Dialectical Behavior Therapy (DBT) developed by Marsha Linehan, PhD is a mindfulness-based version of Cognitive Behavior Therapy to improve mood management, interpersonal relationships, and overall quality of life. It is a multi-prong approach utilizing specific skills training along with psychotherapy and has been proven to reduce destructive behaviors and thinking. The skills we focus on are Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness.
A DBT therapist brings a non-judgmental approach while promoting a solution-focused mindset. The mindfulness foundation allows both client and provider to stay present in the moment to navigate the thoughts and feelings that may be causing trouble. Noticing where our thoughts go and the relationship between thoughts and feelings is why mindfulness is so important. We realize that we can begin to control how much attention and energy we give to certain thoughts. And that certain trains of thought get us more worked up emotionally. Not to say that our concerns and feelings are not valid though!
In fact, validation is a key skill in DBT. It is crucial to know that your thoughts, feelings and urges are interwoven and are completely understandable given the circumstances at hand. However, that does not mean that acting on our urges or building up a head of steam about something is in our best interest. What we want to learn to say to ourselves is “of course you feel that way and want to do _______, but what is in your best interest to do”. Spoiler alert… it is often not what we feel like doing. Though what you feel like doing is very understandable.
The Distress Tolerance and Emotion Regulation skills help us understand our feelings but also ride them out without acting impulsively. When emotional intensity is less, we are better able to make wise choices on how or whether to address the situation that led to the emotion. The limbic system or “emotional mind” thinking is quieter so the frontal lobe or “wise mind” has more control of next steps. Your DBT therapist and mindfulness practice will help you notice the difference between thoughts, facts, feelings and urges. When you can tell the difference, you will have more control of what you choose to think, feel, do, or say.
Interpersonal Effectiveness Skills are designed to help us ask for what we want and say no to what we don’t want. The ability to navigate our relationships, to stay balanced, manage boundaries and our energy is a form of self-care. We have our own back but we also know how to look after the personal and professional relationships in our life.
Balance in the use of our time, energy and resources is an essential part of emotion management. If we are overwhelmed, resentful, or lonely, it is hard to find that “wise mind” we are looking for. Also if our efforts to negotiate result in fights, estrangement or other unwanted outcomes, then it is a key indicator that emotions have ruled over the interaction. When we politely, skillfully ask for what we want or say no means we will more likely have a desired outcome. Similarly, we also will improve our reactions when someone asks of us or says no to us. Emotion management along with these communication skills, leads to better outcomes interpersonally.
DBT as a therapeutic modality can help you achieve that calm and confident demeanor that many are looking for. As you learn more about yourself, with a compassionate mindset, you can accept yourself lovingly while still pursuing change. That is the dialectic of DBT. We can fully accept our emotions and urges and even past negative behaviors, while aiming to improve our reactions, resilience and future behaviors. Knowing yourself is like having a map, you know your limits and strengths and can navigate them to reach the destination. Reach your goals and enjoy the ride, maybe DBT is part of your journey.