Dialectical Behavior Therapy in a Nutshell
MEGAN DAVIES, MA, Registered Clinical Counsellor - VITALITY COLLECTIVE VANCOUVER THERAPIST
Let’s be real, life isn’t easy.
During tough times, it’s extremely difficult to feel in control of your emotions and feelings. Maybe you send big essay text messages to your partner or family member when they’ve hurt your feelings or maybe you find drinking about it easier or eating about it. Maybe you try and avoid your feelings in general, in fear that they will consume you. When you react to a big emotion, it may feel good in the moment to send a big text message to your ex, but you most likely will end up feeling shame or guilt afterward when you feel more regulated. During challenging times, it’s difficult to communicate effectively and rationally with others and it may feel like you’re on an emotional roller coaster without any control of where you’re headed.
What can you do if you’re feeling this way you ask?
DBT!
DBT is short for Dialectical Behavior Therapy, Psychologist Marsha Linehan, Ph.D., developed dialectical behaviour therapy in the 1980s as an effective treatment for people living with suicidal thoughts and borderline personality disorder. The first word in DBT, “dialectical” captures the treatment’s foundation. The “dialectical” in its name refers to a philosophy in which seemingly opposing ideas can exist at the same time. By definition, the term dialectical means “the contradiction between two conflicting forces viewed as the determining factor in the interaction.” In other words, DBT brings together two things that seem to be opposites acceptance and change.
The fundamental idea of DBT is that opposites can coexist and be harmonized. Once we begin to accept ourselves exactly as we are in the present moment, we are more open to change. This concept seems paradoxical in nature, which is perhaps why there is a tendency to resist, hold on, and fight back when we sense that we need to change. The more rigid we become in clinging to the familiar, the more likely it is that we will react to this rigidity by swinging like a pendulum to the other side into chaos and feeling out of control. DBT aims to achieve a balance between validation and acceptance while staying focused on changing problem behaviour. DBT believes you need validation of where you are in life, as well as motivation to try to create positive changes.
Dialectical behaviour therapy believes that everyone does their best in life. It’s just sometimes we don’t have the right tools or knowledge to understand how our behaviours are creating a life we aren’t happy in, or what we can do to change.
There are four pillars of dialectical behaviour therapy:
Distress Tolerance - Learning how to manage and cope during a crisis, and to tolerate distress when it is difficult or impossible to change a situation. Learning to accept any given situation just as it is, rather than how you think it should be, or want it to be. It involves learning new skills like distraction and self-soothing, for both coping with and improving distressing moments.
Emotion Regulation - Learning how to effectively manage your emotional experience and not allow your emotions to manage you. Some of these skills that can help people deal with their emotions include:
identifying and labelling emotions;
identifying obstacles to changing emotions;
reducing vulnerability to “emotion mind”;
increasing positive emotional events;
increasing mindfulness to current emotions;
taking the opposite action;
and applying distress tolerance techniques.
Mindfulness - When we are mindful, we are grounded in the present moment. We are able to recognize our thoughts without being overwhelmed. We can avoid acting on impulse and instead, make thoughtful decisions. Mindfulness makes it easier to focus on, treasure, and enjoy fun times as well. By practicing mindfulness and honing your mindfulness skills, you can feel more aware of your emotions and your state of mind.
DBT teaches you about the three states of mind: Emotional Mind, Rational Mind, and Wise Mind. In the emotional mind, your feelings are in charge and behaviour is driven by them. Emotions are not bad; however, there are good and bad reactions to emotions in situations. In rational mind, you are focused on facts and you are disconnected from your emotions. In rational mind, you do what works and what makes sense. Wise mind is a synthesis of both emotion and logic, you feel your emotions while also focusing on the facts. When using wise mind, you are slowing down to assess if the emotions fit the situation, and acting according to how you feel and the facts of the situation.
Interpersonal Effectiveness - Learning assertiveness strategies to appropriately ask for what you want or need: how to say no, and how to manage interpersonal conflict in a way that maintains respect for yourself and others. These skills are intended to help people function effectively when trying to change something (asking for help) or in trying to resist changes.
DBT skills can help ANY person who struggles with coping skills, emotion regulation or interpersonal connection! It helps people develop coping skills, reduce self-harm behaviours and improve negative patterns of thinking. It also validates and empowers people as they learn and apply skills to manage emotions and urges. The goal of DBT is to create a life worth living.