What is DBT?
The therapy world has a lot of acronyms that many people have a challenging time connecting with or even understanding without a background in this field, for example, DBT. DBT might be an acronym you’ve heard but are unfamiliar with exactly what it is. If so, you may be asking the question, what is DBT?
DBT stands for Dialectical Behavior Therapy, an evidence-based therapy that focuses on four main steps of treatment. DBT is proven effective in helping people develop coping skills, emotional regulations, behavior change, reduce self-harm behaviors, and even improve negative thinking patterns. Some strategies and techniques follow a four-step module process, much like building a house.
Therapy will begin with building the house's foundation, which is the goal of the process. DBT, at its core, teaches that there are always existing opposites in every statement or interpretation. A dialectical stance holds that both opposites can be simultaneously true. Such as, I understand your point, but I am allowed to disagree with you → I understand your point and I am allowed to disagree with you.
In fact, in DBT, we often describe dialectics as two opposing truths, in which many find themselves stuck. The foundation begins by pushing aside judgment and being willing to go on a journey to find a new way of living. We must learn that mindfulness is at the core of one's truth.
Mindfulness
The foundation is Core Mindfulness.
A critical benefit of DBT is the development of mindfulness skills. In DBT, core mindfulness begins with three states of mind that humans experience at various times: wise mind, logical mind, and emotional mind. A wise mind is a goal we all want to get to, which is the balance of our brains' logical and emotional sides. Once we are aware of our feelings, we must seek to understand them and act in ways that honor them. Understanding and embracing mindfulness skills help us to slow down and focus on using healthy parts of ourselves. In this way, we can find clarity and movement to the next step.
Exercise:
Wise Mind – Stay balanced between one's emotions and one's reasoning
Observe - notice your thoughts/feelings without judgment or reaction
Describe – put your experiences into words, but only the facts
Participate – throw yourself into something
Non-judgmental Stance – do not judge yourself or others
One-mindful – let go of distractions and be in the moment
Effectiveness – do what works for you
De-stress and Tolerance
Moving forward with learning to De-stress and create Tolerance
Once the mindfulness foundation is laid, the therapist will move towards building the structure of the house with external practices that help de-stress and embrace tolerance. There is no getting around it; life is stressful, and we will become reactive when we lack the skills to tolerate the pain found in the suffering of life. In many cases, we will try everything to avoid acknowledging this pain, which only prolongs our distress. Dialectical Behavioral Therapy (DBT) gives us the skills to navigate these situations. Instead of fearing and fighting uncomfortable emotions, this module will help us to identify and challenge beliefs we hold about emotions and learn to balance emotional discomfort.
Exercise:
ACCEPTS – Activities, Compassion, Comparison, Emotions, Push Away, Thoughts, and Sensory Skills.
Self-Soothe – Using your senses of sight, touch, hearing, smell, and taste.
IMPROVE the moment – Imagery, Meaning, Prayer, Relaxation, One crisis at a time, Vacation, Encouragement
Pros and Cons – Which skills are best in the situation?
Radical Acceptance – Freedom from suffering requires complete acceptance
Emotional Regulation
Moving from the external to the internal with Emotional Regulation
As we continue down the road of healing with the foundation laid and framework built, it’s time to move inward by focusing on our emotional and cognitive existence. Here, the therapist uses emotional regulation skills to help with navigating powerful feelings more effectively. The skills we learn will help us identify, name, listen to, and change our emotions. We soon learn that we are not a slave to our emotional dysregulation and can recognize and cope with them. Emotion regulation teaches healthy strategies to balance emotions and reduce emotional vulnerability by understanding and accepting the emotional experience that is part of our human design.
Exercises:
PLEASE – Physical Illness, Balanced Eating, Avoid Drugs, Balance Sleep, Exercise
Build Mastery – Do something that makes you feel reasonable and in control.
Build Positive Experiences – Do pleasant things that are possible now to build a life worth living.
Opposite Action – Try things you are afraid of, get active when down -at opposite to your emotions
Interpersonal Effectiveness
Now that the house is ready, we can start to invite people over to the house to share their experiences. Newly polished skills can now be shared with others, but this takes learning to become more assertive in a relationship (for example, expressing emotions, needs, and desires). It’s learning to set boundaries by saying "no" and advocating for ourselves while learning to keep the relationship positive and healthy. The clinician will look at current strengths and weaknesses with our past and current relationships to build healthy and satisfying relationships.
Interpersonal practical skills cannot just be taught; the clinician must help us naturally attain them through practice. As we walk away with a higher understanding of how to attend, listen and communicate more effectively, deal with complex humans, and develop a respect for ourselves.
Exercises:
GIVE - Be Gentle, Interested in others, Validate others, and Emotion Regulate
DEAR MAN – Describe, Express, Assert, Reinforce, and Mindful
FAST – Be Fair, don't over-Apologize, Stick to your values, and be Truthful
Boundary Building Skills
In summary, therapy that incorporates DBT can be incredibly effective when learning to overwrite harmful behaviors. At Arcadian Therapeutic Services, this is one of many types of counseling we provide; learn what to expect for your first session here.
