Dialectical Behavior Therapy

The Simple Science

Dialectical Behavior Therapy, or DBT, is a type of therapy designed to help people change unhelpful behavior patterns, especially those affecting their emotions and relationships. Originally developed for treating borderline personality disorder, it’s now used for a variety of issues including anxiety, depression, and stress management.

Here’s how you can make DBT work for you in everyday life. First, understand its core idea: balancing acceptance of your situation with the effort to change. DBT teaches that it’s okay to accept yourself as you are but also important to strive for improvement.

One practical tool from DBT is the use of mindfulness, which means being fully present in the moment. Start by focusing on your breathing or the sensations in your body, aiming to just notice what’s happening around you without judgment. This can help reduce impulsiveness and emotional reactivity.

Another key component is learning how to manage distress without making things worse. Techniques like deep breathing, distraction (such as engaging in a hobby), and self-soothing (like listening to calming music) can be powerful tools for navigating emotional highs and lows.

By incorporating these strategies into your routine, you can start to see shifts in how you handle stress, respond to emotional challenges, and interact with others, paving the way for more balanced and fulfilling relationships.

The Deeper Learning

Dialectical Behavior Therapy (DBT) is a comprehensive cognitive-behavioral treatment that emphasizes the psychosocial aspects of therapy. It was developed in the late 1980s by psychologist Marsha M. Linehan to specifically treat individuals with borderline personality disorder (BPD) and has since been adapted to treat a variety of mental health issues, including eating disorders, substance abuse, and mood disorders.

Theoretical Framework:

DBT integrates a dialectical approach, which involves finding a balance between acceptance and change. This framework posits that therapeutic success is achieved by synthesizing opposite viewpoints, helping clients learn to manage conflicting emotions and thoughts without becoming overwhelmed.

Core Components of DBT:

• Mindfulness: The practice of being fully aware and present in the moment. This foundational skill in DBT helps individuals to accept and tolerate the powerful emotions they may feel without reacting impulsively.
• Distress Tolerance: Focused on increasing a person’s tolerance of negative emotion, rather than trying to escape from it. Techniques include distraction, self-soothing, improving the moment, and thinking of pros and cons.
• Emotion Regulation: Clients learn to identify and label their emotions, increase positive emotional events, increase mindfulness to current emotions, and take opposite action to change unwanted emotions that may be harmful or are not justified by the facts.
• Interpersonal Effectiveness: This aspect teaches techniques that allow clients to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships. Skills taught include effective strategies for asking for what one needs, saying no, and coping with interpersonal conflict.

Neurobiological Underpinnings:

DBT affects the brain’s functioning in several ways. By increasing mindfulness and stress tolerance, DBT can help modify the limbic system, which is involved in emotion regulation and response to stress. The prefrontal cortex, responsible for decision-making and cognitive behavior, may also become more engaged through the practice of DBT skills, helping to regulate emotional responses via more rational thought processes.

Furthermore, DBT can help to balance neurotransmitters like serotonin, which plays a crucial role in mood regulation and impulsivity, often implicated in disorders like BPD.

Clinical Efficacy:

Empirical evidence supports the efficacy of DBT in reducing suicidal behavior and non-suicidal self-injury, common among individuals with BPD. It has also been shown to be effective in reducing the symptoms of anxiety, depression, and stress.