What Is Dialectical Behavior Therapy (DBT)?

Do you or a loved one suffer from uncontrolled behaviors, emotional outbursts, on-going drug dependence or even feelings of suicide?

Have you or your loved one been diagnosed with Borderline Personality Disorder (BPD)? You may be interested in learning more about a fairly new technique, called Dialectical Behavior Therapy (DBT). It emphasizes positive reinforcement, validation and self-acceptance.

Where did DBT come from?

Dialectical Behavior TherapyDialectical Behavior Therapy, or DBT, was developed in the late 1980’s by psychologist Marsha M. Linehan from the University of Washington.

Dr. Linehan’s theory is essentially that behaviors associated with BPD and other difficult-to-treat emotional problems stem from childhood environments lacking validation.

This can result in an individual who is unable to develop appropriate emotional responses or control emotional highs and lows. It can also lead to severe emotional problems as well as suicidal tendencies.

Dr. Linehan’s technique is based largely on Eastern philosophies, especially Buddhism. One of her main methods is patterned after a zen practice called mindfulness. The art of mindful living was made popular by a Buddhist monk and author Thich Nhat Hanh.

What is DBT used for?

Clinical studies have shown DBT to be effective in treating a number of difficult psychological problems, including bulima nervosa, or binge eating, drug dependence, suicidal behaviors and Borderline Personality Disorder.

In an early study by Dr. Linehan, suicidal patients with a history of drug dependence not only showed improvement in social behavior, but decreased drug use as well. A more recent study from 2006 found that DBT helped decrease suicidal tendencies by more than half, independent of conventional psychiatric treatments.

A report from the American Psychiatric Association  concluded that the use of DBT used to treat bulimia helps decrease binging and purging. Psychologists have now even begun using DBT to treat other conditions such as major depressive disorder and antisocial personality disorder.

What can I expect from a DBT session?

The treatments typically consist of a weekly one on one sessions with a therapist trained in DBT, where patients discuss problems and challenges from the past week.

The therapist teaches adaptive behaviors and then helps the patient find alternative solutions to problems. There is also persistent emphasis on changing certain self-destructive behavioral patterns. In addition, a patient may call the therapist regularly throughout the week.

The second part of the treatment involves the patient attending weekly 2 ¬Ĺ hour group sessions which focus on emotion regulation, tolerance and acceptance of stressful situations and mindfulness skills. The group helps validate one another’s emotions and reinforces positive change. In group, the therapist may discuss several DBT concepts, such as:

  • Accepting reality
  • Letting go of emotions
  • Distraction techniques to avoid self-injury
  • Evaluating Pros and Cons of a behavior
  • Improving the moment by changing one’s attitude
  • Prevention of self-harm by learning to care for oneself, and
  • Interpersonal effectiveness, which involves learning to handle difficult interpersonal situations.

Are there any special precautions I should know about?

If you have significant psychological problems, especially thoughts of suicide, contact your health care provider immediately. Dialectical Behavior Therapy is relatively new, and should be conducted by a trained practitioner.

Remember that newer or alternative therapies are meant to complement and not replace conventional medical care. Talk to your doctor to find out if DBT is appropriate for your condition.