Dialectical Behavioral Therapy (DBT)

DBT is one kind of Cognitive Behavioral Therapy.  This is a therapy that seeks to identify negative patterns in thought and change them.  The objective of the change is positive behavioral change. DBT can be applied to a variety of behaviors that can be self-destructive if taken to the extreme.

What does “Dialectical Behavioral Therapy” mean?

“Dialectical” refers to bringing two ideas together in a therapeutic situation.  The two ideas are, first, acceptance, and, second, change. These two ideas interact and, together, they are more effective than either of them working alone. The word “behavioral” is used because behavior is the focus of the therapy.

In regard to acceptance, DBT relies on the recognition that the experience of the patient is an important element in leading into the work of converting negative behaviors into positive behaviors.

The DBT therapeutic situation operates on several levels. Standard comprehensive DBT has four parts: individualized therapy, skills training in group settings, coaching by telephone if called for to deal with crisis situations between office sessions, and group consultations.  Additionally, patients are provided with “homework” for the practice of new skills. This often entails completing daily diaries, which record the circumstances of a large number of possible mental states, such as self-respect, self-injury, lying, urges, skill activities, and specific behaviors.

What Problems Can DBT Be Used For?

Generally, DBT is used for difficult to treat or high-risk patients, often with more than a single diagnosis.  It was originally used for patients who were suicidal and/or Borderline Personality Disorder cases. It has since been adapted for use with emotional problems that threaten the patient’s personal health and safety, emotional equilibrium, personal and work relationships.

Is DBT Effective for Borderline Personality Disorder?

In the case of Borderline Personality Disorder, there are often problems with intense emotional stress, outbursts of anger, rapid mood swings, aggression, and particular sensitivities to rejection.  There are instability and problems in self-regulating behavior, moods, emotional states, relationships, behavior, thought processes, and self-image. Additionally, these patients may also experience problems related to self-injury, substance abuse, risky sex, homelessness, and legal problems.

After undergoing DBT, Borderline Personality Disorder patients show improvements in regard to less anger and better anger management, a reduction in suicidal and self-injury behaviors, shorter length hospitalization, being more likely to remain in treatment, and improvements in social functioning in interpersonal relationships.

Although DBT contributes to the reduction of substance abuse in Borderline patients, it is not significantly beneficial in regard to the treatment of addictions alone.

As such, DBT is most effective in treating PTSD, binge eating problems, ADHD, and disorders of mood.

What are the identified advantages of DBT treatment?

DBT treatment has been shown to be effective in enhancing the lives of patients in the following ways:

Increased Tolerance for Stress

This means that under stressful circumstances, learned coping skills from DBT can provide for improved ways of encountering and dealing with stress with less avoidance, denial, or isolating behavior. It means that you are better able to handle your emotions and problems when under stress. The advantages of these skills in dealing with stress can provide the basis for you to distract yourself from critical emotional crises. They provide for relaxation and increased feelings of peacefulness. They allow you to function better under stress. Further, it gives you the “emotional space” to consider and evaluate the pros and cons of a stressful situation to determine the most appropriate response.

Regulation of Emotions

While your emotions sometimes make you feel like you are “boxed in,” that there is no escape, improved regulation of emotions helps to alleviate those feelings. You learn to differentiate between primary emotions and secondary emotions. Dealing appropriately with primary emotions reduces the rise and having to deal with secondary emotions. The specific skills in the regulation of emotions focus on how to recognize and identify emotions, the emphasis on emotions that provide positive results, the reduction of emotional vulnerability, to identify emotions without judging them, and the avoidance of potentially harmful urges in emotions.

Increased Mindfulness

Increased mindfulness, which is the state of being aware, responsive, and accepting of living in the moment. Mindfulness provides patients with the ability to be aware of their conscious states of mind and insightful for them. Acceptance provides for recognition of facts in regard to consciousness and acceptance of it without extreme judgments. This includes improved abilities in living in the moment.

Increased Efficiency

Increased effectiveness in interpersonal relationships. By becoming more aware of the adverse effects of strong emotions and mood swings, which have the effect of complicating and potentially damaging interpersonal relationships, the patient becomes better able to manage these problems and thus reduce their damages to relationships. The skills that contribute to more balanced and appropriate behavior in relationships deriving from DBT are improvements in listening skills, training in how to deal positively with potentially threatening situations to disable their negative effects, and improved social skills.

Positive Effects of DBT Treatment

The positive effects of DBT treatment are typically demonstrated in stages:

• The first stage encounters the self-destructive behaviors, such as thoughts of suicide and self-injury, alleviating their emotional motivations.
• The second stage focuses on the skills contributing to quality of life, those identified above, regulation of emotions, increased stress tolerance, mindfulness, and improved effectiveness in interpersonal relationships.
• The third stage focuses more specifically on self-esteem and positive self-image contributing to improved interpersonal relationships and a sense of the quality of life.
• The fourth stage focuses on the development of awareness and experiencing pleasure in life’s activities, enhanced feelings of joy.

Looking for A DBT Therapist in Los Angeles?

At Blair Wellness Group, in Beverly Hills and associated parts of the Los Angeles area, Dialectical Behavioral Therapy is used as a powerful tool to help individuals to gain a better understanding of themselves, comprehension and management of their emotions, mindfulness in their awareness, appreciation, and acceptance of the values of living in the moment. Dr. Blair is a caring professional who will assess your specific circumstances and self-identified problems and ascertain the most effective treatments in the framework of the concierge-style practice that allows the patient to schedule the most advantageous times for treatment. Now is the time to call Blair Wellness Group and start your life on the road to a new and better future!