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Dialectical Behavioral Therapy
What exactly is DBT?
Dialectical Behavior Therapy (DBT) is a unique type of therapy that focuses on learning very specific skills to give you new methods for creating a life you actually want to be living. In addition to exploring your thoughts and emotions like traditional therapies, in DBT your behaviors and urges also get specific attention. In DBT, these behaviors and urges are closely tracked and monitored to really understand what is working and not working in your life on a daily basis.
DBT has been extensively researched since its creation in the late 1980’s by Marsha Linehan, PhD, ABPP. Marsha Linehan originally developed DBT to treat chronically suicidal individuals and those diagnosed with Borderline Personality Disorder (BPD). DBT it is now recognized as the gold standard psychological treatment for this population. The years of research has shown that DBT is also highly effective in treating a wide range of issues such as depression, anxiety, mood disorders, emotional management difficulties, substance misuse/abuse, post-traumatic stress disorder (PTSD), and eating disorders, among others.
What does DBT include?
Comprehensive DBT as a treatment method includes weekly individual DBT therapy sessions and weekly DBT classes. The DBT classes are where you learn new skills for your life and relationships. The individual therapy sessions are where you learn to tailor those skills to your unique life and needs. It takes 6 months to get all the way through the content in the program. And depending on the person, it may take more than 6 months in order to repeat the program for full skills absorption & application (the average according to research from the Linehan Institute is 1.3 years).
What are the DBT skills?
Mindfulness is about learning to better manage your attention. One goal with mindfulness is to focus on the present, rather than dwelling on past pain or worrying about future problems (this just makes the present even harder!). As a regular practice, mindfulness increases your ability to focus your attention...when you want to, the way you want to. Mindfulness skills will teach you to notice your thoughts and emotions and then control and regulate your thoughts and emotions. Mindfulness improves your ability to be more “present” in your daily life so that you can notice and change the things you need in order to make it the life you want to be living. Read more about mindfulness.
Emotional Regulation Skills
These DBT skills are all about understanding, managing, and responding effectively to your emotions. Emotion regulation skills will equip you to recognize and validate your own emotions as an important part of the human experience. You will learn how your emotions bring you valuable information about your own needs and the needs of others in situations and relationships. The DBT Emotion Regulation skills will offer you strategies to have less extreme mood swings and feel more in control of your emotions on a daily basis, by learning how to change and regulate your feelings.
Distress Tolerance Skills
The DBT Distress Tolerance skills will help you to endure bad, painful, and difficult situations (which are inevitable in life!) without making them worse. It's a set of strategies to help you tolerate very upsetting things long enough to survive them instead of turning to unhealthy behaviors or vices. The DBT Distress Tolerance skills offer you actionable steps to notice your extreme reactions in upsetting situations and learn how to make effective choices when under duress. You'll learn how to navigate an intense emotional reaction in an overwhelming situation without losing sight of what you really want in the long term.
Interpersonal Effectiveness Skills
These DBT skills are the relationship tools, and they are all about interacting with others in the ways you need to. You will learn to effectively manage your current relationships with improved communication. You'll also learn how to improve or keep your boundaries, assertiveness, and self-respect so you can more often get what you need in relationships and interactions. The DBT Interpersonal Effectiveness skills include how to negotiate successfully in conversations and relationships with others by asking for what you want and need, or by saying no even when it's hard. There are also some specific strategies for creating new healthy relationships and ending destructive ones.
What will DBT do for me?
DBT can help you feel more able to control your thoughts, emotions, and reactions (behaviors).
The DBT strategies enable you to understand yourself and others much more deeply. Your behaviors will start to make sense and feel more manageable. You will feel more equipped to make the changes you want in your life.
DBT can also greatly enhance your ability to communicate and interact with others in ways that work in both the short and long term.
Most participants in DBT find that by using the skills, they feel stronger & calmer and are more able to manage life's stressors without feeling overwhelmed, breaking down, or over-reacting.
I am currently full for new individual DBT clients.
The August 2022 cohort of my 8-week online DBT course is now closed and the next cohort will start in 2023.
If you want to get started on your own, the following books and websites are a great place to start:
The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance by Matthew McKay (best book when trying to learn on your own)
DBT® Skills Training Handouts and Worksheets, Second Edition by Marsha M. Linehan (best book when in therapy with a trained DBT therapist; there is a lot of content that is best when taught/explained)
r/dbtselfhelp/ - Reddit's anonymous online community dedicated to self-help for DBT with a wealth of info and resources compiled in their FAQ/wiki
Now Matters Now - free videos and resources teaching DBT skills especially helpful for suicidal thinking and intense emotions. Topics include Mindfulness, Mindfulness of Current Emotion, Distraction Techniques, Relationship topics, Problem Solving, Opposite Action and Paced-breathing.
Note that the above book links are affiliate links and if you make a purchase I may receive a small commission.