DIALECTICAL BEHAVIOR THERAPY
WHAT IS DBT?
DBT was created by a psychologist, Marsha Linehan, Ph.D. She wanted to help people who live painful lives, feel depressed or suicidal, feel intense anxiety, hurt themselves to change the way they feel, have trouble staying sober, or feel out of control of their behavior.
Sometimes these people have experienced something painful that they can’t stop thinking about. This makes them have nightmares, feel angry or sad much of the time, or feel misunderstood. They may feel hurt, angry or afraid that others don’t or won’t like them.
What people often do not realize is that they do not have the skills to deal with all of this stuff and therefore do things they have discovered that make them feel better right now. DBT focuses on learning and implementing skills to manage life and to create a life worth living.
What are the skills taught in DBT? What problems are they meant to address?
Mindfulness skills can create a stronger sense of self, increase your attention span and help you gain control over your thoughts. These skills are helpful to address feelings of emptiness, scattered thoughts, obsessive thinking or confusion about self. About a third of the DBT curriculum focuses on mindfulness skills.
Interpersonal Effectiveness skills help you with fears of abandonment or rejection by others, conflicted relationships or "hot and cold" feelings about others. These skills can help create stronger relationships, improve negotiating, increase your abilities to ask for things, and maintain or build self respect.
Emotion Regulation skills help you work toward more "even" moods, acceptance of your feelings and control over their high emotions. These skills are helpful for people who experience intense mood swings or mood-driven choices and behavior.
Finally, Distress Tolerance skills help people "get through the moment without making it worse", and learn to accept things that cannot be changed. These skills help to decrease desperate, impulsive behaviors that lead away from a happy future. They help people increase their ability to handle pain and stress for longer periods of time.
What is Emotional Dysregulation?
Emotional Dysregulation (that emotionally out-of-control feeling) is a label that mental health professionals use to describe the emotions and behavior of certain people who have serious problems in living. People with this dysregulation often experience stronger emotions than the average person, feel afraid or desperate more often and frequently behave impulsively as a result. They may have problems getting and keeping good relationships because their feelings of anger or fear are so strong. People with emotional dysregulation may feel that others are trying to take advantage of them or have hurt feelings easily. Also, they may have feelings of emptiness or sadness inside that cause them to want to die or to find relief in self-harm. For those with emotional dysregulation, these mood swings and subsequent behaviors make it feel impossible to live a good life.
Most people who have this difficulty also have one or several diagnoses. These often include a mood disorder (like Bipolar Disorder, anxiety or depression), Attention Deficit Hyperactivity Disorder, Borderline Personality Disorder or others. Also, they may be on one, several or no medications at all. One rule that applies to almost everyone with emotion dysregulation is that medication is not enough to help people get better and stay better. Therapy is also required in order to make satisfying and lasting life changes and to maintain this dysregulation.
DBT is the treatment that research has proven to be the most helpful in treating emotional and behavioral dysregulation. It can help people stop attempting suicide, reduces self-harm behaviors and helps people feel better inside.
Some people who do not have a diagnosis seem to get better when they are treated with DBT, too. Anyone who has strong mood swings, impulsive behavior, feels anxious much of the time, and lacks coping skills will probably find DBT helpful.
Additional DBT Resources
Resource web site that includes information about research
Behavioral Research and Therapy Clinics includes abstracts of many studies done on effectiveness of DBT.
BPD Central offers information about Borderline Personality Disorder, support for family members and information about how to find a good therapist.
Interested in learning more or have questions about DBT? Please attend our free presentation, Stopping the Emotional Rollercoaster, held the first Saturday of every month at 9 a.m. More information here.
Skills training classes are classes that are held once a week. They teach skills for coping with overpowering feelings, relationship problems and distractibility. At LifeWork, we have skills classes for both adults and adolescents.
Individual DBT Sessions, one session per week of approximately 50 minutes, will help you to apply the skills taught in skills groups.
All DBT therapists must attend a weekly Consultation Team. In these meetings, DBT therapists obtain consultation, training and assistance from others on the team in order to maintain the most effective, evidence-based treatment for you. In addition, DBT therapists continually work to manage and change behaviors in their own lives.
Skills coaching is available by phone 24 hours a day. You will be able to call contact your individual therapist or another therapist for suggestions on skills usage or to report successful skills usage.