Dialectical Behavioral Therapy

Written by Andrea Harrelson and Amanda Wilkes, LPC

DBT (Dialectical Behavioral Therapy) is yet another acronym in the psychotherapy field with enormous meaning behind it as well as enormous potential for change! It is like a ‘how-to manual’ for regulating emotions and improving communication and relationship skills. 

DBT is a specific type of cognitive behavioral therapy for those who deal with very intense emotions and the subsequent stress and relationship issues they can cause. 

Let’s start with the word dialectical, which is also known as ‘both/and thinking.’ Ancient Greek philosophers coined the term dialectical as an approach to debates among themselves. It refers to the ability to see and accept both sides of a situation as valid, in pursuit of the truth. To take a neutral stance on a subject in hopes of seeing it more fully and objectively. This allowed them to remain open and curious. 

As humans, this is NOT our natural tendency. We like to pick sides. For instance, is the glass half full or half empty? Honestly, the glass is both half full and half empty. We often label things as good or bad, hero or villain, healthy or unhealthy when in reality, there are positives and negatives to everything. Life is full of nuances. 

Dialectical thinking highlights that two seemingly opposite ideas can both be true at the same time. Replacing the word ‘but’ with the word ‘and’ is a simple yet very powerful tool in shifting to a more balanced perspective. For instance, with the example of the glass that is both half full and half empty, being able to see both of those truths together, gets us closer to realizing that the glass is also refillable.

People who experience very intense emotions often think in polarized, black and white terms. Basically, they struggle to see situations clearly, which leads to feelings of overwhelm, hopelessness, damaged relationships, and many maladaptive behaviors. DBT teaches clients how to manage their thoughts and perceptions in order to manage intense emotional experiences. Clients that undergo DBT are taught four skills: mindfulness, emotional regulation, distress intolerance, and interpersonal effectiveness. 

Mindfulness: Becoming aware of one's thoughts and emotions without judging them.

Emotional regulation: Managing emotions, influencing unproductive emotions, and nurturing and amplifying positive emotions.

Distress intolerance: Accepting and tolerating what cannot be changed to move forward, coping with pain, becoming tolerant and resilient. 

Interpersonal effectiveness: Communicating in ways that bring about desired results, managing conflict, and creating relationships. 

DBT treatment is conducted weekly over a lengthy period of time and can involve individual therapy, group therapy, and homework between sessions. It is a learning process that requires lots of practice and awareness. 

How it began

In the 1970s and 80s, Marsha Linehan was a psychologist that had personally experienced mental illness. She had a passion for helping those that suffered like she did. She observed that suicide clients often felt judged and resistant to the methods of Behavioral treatment. In controlled trials she began using the methods of Humanism instead. Eventually, she developed DBT, which uses Cognitive Behavioral Therapy, Humanism, and Dialectics.Through Dr. Lindehan’s work, DBT became a trusted, evidence-based psychotherapy approach. Interestingly, it was the first therapy to incorporate mindfulness from the Zen tradition, which Dr. Linehan employed in her own life.

Who It Helps

While DBT was developed for people dealing with severe presenting issues like suicide and personality disorders, it has been shown effective for a wide variety of ages, populations, and situations. 

People of all ages can benefit from DBT as treatment for depression, anxiety, obsessive-compulsive disorder, ADHD, bipolar disorder, post traumatic stress disorder, self-injury, eating disorders, substance abuse disorder, and many more. It is wisdom from the Greek philosophers and Zen masters that we can use today to lasso the wild horses in our hearts and minds. 

If you or someone you know could benefit from Dialectical Behavioral Therapy, contact us to get started. It would be our honor to help! (816)974-7378, admin@twccllc.com

Check back in January for another post to our Types of Therapy series. And as always, be well!