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What Is Dialectical Behaviour Therapy? – An Intern’s Perspective

by | May 2, 2019 | Dialectical Behaviour Therapy

dialectical behaviour therapy intern perspective

What the Heck is DBT?

When I first heard the term, “Dialectical Behaviour Therapy” the concept of it completely went over my head and had me silently swearing that I was never having anything to do with this form of therapy. Chances are, I am not the only one who feels intimidated by this complex approach. I can definitely empathize with anyone for feeling uncertain or overwhelmed by this theory because there’s certainly a lot to it. If you’re curious about DBT and want to learn more about it, then this post is for you!

The goal of DBT is to learn new skills and techniques to transform negative thinking and unhelpful behaviours into positive outcomes.1,2 This approach started out specifically for those with chronic and severe suicidal ideation and suicide attempts, and later for those living with Borderline Personality Disorder (BPD), but has shown to be useful for individuals who struggle with lower thresholds of self-harming, eating disorders, substance abuse, major depression, and more.3

 

What is a Dialectic?

Let’s tackle the first part of DBT – the dialectic. In reference to counselling, a dialectic is finding a balance between two opposites. It’s the understanding that two ideas can be correct at the same time, letting go of black and white thinking, and understanding that there’s no universal truth.4 A real-life example of finding a dialectic would be having to opposing thoughts such as: “I can trust everyone,” or, “Nobody can be trusted,” which then the dialectic would be finding that sweet spot in the middle which would be, “I can trust some people, but not everyone I know,” and coming to terms with the fact that those two opposing beliefs, trust and distrust, can exist at the same time.4

In DBT, we encourage clients to ask themselves, “What is missing from my understanding?” instead of accepting a final answer or conclusion. This is a way of expanding our perceptions of things and understanding and validating another person’s perspective.4

 

What is the Behaviour part of DBT?

The behaviour part of DBT includes learning practical skills and helpful behaviours and letting go of the actions that interfere with our quality of life and personal wellbeing. There are four main modules that are covered in DBT to teach these skills:

  1. Interpersonal Effectiveness: this module includes being able to ask for what we need, reach our goals, and to cope with difficult interactions or conflicts.
  2. Distress Tolerance: this module builds the ability to notice situations that evoke a negative emotional response and to be able to see the impact it has on us. The purpose of this is to be able to make rational decisions about how we want to proceed.
  3. Emotion Regulation: this module encourages noticing our emotional experiences, but not letting the emotion completely take over. Clients learn to use self-soothing techniques to cope with the strong feelings and develop the skills to act mindfully and intentionally while experiencing emotions.
  4. Mindfulness: this module teaches us how to accept and cope with powerful emotions and to be able to notice the present moment we are experiencing, along with the emotions and sensations that come with it with a non-judgmental mindset.

 

What is the Therapy part of DBT?

DBT is implemented through a variety of ways, such as skills training group and individual therapy. The group is typically 6-12 months long and is meant to introduce us to skills that are intended to improve our coping and ability to manage powerful feelings. The individual sessions focus on increasing our motivation and skill application. Individual DBT sessions give us a chance to work towards our personal goals and to apply our skills in our day-to-day life.

 

Final Thoughts

I hope that this article helps you understand a bit more about DBT. It’s certainly been a big learning curve for me, and I’ve come to appreciate the complexity of issues it’s able to address. While it can still be daunting at times, the beauty of DBT is that it can be broken down into bite-sized, practical skills and steps that help us move forward.

If you think DBT could be helpful to you, or you just have some more questions about it, please feel free to give us a call, we’d love to hear from you!

 

Resources

  1. Centre for Addiction and Mental Health. (2019). Dialectical Behavioural Therapy, from https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/dialectical-behaviour-therapy
  2. Child Youth Mental Health. (2010, May). DBT Training. Lecture presented at DBT Training, Abbotsford
  3. Gleissner, G. (2016). What Is DBT? Retrieved March 18, 2019, from https://www.psychologytoday.com/us/blog/hope-eating-disorder-recovery/201609/what-is-dbt
  4. Miller, A. L., Rathus, J. H., & Linehan, M. (2007). Dialectical behavior therapy with suicidal adolescents. New York: Guilford Press.