Dialectical Behavior Therapy
The core of DBT flows from Mindfulness, the first of four modules. Mindfulness is essentially being aware of and attending to just what is present in this moment. Mindfulness leads to increased self-awareness and supports an increased sense of control over emotions and actions. Mindfulness is supported by an increasing body of research that shows the powerful effects of mindfulness practices on the brain, including reducing the size of the amygdala (the part of the brain that is particularly impacted by trauma) and the number of connections between the amygdala and the rest of the brain.
The next two modules, Distress Tolerance and Emotion Regulation, focus on tolerating or changing emotions. Distress Tolerance, as you might expect, is focused on developing healthy and adaptive strategies to manage intense emotions when the situation cannot be changed in the moment – basically, crisis survival skills. Emotion Regulation focuses on the choices we can make every day to increase our resilience and support a stable emotional baseline. Taking care of our physical selves through healthy eating, physical activity, treating illness and avoiding mood altering substances except as prescribed by a physician are all part of this module. Also included is the importance of doing things you enjoy, things you do well, and learning new things, all of which support a positive self-image, increase experiences of joy. Additionally, this module also addresses ways to change your relationship to a given problem, taking a stepping back and finding solutions you didn’t realize exist.
The fourth module is interpersonal effectiveness. An important part of healing from interpersonal trauma is to address the rupture of trust in humanity that occurs when a person harms another. This module focuses on building healthy relationships. Learning healthy ways of being assertive and asking for what you need, setting limits and maintaining relationships while staying true to your values, and learning how to show your loved ones they matter without losing yourself in the process are all components of this module.
While DBT may have been developed to help those struggling with self-injury and chronic suicidality, its components are applicable to many struggles that people face. DBT is truly that – dialectical, embracing that two things that seem like they can’t both be true, are actually both true. Primary to DBT is the assumption that we are all always doing our best, and at the same time we must continue to work harder in order to create a life worth living. DBT accepts you for who you are right now in the moment without judgment and with the understanding that your symptoms serve a function and probably helped you survive until this point, even if they are also now causing you distress. DBT also understands that acceptance alone will not bring relief from suffering and supports you, the individual, in making changes in your thinking and behavior to support the creation of a life worth living as defined by you.