Dialectical Behavior Therapy


Fun fact about counselors: We don’t want you to keep coming to us forever. Not that we don’t want to see you – ending a counseling relationship is as bittersweet for us as it is for our clients – but we don’t want you to need to see us.

As a counselor, my goal is always to equip my clients with the tools they need to function well and carry the work we’re doing in session out into their everyday lives. I will gladly see my clients for as many sessions as we need or want, and love seeing clients for “check-ups” after they’ve had some time to try things on their own , but I never want my clients to be dependent on me. I want to empower you with tools and skills that you can keep using for the rest of your life, to live happily and healthily.

One of my favorite ways to empower clients is by teaching the skills of DBT. Dialectical Behavior Therapy, or DBT, was created by Marsha Linehan to help people struggling with Borderline Personality Disorder. However, you don’t have to have a personality disorder to benefit from the principles and skills that DBT teaches! If you struggle at all with behaviors, thoughts, or emotions that seem uncontrollable and cause problems in your life, DBT may be very helpful to you.

What is DBT?

First, let’s talk about the name. “Dialectical”, or dialectics, refers to the tension that exists between opposing forces or ideas. Most humans, because of how our brains work, tend to see the world in dichotomies: good or bad, black or white, yes or no. These are easy to understand, and help us organize the world. However, the reality is that most things in life exist on a continuum; in shades of grey. Real people are a complex mix of conflicting moralities. Even comic book heroes tend to have a little bit of bad mixed in with the good. Seeing the continuum between the polar opposites allows you to see the world as much more dynamic, vibrant, and open.

The dialectics of DBT are the tension between acceptance and change. It sounds contradictory to say that accepting the aspects of your thinking that are bothersome will eventually lead to them changing, but this is actually true! Sometimes pushing for change only slows down the process. Have you ever mixed cornstarch and water? As non-newtonian fluid, this mixture is solid when met with sudden force (such as punching it), but when gently handled it flows like water. The same can be true of us: if we struggle and fight against our flaws and short-comings, sometimes they just seem to become a more distinctly pronounced part of us. However, if we accept the issues we have instead of forcing our way through them, the gentleness of that approach will allow change to actually occur.

What does DBT look like?

DBT is very closely related to Cognitive Behavioral Therapy in that the main focus is on changing thoughts and behaviors. What makes it unique, however, is that mindfulness is an integral part of DBT. This is where the balance of acceptance and change comes in. Mindfulness teaches you to be aware, present, and an active participant in your life while at the same time avoiding judgments of what you observe. This includes observations of yourself. It means noticing that you are angry or sad without thinking “Why am I so angry? This is ridiculous! What is wrong with me?” Instead, you may think “I feel angry. I’m not sure why, but I do.”

Distress tolerance is another DBT skill that emphasizes acceptance. Particularly, it emphasizes accepting pain you may be feeling without trying to change it. Similar to an animal caught in a trap, sometimes trying to escape our pain only serves to deepen the wounds and increase the suffering. Instead, we may accept the pain that we feel, observe its intensity, and finally explore options for moving past it.

DBT has two other sets of skills, both of which are more on the change side of the continuum. These are interpersonal effectiveness and emotional regulation. Interpersonal effectiveness teaches practical skills for making yourself heard, strengthening your relationships, and building new relationships. Emotional regulation, as its title suggests, contains skills for managing your emotions so that they have less control and power over you.

What is the goal?

These four skills [Mindfulness, Distress Tolerance, Interpersonal Effectiveness, and Emotional Regulation] put together mean living intentionally, healthfully, and independently – that is, not at the mercy of your emotions or circumstances. It means communicating well and having positive relationships. It means that change is possible, but also that you can accept yourself while the change is in progress, because (spoiler alert) it always will be.

Need Help?

If you are interested in learning more about DBT, stay tuned for more detailed blogs about each of these skill sets. But more immediately, I would love to talk with you about how to learn and apply these skills in your particular situation. You can contact me at 940-222-8703 x705 or LauraL@acorncounseling.services, or schedule an appointment online!Laura Lanier Licensed Professional Counselor-Intern

Linehan, M. M. (2015). DBT skills training handouts and worksheets. New York, NY: The Guilford Press.

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