulsive reactions and make more balanced choices.
Emotion Regulation:
Emotion regulation skills are a valuable tool for individuals to effectively manage and modulate their emotions. While complete emotional control may not be attainable, emotion regulation empowers us to enhance our ability to navigate and manage our emotional experiences.
By developing these skills, we gain a deeper understanding of our emotions, learn to identify and label them, and reduce the intensity of painful or unwanted emotions. Moreover, emotion regulation helps to decrease our inherent vulnerability to becoming extremely emotional. This module specifically addresses challenges related to emotional experiences, emotional dysregulation, and difficulties in regulating emotions in a healthy manner.
Through the practice of emotion regulation skills, we not only cultivate a greater sense of emotional stability but also increase our capacity for positive emotional experiences. These skills encompass various aspects, such as recognizing the functions of emotions, reducing emotional vulnerability, and fostering positive emotional well-being.
Interpersonal Effectiveness:
The interpersonal effectiveness module focuses on improving and maintaining healthy relationships while improving and maintaining self-respect. It addresses challenges such as difficulty asserting one's needs, maintaining boundaries, and resolving conflicts effectively. Interpersonal effectiveness skills include effective communication, assertiveness training, setting and respecting boundaries, and problem-solving in relationships.