Dialectical Behavior Therapy

I came across the letters DBT in an adoption discussion group and as I had no idea what it stood for, I do what I often do in such cases, google it. It started with this comment by an adoptive parent –

“I just had it click in a deeper way yesterday that I put a lot of thought and effort and will into trying to heal my kids. As if I’m a savior. As if I can. But in DBT, it talks about creating a change ready environment for your kids. By the way, if you can find a child DBT therapist, do it! Its expensive and it involves individual and parent and group sessions, and its work and learning, but its SUPER effective. All kinds of stuff prove its effective. Back to my point, if I’m trying to create a change ready environment, a calm and consistent environment where mean words can roll off my back, and I’m working on me setting the example that self care is important and I’m working on me so that I can hold all the pain they send my way, that’s where I make the most beneficial impact for all of the family and that’s where I love my kids the best.”

DBT stands for Dialectical Behavior Therapy. Dialectical behavior therapy is an evidence-based psychotherapy that began with efforts to treat borderline personality disorder. There is evidence that DBT can be useful in treating mood disorders, suicidal ideation, and for change in behavioral patterns such as self-harm and substance abuse. Many of these issues are aspects experienced by adoptees due to the trauma of separation from their original mothers.

One woman commented – “DBT absolutely SAVED MY LIFE. The skills helped me stop with SI and I then went on to lose 140 pounds.” I had to google SI too. Introverted sensing (or Si for short) is one of the most misunderstood cognitive functions in the personality community. Introverted sensing is a perceiving (information-gathering) function. It focuses on the subjective, internal world of personal experience and compares and contrasts new experiences to past experiences and memories. Si-users tend to notice patterns repeating themselves and are quick to spot changes or inconsistencies in their environment. They trust personal experience and subjectively explore the impact of current events, choices, and consequences.

So back to DBT . . . .

Its main goals are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others. DBT can help people who have difficulty with emotional regulation or are exhibiting self-destructive behaviors (eating disorders and substance use disorders). DBT is sometimes used to treat post-traumatic stress disorder (PTSD).

DBT incorporates a philosophical process called dialectics. Dialectics is based on the concept that everything is composed of opposites and that change occurs when there is a “dialogue” between opposing forces. The process makes three basic assumptions:

All things are interconnected.
Change is constant and inevitable.
Opposites can be integrated to form a closer approximation.

Mindfulness skills help you slow down and focus on using healthy coping skills when you are in the midst of emotional pain. The strategy can also help you stay calm and avoid engaging in automatic negative thought patterns and impulsive behavior. BTW, I am a BIG believer in mindfulness.

Distress tolerance techniques help prepare you for intense emotions and empower you to cope with them with a more positive long-term outlook. There are 4 techniques – distraction, improving the moment, self-soothing and thinking of the pros and cons of not tolerating distress.

Emotion regulation lets you navigate powerful feelings in a more effective way. The skills you learn will help you to identify, name, and change your emotions. When you are able to recognize and cope with intense negative emotions (for example, anger), it reduces your emotional vulnerability and helps you have more positive emotional experiences.

Interpersonal effectiveness helps you to become more assertive in a relationship (for example, expressing your needs and be able to say “no”) while still keeping a relationship positive and healthy. You will learn to listen and communicate more effectively, deal with challenging people, and respect yourself and others.