The letter D stands for dialectical. Everything, according to dialectics, is made up of opposites, and change occurs through “dialogue” between opposing forces. Dialectics is separated into three categories: thesis, antithesis, and synthesis (the synthesis of two opposites). The two key tenets of the DBT approach involve acceptance and change, which are important for both clients and therapists. Dialectics is founded on three fundamental assumptions:
• All things are interconnected.
• Change is constant and inevitable.
• Opposites can be integrated to form a closer approximation of the truth.
The letter B represents behavior. Because DBT is a behavioral approach, recognizing and treating behaviors is a priority to help clients solve their problems. The ultimate objective is to identify problem behaviors, monitor them, and then thoroughly investigate the emotional/ cognitive/behavioral determinants of the behavior. This comprises first concentrating on purposeful self-harm/suicidal impulses or other dysfunctional behaviors and then working with the patient to understand what circumstances, both before, during, and after the behavior, increase the likelihood of the behavior occurring. This leads to a collaborative solution analysis in which new techniques for dealing with excessive negative emotions are devised, evaluated, and then implemented in everyday life. Learning new life skills in a group program that runs alongside individual treatment is a vital component of this.
What are the four components of DBT?
The primary purpose of dialectical behavior therapy (DBT) counselors is to achieve a balance between validation (acceptance) of who you are and your issues, as well as the rewards of change. Your therapist will help you acquire new skills for better emotion management. Depending upon that therapist, dialectic behavioral therapy’s framework might change, but generally speaking, DBT sessions fall into one of 4 categories:
• DBT pre-assessment.
• Individual therapy.
• Skills training in groups.
• Telephone crisis coaching.
DBT pre-assessment
DBT therapists must finish significant training. They must also remain up to date on the most recent DBT discoveries, as well as the most recent research, studies, and all other facets of mental health therapy. Before beginning DBT, your therapist may do an evaluation. They will ask you questions and explain how DBT works to see whether it is right for you. If you determine that DBT is the proper therapy for you, you must commit to the program and its duration.
Individual DBT therapy
Individual DBT treatment entails weekly appointments with your therapist. Each session lasts around 40 to 60 minutes.
• If applicable, keep you safe by reducing suicidal and self-harming behavior.
• To reduce habits that impede effective therapy.
• To support you in achieving your goals and enhancing your quality of life by addressing any impediments to your growth, such as mental health issues or relationship issues.
• To help you acquire new skills to replace troublesome behaviors.
Almost sure, your therapist will encourage you to keep a diary to record your thoughts and behaviors and to search for patterns in your behavior. You will bring this diary to each visit so that you and your therapist may discuss what needs to be worked on.
DBT skills training in groups
Your therapist will teach you skills in a group environment over these sessions. This is not the same as group therapy, in which you share your difficulties with other people. Consider it more like a classroom teaching and learning session. DBT skills are intended to help you improve your performance in everyday circumstances. Your therapist will teach you the following four skills:
Mindfulness is the practice of being fully aware and focused on the present moment rather than dwelling on the past or the future. Being aware will help a patient accept and tolerate any strong or overwhelming feelings they may experience daily. The accepting principle underpins mindfulness. People will learn to accept all events, regardless of how powerful or overwhelming their feelings become. The patient will eventually master the techniques taught in their skill groups. This strategy allowed you to mentally slowdown in life and focus on yourself and the wonderful things around you, no matter how stressful or unfavorable a situation became.
Distress tolerance is the capacity to recognize and control your emotions in difficult or stressful conditions without engaging in harmful behaviors such as
• Self-soothing
• Improving uncomfortable circumstances.
• Considering the advantages and disadvantages of the scenario
• Keeping oneself busy
Knowledge acceptance necessitates a knowledge of the idea of extreme acceptance. Radical acceptance allows you to accept that you will have both wonderful and negative life experiences. Nonetheless, you will learn how to assess these situations objectively—how to accept the conclusion despite the suffering. The first mentioned talent, mindfulness, is highly reflected in this skill set.
Interpersonal Effectiveness is knowing how to ask for what you want and need, as well as setting limits while respecting yourself and others. When you develop interpersonal effectiveness skills, you will learn how to disagree or say no to a scenario or request in a straightforward and non-aggressive manner. Individuals will also learn to ask for what they want while retaining their self-esteem and a positive connection with others.
