Dialectical Behavior Therapy (DBT) is an evidence-based treatment that was developed by Dr. Marsha Linehan after her own unsuccessful encounters with a variety of psychiatric treatments, to include a traumatic psychiatric hospitalization at the age of seventeen that lasted more than two years. The “dialectical” component of DBT refers to the movement away from extremes and towards a Middle Path, as well as the belief that two seemingly opposing truths can exist at the same time. For instance, a client can want and not want to change at the same time. A DBT or DBT-informed therapist will work to help clients balance dialectics to facilitate helping them get unstuck at various points along their journey.
There are several underlying assumptions about clients that guide a DBT or DBT-informed clinician in their work, namely that clients are simultaneously doing the best they can, and they need to do more to manage their symptoms. A DBT or DBT-informed clinician assumes that clients cannot fail at therapy, no matter how severe their current symptoms are and how difficult it has been for them to enact changes in the past. DBT posits that clients benefit the most from DBT or DBT-informed individual therapy in conjunction with a DBT Skills Group to balance more in-depth viewing with learning new skills and concepts, as well as to allow for the practicing of DBT skills in different contexts.
DBT differs from other cognitive and behavioral therapies in that it does not just focus on the teaching of skills and concepts to promote change, it also allows for the incorporation of validation and acceptance of where a client currently is. DBT integrates Eastern mindfulness practices throughout the client’s process of reflecting and integrating new ways of thinking and behaving. Along with the development of present-mindedness and radical acceptance, DBT helps clients better understand and regulate emotions, tolerate distress, and build healthier relationships with others. A client doing DBT may need to start in the “basement” of the house – that is, learning how to ride the waves of distressing emotions – and the more skills they effectively integrate, the more they can focus on self-actualization (the “roof” of the house).
Although DBT was originally designed for the treatment of Borderline Personality Disorder, it is used nowadays to treat a variety of mental health concerns such as: substance use disorders, anxiety, posttraumatic stress, and disordered eating. DBT helps clients move from simply surviving their symptoms towards building a meaningful life worth living. If you would like to determine if DBT may be the right fit for you, please contact me to schedule a free 15-minute phone consultation.