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Understanding Dialectical Behavior Therapy

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When people talk about going to therapy, they often don’t realize that there are many different approaches to treating mental health disorders. One of the most common is dialectical behavior therapy (DBT).

About Dialectical Behavior Therapy

DBT was developed by psychologist Marsha Linehan in the late 1980s. It incorporates elements of cognitive-behavioral therapy (CBT) with concepts from dialectics, which is the process of balancing and reconciling opposing viewpoints or perspectives. DBT emphasizes the importance of accepting yourself while also recognizing the need for positive change.

There are four main skills dialectical behavior therapy helps you develop: 

  • Mindfulness. This involves learning to focus attention on the present moment without judgment. Mindfulness skills help people become more aware of their thoughts, feelings, and sensations, which can then be used to better regulate their emotions.
  • Distress tolerance. These skills are designed to help individuals cope with intense emotions without resorting to harmful behaviors. Distress tolerance techniques include distraction, self-soothing activities, and radical acceptance.
  • Emotion regulation. Emotion regulation skills teach people how to identify, understand, and manage their emotions more effectively. Sessions focus on developing strategies for reducing emotional vulnerability and increasing emotional resilience.
  • Interpersonal effectiveness. In DBT, people learn how to express their needs, set boundaries, and navigate interpersonal conflicts in a constructive manner. The goal is to promote healthier, happier relationships with others. 

Conditions DBT Can Help Treat

Dialectical behavior therapy can be useful for a wide range of mental health conditions. For example: 

  • Borderline personality disorder (BPD). DBT was originally developed to address the symptoms and behaviors associated with BPD, such as intense emotional swings, unstable self-image, impulsivity, and relationship difficulties.
  • Depression. DBT can be helpful for people experiencing depression, particularly those who have difficulty regulating their emotions or refraining from engaging in behaviors that contribute to their depression.
  • Anxiety disorders. DBT includes mindfulness techniques that can help those with anxiety disorders manage their symptoms by increasing awareness of their thoughts and emotions while developing healthy coping strategies.
  • Eating disorders. DBT has been adapted to treat eating disorders such as bulimia nervosa, binge eating disorder, and anorexia nervosa. It can help sufferers manage emotional triggers and develop healthier coping strategies for dealing with food-related issues.
  • Substance use disorders. DBT has been found to be effective in treating substance use disorders, particularly when combined with other approaches such as substance abuse counseling and medication-assisted treatment. It can help individuals develop skills for managing cravings, coping with stressors, and preventing relapse.
  • Post-traumatic stress disorder (PTSD). DBT skills, particularly those related to distress tolerance and emotion regulation, can be beneficial for people with PTSD who struggle with managing their emotional responses to trauma triggers.
  • Bipolar disorder. DBT can be beneficial for people with bipolar disorder, particularly during depressive or mixed episodes when emotional dysregulation and impulsivity can be more pronounced.
  • Non-suicidal self-injury (NSSI). DBT is effective in reducing non-suicidal self-injury behaviors by teaching people with this disorder alternative coping strategies and emotional regulation skills.

What to Expect From a DBT Session

Dialectical behavior therapy can be part of both individual and group therapy sessions. Individual therapy sessions focus on addressing specific problems and helping people apply DBT skills to their daily lives, while group sessions provide structured instruction and practice implementing DBT skills.

 Here are some examples of DBT exercises you might encounter as part of a session:

  • Mindfulness meditation. Practicing mindfulness meditation helps you develop awareness of your thoughts, feelings, and sensations in the present moment. This can involve focused breathing exercises, body scans, or guided imagery.
  • Interpersonal effectiveness role-playing. Role-playing exercises enable you to practice assertiveness, effective communication, and boundary-setting skills in a safe environment. This can involve scenarios such as negotiating with others, saying no to requests, or expressing feelings and needs assertively.
  • ABC PLEASE skills. ABC PLEASE is an acronym representing a set of skills aimed at reducing vulnerability to emotional distress. These skills include accumulating positive emotions, building mastery (engaging in activities that foster a sense of competence), coping ahead (preparing for anticipated distressing situations), and taking care of your physical health via balanced eating, exercise, sleep, and avoiding addictive substances.
  • Daily diary cards. Daily diary cards are used to track behaviors, emotions, and skill usage. They can help you identify patterns, monitor progress, and reinforce the use of DBT skills in your everyday life.
  • Wise mind worksheets. Wise mind is a concept in DBT that refers to a balanced state of mind that integrates emotional and rational thinking. Wise mind worksheets help you identify when you are in a wise mind and practice making decisions from this balanced perspective.

Learn More About Treatment Options at Raleigh Oaks Behavioral Health

Located in Garner, North Carolina, Raleigh Oaks Behavioral Health offers dialectical behavior therapy and other forms of evidence-based care to help people struggling with their mental health manage their symptoms and enhance their overall well-being. Contact us today for a no-cost confidential assessment.

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