Emotion regulation entails comprehending, being more aware of, and exerting more control over one’s emotions. This skill is critical to master; learning to manage your emotions when you are an intense person might be difficult, but with the appropriate assistance, you can do anything. An emotion control session is ideal for people who frequently experience the following emotions:
• Anger
• Depression
• Anxiety
• Frustration
Individuals who frequently experience severe unpleasant emotions can benefit from learning how to control and manage their emotions. When a patient learns to manage their emotions, they become less sensitive to unpleasant emotions caused by circumstances over which they have no control.
Telephone crisis coaching
DBT typically involves telephone crisis therapy to help you in your daily life. This means you may contact your therapist for assistance between sessions at particular times. Here are some scenarios in which you should contact your therapist:
• When you need emergency assistance, such as when you intend to self-harm.
• When you’re attempting to use the DBT techniques you’ve learned but need some guidance.
However, your therapist will define when you can call them, such as during a specified time of day. On an as-needed basis, crisis counseling is offered. Calls are frequently brief, and they should not be used to replace the work of individual or group sessions.
DBT TREATMENT TARGETS:
Clients who get DBT often have a range of concerns that demand treatment. DBT uses a treatment goal hierarchy to help therapists decide which issues to address first. The following therapy goals are given in order of priority:
• Life-threatening behaviors: First and foremost, suicide messages, suicidal ideation, and all types of suicidal and non-suicidal self-injury are targeted.
• Therapy-interfering behaviors: Any activity that prevents the client from obtaining effective therapy. These behaviors can be displayed by the client and/or the therapist, such as arriving late for sessions, canceling appointments, and being uncooperative in achieving treatment objectives.
• Quality of life behaviors: This category includes any type of behavior that interferes with clients having a reasonable quality of life, such as disorders, relationship challenges, and financial or housing crises.
• Skill acquisition refers to the necessity for clients to adopt new skilled behaviors to replace ineffective habits and assist them in achieving their goals.
DBT four therapeutic stages
DBT has four therapeutic stages in the phases. The intensity of the client’s behaviors determines the stages, and therapists work with their clients to achieve the goals of each stage on their way to living a life worth living.
• During Stage 1, the client is unsatisfied and their behavior is out of control: they may attempt suicide, hurt themselves, use drugs and alcohol, and/or engage in other self-destructive behaviors. When clients initially start DBT treatment, they frequently characterize their situation as “hell.” Stage 1’s purpose is for the client to progress from having no behavioral control to having it.
• In Stage 2, they live a life of quiet desperation: their conduct is under control, yet they continue to suffer, generally as a result of prior trauma and invalidation. Their emotional experience had been choked. The purpose of Stage 2 is to assist the client in transitioning from a state of silent desperation to one of full emotional experience.
• Stage 3’s purpose is to learn to live: to set life goals, create self-esteem, and achieve peace and fulfillment. The client’s objective is to live a normal life full of happiness and sadness.
A fourth stage is necessary for some: uncovering a deeper meaning. Linehan developed Stage 4 specifically for consumers who fail to achieve a further goal of fulfillment or a sense of connection to a larger whole throughout their everyday happiness and sadness. The goal of treatment at this level is for the client to go from a sense of incompleteness to a life with a constant capacity for joy and freedom.
Differences between Dialectical Behavioral Therapy and Cognitive Behavioral Therapy
DBT is just a modified form of CBT that includes mindfulness, acceptance, and tolerating pain in addition to traditional cognitive-behavioral therapy.
CBT
• Helps clients change how they think/behave
• Clients learn how to manage negative emotions
• Can be used in the treatment of many disorders
DBT
• A type of cognitive-behavioral therapy
• Incorporates other skills (e.g., mindfulness)
• Specifically treats borderline personality disorder
The good news is that DBT is far more successful in treating borderline personality disorder. It’s worth noting that some cognitive-behavioral therapists add DBT model features into their therapy sessions. Additionally, new DBT-inspired versions of CBT have evolved. For example, mindfulness-based cognitive therapy combines classic cognitive-behavioral approaches with mindfulness to treat depression.
Learning to control your emotions or express them aptly, will change the way you look at things. Seek therapy to improve your emotional regulation. Visit Ganeshaspeaks.com and download the app now.