Getting to Know DBT
Dialectical Behavior Therapy, also known as DBT, is a subtype of Cognitive Behavioral Therapy, or CBT. This type of therapy helps individuals find more effective ways to regulate their emotions and the actions that these emotions inspire.
DBT has some core goals, seeking to increase the following in patients:
- Emotional Regulation
- Interpersonal Effectiveness
- Stress Tolerance
DBT is always customized to fit a patient’s needs. Some patients may be strong at mindfulness, for example, but need support in the other three categories. Yet other patients may need some help working on all four. The end goal is to tailor to program to the patient.
Philosophy and Dialectical Behavior Therapy
Dr. Marsha Linehan was one of the first pioneers in the field of DBT. She began developing this approach based on her observation that traditional CBT had less success with borderline patients. DBT was created specifically, as a result, to help patients with borderline personality disorder.
The doctor and her team centered their new therapy in the world of dialectics. Dialectics is a type of philosophy focused on the inevitability of change and interconnectedness of everything. It also asserts that truth often exists in between two diametrically opposed ideas. Given these core ideas, DBT developed as a way to loving yourself just the way you are and learning to change.
Types of Dialectical Behavior Therapy
Therapists typically work with DBT patients in three different settings. These separate types of DBT allow the patient to have a more holistic experience with healing.
The first type of DBT is working with the therapist in an individual therapy setting. Second, the individual will work in-group with others. These group sessions function as classroom environments and center on the teaching of specific techniques, unlike traditional group therapy. The patients can then learn to integrate these techniques by roleplaying them in the classroom with the other patients.
Finally, patients also have the opportunity to engage with their therapists via phone consultation. Any time a patient feels stress levels rising or feels triggered, he or she can contact and consult with a therapist in the moment.
Disorders Treated by Dialectical Behavior Therapy
While it began as a treatment for BPD, DBT now helps patients with a wide range of disorders. DBT works best for those with self-destructive tendencies, generally speaking. The following are some of the mental health issues helped by DBT.
Borderline Personality Disorder
DBT was revelatory for many with BPD, as the disorder had been viewed as untreatable by many mental health professionals previously. Today, DBT is the go-to treatment for many patients dealing with borderline personality disorder. By some estimates, almost 80 percent of BPD patients treated with DBT experienced so much improvement that they no longer qualified for a diagnosis of the disorder.
Since DBT is helpful with destructive behaviors, it is often beneficial for those with eating disorders. Therapists have learned to adapt DBT techniques so that they work for these patients specifically. A whopping 89 percent of women with one form of eating disorder, binge eating disorders, stopped engaging in harmful binging behaviors after DBT.
Substance Abuse and Other Addictions
DBT also can benefit those with substance abuse issues and other addictions, as well as patients with impulse control disorder. This can be a life saver for some patients. DBT therapists treating substance abuse use dialectical precepts to teach abstinence from substances to patients.
Accepting the trauma that occurred is one of the most difficult things for patients with PTSD. Using the dialectical techniques of DBT, therapists teach these individuals to give themselves the space they need to accept the past and themselves. DBT also aids in reducing flashbacks and regulating emotions.
DBT – Helping with Complexity
DBT often serves as an answer for patients with complex illnesses who have tried other therapies to little success. Therapy or medication, too, might only help a patient with one issue when they have co-existing conditions. DBT can offer a holistic way to address these complex issues.
For Patients Who Tried Everything
Patients often become emotionally exhausted when they try therapies without seeing positive results. This can leave them feeling as if there is no hope by the time they come to our clinic. Patients such as these may find that the holistic approach of DBT and its adaptable techniques help them in ways other therapies have not.
Those with Multiple Disorders
DBt is particularly effective at treating patients with two or more mental health disorders. This is because DBT’s adaptability allows it to treat the root problem that may be driving these multiple disorders. As an example, a patient with BPD and alcoholism may have poor emotional regulation at the core of both disorders. DBT can help this person address the interpersonal deficits their poor emotional regulation causes via BPD as well as their drinking, which they may engage in to numb their faulty emotional regulation.
For Those Who Have Lost Hope
Many who deal with mental illness may be worn out or have low self esteem. Going into treatment seems to these patients like something they don’t “deserve.” The symptoms of their disorders themselves can even stop them from seeking treatment.
DBT serves as a very viable choice for patients dealing with these issues. As a structured intervention, it provides patients who are hesitant with a clear road to healing. DBT also provides tools immediately, so that patients can feel as if they are finding some success early on in the process.
Preparing for DBT
Going to a DBT session for the first time can make some patients anxious. After all, it is a new and unknown experience. DBT also takes dedication and a good deal of work on the part of the patient. Understanding what DBT involves can help prepare a patient before their first session.
Keeping an Open Mind
Anyone can be skeptical about something new; patients coming to DBT also may have experienced disappointments with therapy in the past. Anyone feeling doubts about DBT should remember that it is a proven modality with scientific research backing it up. It has also given countless patients positive results. Understanding this and keeping an open mind about the process can help ensure that patients start off on the right foot.
Have Questions Ready
Even though you want to go in with an open mind, you can still ask questions. Prepare any questions you may have for your therapist in advance of your first meeting. They can help you get clarity on DBT and tell you what will happen down the road or how you can manage certain things that might come up.
Questions to consider asking include:
- How many sessions will I need a month?
- What can I expect in group?
- If I need to call you in an emergency, what number do I call?
Finally, try to be yourself in your meetings with your therapist. DBT is most effective when you are honest and when your therapist can get to know you and your thinking well.
Being transparent in therapy can be difficult. After all, your therapist may need to ask some probing questions. If you were to answer those types of questions in a social setting, you might be afraid of those around you passing judgment on you. Keep in mind that your therapist is there to help, not to judge. Your therapist is a professional, whose goal it is to help you deal with symptoms of a disorder. He or she will understand that your symptoms are just that, and that they do not define who you are.