
Dialectical Behaviour Therapy
April 15, 2024
Dialectical Behaviour Therapy
Dialectical Behaviour Therapy (DBT) has gained popularity in recent years for its effectiveness in treating a range of mental health disorders, particularly Borderline Personality Disorder (BPD). It Is predominantly used for individuals who are expressing suicidal behaviour, where addressing these needs is a top priority.
What is DBT?
DBT is a form of talking therapy that draws on Cognitive Behavioural Therapy and is influenced by mindful awareness (a type of Buddhist meditative practice). Its main focus is teaching individuals important long-lasting skills to improve coping strategies and overall quality of life. What distinguishes DBT from previous talking therapies is its focus on acceptance.
DBT is delivered by therapists trained in DBT such as a psychologist or a dialectical behavioural therapist.
Break down of DBT
D: Dialectic, meaning to recognise that seemingly opposite ideas can coexist. Using a dialectical approach in DBT involves embracing contradictions, allowing individuals to accept their current state while actively pursuing change. This is called finding the middle path.
B: Behaviour, DBT focuses on observable behaviour that may be damaging and alters them through reinforcement principles.
T: Therapy, DBT was created by Prof Marsha Lineham in response to some limitations she noticed in CBT, originally for women experiencing parasuicidal behaviours.
Whilst CBT focuses on changing thoughts, feelings and behaviours, she felt this expectation is invalidating to those who believe they are incapable of change. DBT works on regulating and accepting these thoughts and develops stronger emotional regulation skills.
Who is DBT for?
DBT is for individuals experiencing intense emotions, such as those with BPD and adolescents experiencing self-harm tendencies and chronic suicidality.
What is to be expected in DBT?
DBT runs for around 6 months and can be delivered as an individual therapy or in groups. However, it is recommended to investigate your local healthcare services to see what they provide as not all NHS services provide it. The best way to seek DBT is with a referral from your doctor/GP or mental health team. DBT often requires a parent/carer to be present in the sessions to help improve outcomes of the therapy. Individuals should also expect homework to be completed.
The 4 core components of DBT
Mindfulness
For anyone engaging with cognitive therapies, mindfulness is a commonly used technique. By practising mindfulness, we learn to be present with ourselves without judgement. For example, in DBT, mindfulness skills are taught to help individuals observe their thoughts, feelings, and bodily sensations without reacting impulsively or judgmentally.
Distress Tolerance
This is about how to cope with the difficult events in life. It changes the focus from short-term thinking and impulsive actions in times of distress to a more long-term approach. This includes building tolerance when things do not go to plan and how to manage the urges of impulsivity by considering different pros and cons of our actions.
Interpersonal effectiveness
Interpersonal effectiveness fosters a sense of connection and belonging, which is essential for psychological health. For example, by building up strong relationships an individual is better able to access emotional support. Additionally, the individual can learn to express needs, thoughts and feelings effectively, and therefore manage conflicts with healthy resolutions!
Emotional Regulation
For individuals who access DBT, emotional regulation can sit at the heart of their distress. DBT takes a step-by-step approach to build up vital emotional regulation skills. The first step in the process is to develop an awareness of one’s emotions, a skill honed through mindfulness practices. Once this awareness is achieved, individuals can then progress to identifying and labelling their emotions.
From there, DBT will begin creating a Emotional Regulation Toolbox, which includes:
- Identifying useful coping skills: deep breathing exercises, progressive muscle relaxation and visualisation techniques.
- Opposite Actions: DBT encourages individuals to engage in behaviours that are opposite to the emotion they are experiencing when that emotion is not helpful or appropriate. For example, if someone is feeling depressed and withdrawn, DBT might encourage them to engage in activities that bring them joy or connect with others.
Note that, the development of DBT skills is a gradual process that requires patience and consistent practice. Improvement may not occur overnight, and individuals may experience setbacks along the way, your DBT therapist is there to guide and support you through this!
Additionally, not all DBT techniques may be equally effective for everyone. Each individual is unique, and what works well for one person may not work as effectively for another. Therefore, it is essential to approach DBT with an open mind and a willingness to explore different strategies to find what works best for you. The qualified mental health professional will help you navigate and tailor the techniques for your specific needs.
To start your DBT journey, visit the Mindsum platform and get your free initial consultation today.