What is DBT?

(Dialectical Behavior Therapy)

-a type of cognitive behavioral therapy that focuses on the psychosocial aspects of therapy, emphasizing the importance of a collaborative relationship, and the development of skills for dealing with highly emotional situations

-DBT was created by Marsha Linehan, for the treatment of individuals struggling with suicidal thoughts, and has now become the gold standard treatment for Borderline Personality Disorder (BPD)

-covers four areas-

1 interpersonal effectiveness

2 distress tolerance

3 emotion regulation

4 mindfulness

1 interpersonal effectiveness-

-skills are related to interacting with others, especially in difficult situations

-objective effectiveness

“DEARMAN” skills

D escribe

E xpress

A ssert

R einforce

M indful

A ppear confident

N egotiable

-relationship effectiveness

“GIVE” skills

G entle

I interested

V alidate

E asy manner

self-respect effectiveness

“FAST” skills

F air

A pologies/no apologies

S tick to value

T ruthful

2 Distress tolerance

-skills relating to accepting, tolerating, and learning from suffering

-distracting

-self-soothing

-improve the moment

-pros and cons

-also radical acceptance and willingness vs willfulness

crisis survival

“ACCEPTS” skills

A ctivities

C ontributing

C omparisons

E motions

P ushing away

T houghts

S ensations

self-soothing skills

-taste

-smell

-see

-hear

-touch

improve the moment

“IMPROVE” skills

I magery

M eaning

P rayer

R elaxation

O ne thing at a time

V acation

E ncouragement

pros and cons/accepting reality skills

-willingness

-turning your mind

-radical acceptance

3 Emotion Regulation

-identifying and labeling emotions

-identifying obstacles to changing emotions

-reduce vulnerability to “emotion mind”

-increasing positive emotional events

-increasing mindfulness to current emotions

-taking the opposite action

-applying distress tolerance techniques

reducing vulnerability skills

-treat physical illness

-eating

-altering drugs

-sleep]

-exercise

build mastery skills

-build positive experiences

-be mindful of current emotion

-opposite to emotion action

4 Mindfulness

-skills include “what” skills, like observing, describing, and participating, and “how”skills, like non-judgement, and practicing “one-mindfully” effectively

mindfulness skills

-“what”skills

-observe

-describe

-participate

-“how”skills

-non-judgementally

-one-mindfully

-effectively

Reality Acceptance

-accepting reality is an effective antidote for a common problem in our society: struggling against the pain and suffering that is inherent to life as a human

-observe that you are fighting the reality of your situation, acknowledge that you are reacting to something that you cannot change

-remind yourself what the reality is, even if it’s difficult

-consider the causes of your current reality and incorporate the skill of non-judgement to remind yourself that this is a random occurence set in motion by a million other factors that are outside of your control

-accept this reality with your whole being, or your mind, body, and spirit

Radical Acceptance

-simply acknowledging the reality of your circumstances instead of fighting it by thinking “this isn’t fair”

-it can be difficult to accept pain, but fighting the reality of your pain only creates more pain, and this pain is optional

-radical acceptance helps us accept the reality of things that we cannot change, it can also help us to realize what can be changed

Non-judgemental stance

-you avoid assigning value to events and feelings

-instead of facing a difficult situation and thinking “this is awful”, practicing non-judgement allows us to take a step back and realize that the value judgements we make are based on facts and the emotions we are feeling in reaction

-when you break a judgement down into a fact and your emotional reaction, you not only reduce the emotions you are feeling, you can also be empowered to think about ways to solve the problem and make healthy decisions