What Are DBT Dialectics? Dialectical Behavior Therapy (DBT) is a form of psychotherapy that has proven to be effective for teenagers and adults who engage in problematic behaviors and find it difficult to manage strong emotions.
DBT is based on cognitive-behavioral therapy which is designed to identify and change negative thinking patterns and produce positive behavioral changes. In both CBT and DBT, an individual talks to a mental professional about the challenges they’re facing and they gain skills to help them cope.
However, there are key differences. CBT focuses on learning how to change unhelpful thoughts, feelings, and behaviors. DBT teaches individuals to accept their thoughts, feelings, and behaviors along with the techniques to change them.
The Origins and Philosophy Behind DBT
DBT has been around since the late 1980s. It was developed by Dr. Marsha Linehan and her colleagues when they realized that CBT alone was less effective in patients with borderline personality disorder (BPD). The team developed a type of treatment that was better suited to these individuals. Though developed to treat BPD, DBT is now used in the treatment of several conditions including substance use disorder particularly when it occurs with other mental health problems.
The word “dialectic” isn’t commonly used in everyday language so you may be asking “what are dialectics?”. DBT dialectics are opposing ideas that can be true at the same time. When viewed together, they present a new way of interpreting a situation. In dialectical therapy, the main dialectic is acceptance and change.
Ordinarily, you may assume that you must either accept a situation or want it to change. DBT says you can accept something and want to change it at the same time.
What Happens During Dialectical Behavioral Therapy
In therapy, you’ll be taught how to feel emotions without acting on them. You’ll also be taught how to replace drug abuse and other harmful behaviors with more effective ones.
You will learn skills that help you to decrease your suffering and improve relationships with others. You will be in charge of your own goals during treatment but you will work with your treatment team to use your new skills to accomplish your goals. The aim is always to create (and then support) a life that you truly believe is worth living and are proud of.
You and your therapist will work to resolve what appears to be a contradiction between accepting yourself and making the changes necessary for a healthier life. One of the things your therapist will do is validate that your actions make sense given your individual experiences. This does not mean that they agree that your actions were the best approach. However, their validation increases the likelihood that you will cooperate with their recommendations and the idea of change will be less distressing.
Who Does DBT Help?
DBT can be helpful for people who experience strong emotions and display symptoms of:
- Substance use
- Suicidal thoughts
- Rapid mood swings
- Extreme stubbornness
- Bingeing and purging
People who undergo dialectical behavior therapies must be willing to participate in group therapy, individual therapy, and phone coaching. In group therapy, people learn behavioral skills in the company of other individuals. In individual therapy, the therapist guides the person in applying the skills to their personal challenges. Between sessions, patients can call their therapist for guidance on specific situations they are dealing with.
What Are the Six Main Points of Dialectical Behavior Therapy?
As you may already be able to tell, there are many elements involved in DBT. We’ll discuss the four stages in a bit but you also need to be aware that there are six main points to this type of therapy.
The first, which we have already mentioned. is acceptance and change. You will be taught strategies to help you accept your circumstances, feelings, and self. You will also learn how to adopt positive behaviors and change the way you interact with other people.
The other points are:
- Behavioral: You’ll learn to examine your harmful behavior patterns and replace them with more effective behaviors.
- Cognitive: You’ll focus on changing ineffective or unhelpful thoughts and beliefs.
- Collaboration: You’ll learn how to communicate more effectively and work with your clinicians, skills that will serve you well later in your recovery.
- Skill sets: You’ll gain a variety of new skills that you can use to strengthen your capabilities.
- Support: You’ll be applauded when you recognize your own strengths and positive abilities, grow them further, and use them in a variety of situations.
Stages Involved in DBT
Therapists follow a multistage approach that often termed the DBT House of Therapy:
- In stage 1, therapists treat extreme self-destructive behaviors such as self-harm and suicidal attempts.
- In stage 2, the focus is on inculcating skills that will improve the patient’s quality of life such as distress tolerance and emotional regulation.
- In stage 3, the patient builds their self-esteem and works on improving relationships. The final stage is designed to promote joy and deepen connections in relationships.
Skills Taught in DBT
So far, we have made mention of skills several times. Now let us look together at some of the skills you will likely be taught if you get dialectical therapy.
Mindfulness is all about living in the moment and focusing on the present. Developing mindfulness skills is one of the biggest benefits of DBT. You’ll learn to pay attention to your thoughts, feelings, and impulses as well as what is happening around you without offering judgment.
These skills help you to slow down and draw on healthy coping mechanisms if you’re dealing with emotional pain. Mindfulness can also help you to stay calm and not automatically respond with negative thoughts and impulsive actions
A simple way to observe mindfulness is to pay attention to your breathing and how your belly rises and falls as you inhale and exhale.
Building your distress tolerance skills will help you to accept yourself and your situation as it currently stands. It helps you to prepare for intense emotions and gives you tools to cope with them. Techniques for skillfully managing a crisis include:
- Improving the moment
- Considering the pros and cons of not tolerating the distress
You can practice your distress tolerance skills by getting up and walking around, changing your location, or running up and down the stairs. This is a form of distraction where you try to get your emotions to follow your body.
Building your interpersonal effectiveness allows you to be more assertive in your relationships while keeping those relationships healthy. DBT will teach you how to listen and communicate better and deal with difficult people.
One acronym you can use to improve your communication is GIVE. This encourages you to be gentle, show interest, validate the other party’s thoughts and feelings, and have an easy attitude.
Here, you learn how to identify your emotions, name them, and change them. When you can recognize and manage negative emotions like anger, you’ll be less emotionally vulnerable, and you’ll have more positive emotional experiences. A helpful exercise here may be to identify the way you are feeling currently and then act in the opposite way.
Things to Consider If You’re Interested in DBT
Dialectical therapy isn’t for everyone. It requires a lot of time since you need to do homework outside of the individual, group, and phone sessions. Some people may not be able to keep up.
Some individuals also find it difficult to practice some of the skills especially when they need to explore traumatic experiences.
Talk to the Team at Circle of Hope to Learn More
To find out if DBT techniques can help you overcome your drug or alcohol addiction, you need to talk to a trained professional. At Circle of Hope, we will thoroughly assess your symptoms, medical and psychological history, and treatment goals to help us decide on which methodology is best. Call us today to learn more about incorporating DBT in recovery and other options for treatment.