DBT stands for Dialectical Behaviour Therapy. Before we break this down further, it is important to understand what exactly a dialectic is.
A dialectic is to have two seemingly opposed ideas be true at once. This may seem like an odd or impossible thing, but when we look at some examples, we find that we see dialectics all the time. Within DBT, we learn to replace the word BUT with the word AND as two extremes can happen at the same time.
For example:
How is it that you can love a person, BUT hate them at the same time?
When I see some cake, I want to avoid it to keep healthy, BUT also really want to eat it.
Taking medications makes me feel like I’m unwell, BUT I need them to get better.
Now that we have an understanding of dialectics, let’s have a look at DBT.
DBT is a therapy that looks at the main dialectic of ACCEPTANCE Vs CHANGE. In every situation we find ourselves in, we have the ability to learn to ACCEPT that this is a part of our life, or we have the option to make CHANGE in our lives to create improvement.
The main goal of DBT is to ‘LIVE THE LIFE WORTH LIVING’. This is important, as no matter what your history is, we can find value in every life, and we can make choices to improve the life we have. DBT allows us to live the life worth living by allowing us to ‘find the grey’ when we are black and white thinking. We naturally tend to think in extremes (for example pass or fail, good or bad, perfect or imperfect), but there are often
DBT is traditionally run over four modules. They are:
Mindfulness: In order to know what we are wanting to accept and what we are wanting to change, we need to know ourselves. We can achieve this knowledge of self through mindfulness. In the mindfulness module we learn about Wise Mind, the balance between acting out in Emotion Mind and the facts of Logical Mind.
Distress Tolerance Skills: These are life saving skills that we can use when we are approaching or in crisis. These skills are designed to allow us to make it through crisis points in our lives and to choose survival. Skills include the STOP skill, where we learn to Stop what we are doing, Take a step back to reinforce that we have control over our behaviour, Observe what led us to this point, and Proceed mindfully, where we do what we NEED not what we WANT.
Emotion Regulation Skills: These are skills that are designed to help us identify, understand and feel our emotions. They are also designed to help us get back to our emotional baseline quicker after allowing the emotional experience to occur. An Emotion Regulation skill includes opposite action. This skills gets us to reflect on what the action urge of the current emotion is and do the opposite action in order to try bring on the opposite emotion.
Interpersonal Effectiveness Skills: No person goes through life completely isolated. Interpersonal skills are skills between two or more people. They are designed to help us create healthy relationships, end destructive relationships, and communicate with the people around us giving us the highest chance of success in getting what we want from others. An example of interpersonal effectiveness skills is the communication skill DEAR MAN: Describe, Express, Assert, Reinforce, (stay) Mindful, Appear confident, and (be willing to) Negotiate.
DBT is most commonly run as a group program. The reason for this is to have people to practice these skills within a group setting, before testing these skills in your home environment. It usually is a 6-month program that is repeated (12 months of therapy!), however there are shorter ‘introduction to DBT’ programs available that provide many of the skills, though without the in-group practice. DBT can also be practiced in individual (1:1) therapy as well.
What should you be looking out for in a DBT therapist?
A good DBT therapist is one that will ‘validate the valid’, but also challenge you to make the changes you recognise are needed. To validate the valid means to point out the aspects of your situation that are valid, and encourage appropriate emotional expression around these.
For example, if someone is experiencing an injustice and they are angry about this – that is valid, and they should express their anger accordingly. A DBT therapist would then challenge aspects of your situation that are invalid. For example, the angry person may have internalised the anger, and not expressed it to the person creating the injustice. In this case the person creating the injustice may remain unaware that an injustice has been caused, and they ‘get away with’ that injustice. A challenge may be to address the person and let them know (even historically) that their actions created an injustice, and even suggest a more appropriate action to take in future.
If you would like to know more about DBT, or even see a DBT therapist, please contact us at The Mind Body Practice on 02 8088 1014.