DBT Therapy: Acceptance and Change

Everybody goes through challenges in their lives. Many of these challenges can bring highs and lows creating mental stress that affects the entire body. There are a variety of ways to deal with this stress including talk-therapy, medicine, and meditation. However, sometimes these treatments can fall short of those struggling outside the “normal” spectrum of mental and mood disorders. This outside realm is a deeper level of struggle which may require a more detailed, structured, focused therapeutic approach. This is what DBT was developed for. 

DBT stands for Dialectical Behavioral Therapy and it is an all-natural direction certain patients can take to heal themselves from the challenge of various mood disorders. This therapy has shown to be significantly helpful in treating challenges that have otherwise been minimally responsive to other approaches. 

Tough to Treat

DBT was originally developed for tough-to-treat conditions. These are high risk behaviors with dire circumstances which particularly revolve around borderline personality disorders (BPD) and suicidal tendencies. However, since DBT has been used for these challenges, it has branched out to be applied to other instabilities associated with:

• Moods
• Behavior
• Self-Image
• Negative Thinking
• Relationships

Also treated by DBT can involve people with impulse behavior such as risky sex, substance abuse, and repeated bad life decisions that has shown to lead to homelessness and legal troubles. 

The DBT Recipe

Dialectical is the first word in DBT and it stands for: “concerned with or acting through opposing forces; relating to the logical discussion of ideas and opinions”.

Overall, undergoing DBT therapy is all about balancing opposites. Psychology Today explains the process:

“The therapist consistently works with the individual to find ways to hold two seemingly opposite perspectives at once, promoting balance and avoiding black and white—the all-or-nothing styles of thinking. In service of this balance, DBT promotes a both-and rather than an either-or outlook. The dialectic at the heart of DBT is acceptance and change.”

The DBT recipe requires a determination of symptoms before it can be applied. WebMD describes the most common presentation of cognitive challenges and a multistage DBT approach on how to treat them:

• Distress tolerance – Feeling intense emotions like anger without reacting impulsively or using self-injury or substance abuse to dampen distress
• Emotion regulation – Recognizing, labeling, and adjusting emotions
• Mindfulness- Becoming more aware of self and others and attentive to the present moment
• Interpersonal effectiveness – Navigating conflict and interacting assertively

Multistage approach:

Stage 1: Treats the most self-destructive behavior, such as suicide attempts or self-injury

Stage 2: Begins to address quality-of-life skills, such as emotional regulation, distress tolerance, and interpersonal effectiveness

Stage 3: Focuses on improved relationships and self-esteem

Stage 4: Promotes more joy and relationship connection

Reversing Negative Thinking Patterns

Although BPD is a valid, clinical affliction there are triggers that can exacerbate symptoms. Being surrounded by negativity and absorbing more than others might normally pay attention to (such as a chronic news diet) can certainly be a factor in succumbing to cognitive decline. BPD can be stimulated by negative thinking patterns and DBT may be able to help. 

WebMD reports on the four parts of DBT and how it focuses on “acceptance of a patient’s experience as a way for therapists to reassure them — and balance the work needed to change negative behaviors” These four parts are:

• Individual therapy
• Group skills training
• Phone coaching, if needed for crises between sessions
• Consultation group for health care providers to stay motivated and discuss patient care

This protocol has shown significant success, particularly for the more serious cases which have reported improvement with:

• Less frequent and less severe suicidal behavior
• Shorter hospitalizations
• Less anger
• Less likely to drop out of treatment
• Improved social functioning

As DBT is a very unique and somewhat new therapy (developed in the 1980’s by Dr. Marsha Linehan) it is required for practitioners to apply it to themselves. This involves basic behavior therapy and DBT strategic treatments. It is important to seek a professional that is affiliated with The Linehan Board of Certification which developed a criteria for practitioners to follow so a valid certification is attained. This is extremely important as DBT deals with deep, personal challenges that need professional guidance. 

Sources:

https://www.webmd.com/mental-health/dialectical-behavioral-therapy

https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy