Dialectical Behavior Therapy (DBT)
What is Dialectical Behavior Therapy?
Dialectical Behavior Therapy uses the principles of CBT and to focus its therapeutic practice on preparing the individual through the use of four major techniques:
The first of these is distress tolerance. As we go through life, we all encounter circumstances that create problems and challenges for us, but, in some cases, when not appropriately dealt with, they can get out of control and cause acute or chronic emotional distress. The skills of distress tolerance provide the individual with the capacity to recognize potentially serious circumstances before they become acutely psychologically damaging and accept them without letting them become overwhelming. So, distress tolerance is a critically valuable skill used to avoid serious psychological complications before they become significantly damaging.
The second skill in DBT is emotional regulation. In emotional regulation, the focus is to increase awareness so the individual learns to control his or her emotions. Oftentimes, one’s emotions get out of control and cause people to do things that are harmful to themselves or others, psychologically or physically. With emotional regulation, the individual learns how to recognize emotions that are going out of control so they can control them. One technique for regulation can be re-thinking the situation which, by advancing one’s understanding, reduces anger or anxiety that can often lead to further psychological problems. With this understanding and the techniques used to achieve it, the individual’s capability of control over his or her emotions is empowered.
The third skill is mindfulness, which is the critical state of learning to live in the moment. Basically, this skill teaches one that “emotions are not facts” and that allowing oneself to be controlled by emotions can lead them away from learning to accept and live in reality as it is, not as one fears that it may become. Mindfulness orients one’s thinking to accept and acknowledge thoughts, feelings, and physical sensations in order to enhance mental focus on the here and now instead of on imagined threats, fears, and challenges of the near or far future. Living in the moment dissipates many of the thought patterns that people allow to get out of control causing them to think or act inappropriately.
When put together as a therapeutic program, using these three critical skills, distress tolerance, emotional regulation, and mindfulness, DBT is directed towards a fourth objective: interpersonal effectiveness. This is a powerful emotional and psychological accomplishment that provides one with the skills and abilities to carry on positive communications with other people, to be self-assertive but without being controlling or demanding, and to establish and maintain one’s self-respect in communications and interpersonal relations with other people while not alienating or abusing them. Together, these skills contribute to the building and maintaining of strong interpersonal relationships by minimizing unhealthy or negative interactions.
Understanding Dialectical Behavior Therapy
The word “dialectical” refers to the integration or putting together of opposites. A simple example of a dialectical situation is when someone that you love does things that continually irritate you to the point that you have a conflict with the other person. This is an unhealthy situation psychologically for both parties, so a critical way to approach and deal with this conflict of two opposite emotional states is to figure out how to positively approach the relationship with the other person and counter the problems that are arising. In using DBT to reconcile this situation, distress tolerance gives you the power to recognize and identify the point or points of conflict, allowing you to see that they are only a small part of your overall relationship and to not let them dominate the relationship as a whole. Thus, you are specifically recognizing the points of distress so that you can deal with those elements instead of destroying the whole relationship because of them.
In this example, emotional regulation provides you with the tools and skills to control your emotions in order to keep them from overpowering you and adversely affecting your self-concept and behavior in the relationship. Mindfulness gives you the understanding of seeing the situation, and yourself, in terms of the here and now — giving you clarity and a focus of immediacy in accepting, understanding, and approaching the problem and conflict in realistic and immediately relevant terms.
The critical aspect of the “dialectical” situation is that, while there are two conflicting elements when organized and integrated, they actually can become a third element. What this means in terms of the simple dialectical relationship described above is that from the conflict of these two people, after one partner has gone through the program of DBT, that partner can work to relieve the stress and conflict in the situation, and, in so doing, create an improved and better relationship for the two partners. That is the third “thing” that results from the dialectical conflict — an improved relationship with more understanding and appreciation by the conflicted partner of the other partner.
Thus, the overall objective of DBT is to provide you with the basis for integrating the dualities that create and exacerbate psychological and interpersonal problems by improving your abilities in interpersonal effectiveness. In life and interpersonal relationships, when one analyzes them, many psychological problems and challenges can be seen as some form of duality — two “things,” me and the other, two opposing points of view, two conflicting emotional responses and behaviors. So, it is the objective of DBT to give the individual the tools to reconcile the two conflicting circumstances and to integrate or approach their solution in positive ways that are not detrimental or destructive to either of the two or more parties involved and contribute to the creation of a better relationship for all.
Conditions Treated with Dialectical Behavior Therapy
There are a number of conditions that can be effectively treated through DBT:
- Bipolar disorders
- Eating and food disorders
- AD/HD disorders
- Borderline personality disorders
- Generalized anxiety disorders
- Mood disorders
What to Expect from DBT Treatment
To begin with, as the Dialectical Behavior Therapy program progresses, you can expect to develop a different perspective on your awareness, understanding of, and approach to circumstances that could potentially create psychological challenges and problems for you. DBT will not change the circumstances, but it will contribute to you discovering a new way to see, think about, and react towards these challenges and problems. DBT is a kind of one-on-one coaching situation between your therapist and you.
One important objective of the therapy is to maintain the focus, attention, and interest in pursuing the steps and elements of the therapeutic process. Each of the four techniques will involve differing input, activities, and outcomes. The objective is for the patient to become more aware of emotional responses and reactions that may pose problems, so they may anticipate their effects. In doing so, the patient can gain improved control of emotional responses and reactions, reducing their adverse psychological effects.
Through the practice of mindfulness, the patient becomes more self aware, and recognizes the positive aspects of him or herself. This higher sense of individuality promotes living in the moment and is utilized as a source for personal enrichment and establishing a more balanced and positive mental state. Thus, the final outcome is that the patient may see his or her problems and challenges in a new and less threatening way since they have the “tools” needed to approach and defuse them.
Contact Blair Wellness Group For Therapy in Beverly Hills
Everyone has mental and emotional challenges they wish they could overcome. Like a mechanic has many different tools in his toolbox that he can use to help fix a problem, DBT is just one tool of many used by psychologists to help clients improve awareness, build resilience, and overcome their psychological problems.
At Blair Wellness Group, we specialize in treating clients with a wide variety of mental health challenges including anxiety, depression, mood disorders, addiction, relationship issues, and more. Through personalized treatment plans and expert guidance from Dr. Blair, clients learn to strengthen their emotional health and psychological wellbeing, and in turn, overcome obstacles to their health and happiness. For more information or to make an appointment, please contact us at 310,999,4996.
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