Dialectical Behavioural Therapy. If the meaning of DBT is over your head, believe me you are not alone. I definitely had no idea what 'dialectics' were before I was trained in this method which was designed for Borderline Personality Disorder (BPD) but is now applied widely to anyone seeking to manage emotions better. This approach was created by Marsha Linehan who had first-hand experience with BPD and therefore created strategies that she knew would work. So let's see if I can explain it in a way that makes sense to non-psychologists..: Dialectics means bringing together two things that seem incompatible or like opposites. In the case of Dialectical Behavioural Therapy they are specifically talking about bringing together two concepts: ACCEPT YOURSELF and CHANGE. What?!? You might ask... and that's kind of the point. To suggest that you can do two things that seem incompatible. But aren't. Accept yourself ("I'm fine just the way I am") and change ("Yet, there are things I could do better.") And there you have it: the seed of a new beginning, a middle ground wherein you don't have to reject yourself altogether in order to start making changes, thereby allowing the space to try new skills while also exploring gentleness with yourself. Much unlike some of the invalidating environments that create emotional dysregulation patterns, DBT creates space for a growth mindset, or the perspective that difficulties are opportunities for learning and expansion. Whether you have BPD or are just sensitive, this gentler approach can offer the safety in which to build confidence, make mistakes and learn by doing. Now that we've explored the name and the philosophy behind DBT, I'd like to shed a bit of light on the process of the approach itself.
What sorts of skills will you learn through DBT? DBT skills fall into four categories. Mindfulness skills are the foundation: through learning how to be present in the here and now, you bring the necessary awareness to allow yourself to notice when you need to use other skills and to choose the right skill. Without mindful awareness it is very difficult to learn or problem-solve adequately. However, mindful awareness is something that leaves many of us through our adolescent and early adult years. Rather than be aware of the present moment, we daydream, distract, worry, plan or dwell in the past. Although being able to anticipate future threats and reflect upon past experiences are incredibly useful functions of the human brain, if left untrained the mind will often do some of these things in unproductive, compulsive and detrimental ways. This looks like ruminating instead of problem-solving and dwelling in regrets or resentments instead of making amends or forgiving. So DBT teaches us methods of training the mind, bringing awareness back to the present moment and (at least for a moment) simplifying life to what is here now. In this space we can step back and collect information about what is causing us suffering (including mental and emotional processes) and become more conscious in making decisions about how to behave in each situation (think responding rather than reacting).
Another category of DBT skills is distress tolerance. It means just what it sounds like: ways to tolerate distress. How to build resilience to the difficult emotions that we all feel as human beings. These skills offer alternatives to unhealthy coping like self-harm, suicidal ideation or actions, and substance use.
The third category of DBT skills is emotional regulation. Emotional regulation is about understanding your emotions and acknowledging that even the uncomfortable ones have purpose. It is also about ways of managing emotions and making wise choices about how we want to respond to them.
Finally, DBT also covers interpersonal effectiveness. This is about dealing with people. People can be difficult... not only do you have your triggers or sore spots, but so does everyone else! Sometimes we're good at letting things go when someone pushes our buttons... but other times we're TOO good at it, letting others cross our boundaries. Sometimes we can stand up for ourselves when someone steps on our toes, but other times we can react a little too strongly, snipping at our colleagues or loved ones when they had no intention of hurting us. Interpersonal effectiveness skills provide options for dealing with people whether the objective is to get what we want, to preserve the relationship or to maintain self-respect.
So that is a little intro to what DBT is and a sneak peek into what sorts of things it helps with! If you want to do some DBT self-study, I would highly recommend this website:
If you would prefer to work on learning and applying these skills with the support of a Psychologist, please contact me. I'm happy to answer any further questions you might have about this approach or the other approaches I offer!
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