This was developed by Dr. Marsha Linehan and it's a modification of the traditional Cognitive Behavioral therapy. I will define both
- a type of psychotherapy in which negative patterns of thought about the self and the world are challenged in order to alter unwanted behavior patterns or treat mood disorders such as depression.
In standard DBT, different types of psychosocial therapies (e.g., individual psychotherapy, group skills training and even phone consultations) may be used as part of treatment. DBT differs from traditional CBT in its emphasis on validation—a powerful tool whereby the therapist and the patient work on “accepting” uncomfortable thoughts, feelings and behaviors rather than struggling with them. Once an identified thought, emotion or behavior has been validated, the process of change no longer appears impossible, and the goals of gradual transformation become reality. The term dialectics refers to the therapist’s goal of establishing a balance between acceptance and change and effectively integrating these two fundamental principles of successful therapy. DBT also focuses on the development of coping skills—specific behavioral techniques used to combat the disabling symptoms of mental illness.
1) This is a validation based system. If you read this blog you can see how important that is to someone struggling with Reality, low self esteem. This is completely opposite of cognitive in the fact it sorta says ok how we got here isn't as important as what we do with it. Validation is huge...for any of us but specifically those with more serious personality disorders.
2) As part of the skills-based element of DBT, emphasis is often placed on the development of mindfulness practice and other relaxation techniques. Mindfulness has its roots in Eastern meditation practices (e.g., yoga) and teaches individuals to become increasingly conscious of their thoughts and feelings through observation of bodily sensations. Through this practice, an individual develops the ability to accept distressing thoughts without self-criticism and to tolerate self-destructive urges (e.g., the desire to cut oneself) without acting upon them. Deep breathing and progressive muscle relaxation are examples of specific mindfulness techniques. People in DBT will frequently be asked to use their “wise mind” to help them make better choices
As you can see with #2 this is a very practical based attack. To me its like applying medicine on an illness versus studying it only. In a month my therapist has given me several homework assignments (I am 100% in thinking about them...only 50% in doing them lol) and my favorite so far as been the senses. We wrote down 4-5 things associated with each sense that give me joy or comfort. Like under smell I listed
Fresh rain, the fall, scented candles and bacon (Sorry I did though lol) So the goal is when I begin to feel the intensity of feelings I try to step back and focus on one of those things that bring me comfort. Meditation and other techniques are used or brushed up on at least. We have practiced breathing exercises which I have used in the past. The hardest part is catching yourself before a self destructive behavior wins. This is hard, for me anyway. When it's at it's worst....everything I have learned goes out the window (It feels)
What can DBT accomplish?
As a comprehensive treatment, DBT can:
- Decrease the frequency and severity of self-destructive behaviors.
- Increase the motivation to change by providing positive reinforcement.
- Teach new “coping skills” that generalize to a person’s natural environment.
- Provide a treatment environment that emphasizes the strengths of both individuals and their treatments.
- Enhance the therapist's motivation and ability to treat their clients effectively.
I want to make sure I am not disparaging Cognitive therapy. First DBT uses much of it and more importantly its a success with many. And as my therapist said we will go back and look at my past but initially I need training in how to deal with the corresponding feelings and emotions that arise. That made sense to me.
I guess I don't understand why DBT isn't applied to other disorders. It's both logical and can be individually tailored to a person, again reinforcing our feeling of validation.
Dr. Marsha- You rock! Now if we can get people to understand we need to talk everyday about this to get better as a country.