What is DBT?
/I primarily approach sessions with clients from the perspective of DBT. A session with me using DBT to inform our sessions looks like this:
- I provide you with education and information on coping skills that are specific to your needs
- I’m validating and accepting of all things that you are feeling
- I accept who are you
- I challenge you to make changes you want
- I’m dialectical in my understanding of you and try to remind you to be dialectical in your own thinking
- I’m nonjudgmental of your experiences, thinking, and behavior, and encourage you to try to be nonjudgmental as well
I further explain what some of this means below.
What Is DBT?
DBT stands for Dialectical Behavior Therapy. Dialectic means two opposites can both be true. For example, if a loved one did something that was hurtful to you, you can be angry with them, maybe even hate them, and still love them. Balancing two things helps keep us from experiencing emotions in extremes. Sometimes this is as simple as changing “OR” into “AND”. Instead of being happy OR sad, we can be happy AND sad. It’s hard to stay calm when you’re thinking in extremes, and dialectics allow us to stay balanced by noticing two truths at once.
In DBT we try to think about acceptance and change. Acceptance and change are opposites. It may seem like you can’t accept yourself while working to change yourself. Accepting who you are while making changes allows you to be compassionate with yourself about who you are and where you are right now, while giving yourself the ability and opportunity to grow. For example, you can accept that you’re unhappy and stressed with your current job AND you can take steps to change that job and make it more satisfying, or to change jobs all together. You can accept that you’re doing the best you can AND you can do better and try harder.
The way we learn to be dialectical (accept ourselves and to make the changes we want) is by using coping skills. These coping skills fall in to 4 categories:
1. Mindfulness: these skills help you focus on the present moment without worrying about the future or feeling shame or regret about the past.
Example: if Sunday evening rolls around and you struggle to enjoy the end of your weekend because you’re worried about the work week ahead, mindfulness skills can teach you to notice those thoughts and make the choice to focus on the moment you’re in right now and deal with the work week when it approaches.
2. Distress Tolerance: these skills help you learn to bear with uncomfortable or painful experiences more effectively, rather than reacting in ways that could ultimately make things worse.
Example: if you’re arguing with a family member and they say something hurtful, your automatic reaction might be to get defensive, yell, and insult them. Distress tolerance skills help you to step away from the situation, calm down, and find a way to move on that doesn’t make things worse.
3. Emotion Regulation: these skills help us to have more control over our emotions. Sometimes emotions feel uncomfortable and overwhelming. Emotion regulation skills help us to feel those painful emotions less intensely or change them altogether.
Example: if someone cuts you off in traffic, you may become overwhelmed with anger. You may even continue to think about being cut off and stew over it after you’ve completed your drive. At times the anger might be so overwhelming that you have trouble focusing on what you need to do. Emotion regulation skills will help you to move on from the event and move on from the anger.
4. Interpersonal Effectiveness: these skills help us to create new relationships, maintain relationships that are important to us, and end relationships that are destructive while maintaining our own self-respect.
Example: when you enter a new relationship, you may prioritize the needs of the other person and neglect the things that are important to you. This may work at first, but over time you become resentful because you’re working so hard to meet the needs of your partner while your needs are left unmet. Eventually, this results in a blow up or the relationship ending. Interpersonal effectiveness skills help you to balance your own needs with that of the other person so that the relationship can maintain in a healthy way.
I’ve found that many of my clients enjoy these skills because it gives them a clear guideline to follow to support them in making changes to how they react to certain thoughts, emotions, or situations that they may find unpleasant or uncomfortable. These skills combined with dialectic thinking, validation, and support from a compassionate caring therapist can help you in making the changes you want and to accept who you are.
Who benefits from DBT?
DBT was originally developed for people with Borderline Personality Disorder (BPD) and it is still the therapy of choice for people with this diagnosis. However, since DBT was created it has been found to work for many groups of people including those who struggle with intense emotions that feel out of control, impulsive or self-destructive behavior (like self-harming, gambling, excessive shopping, etc.), depression, anxiety, eating disorders, substance use, and a number of other challenges.
If you’re looking to change some of your behaviors, emotions, thinking, and relationship patterns that get in the way of living the life you want, DBT might be a good fit for you!
In addition to offering DBT, the mental health therapists at our office offer counseling for a variety of issues including trauma using EMDR, depression, anxiety, grief, and couples counseling. We work with teens, adults, and couples. We also offer online counseling services which can be great for people with busy schedules or for people who live in parts of Pennsylvania with limited counseling options. You can check out our website to see the full list of counseling services that we offer. Or, Request An Appointment here.