DBT: What, Who, How, and Why
Dialectical Behavioral Therapy. It sounds intimidating – something some people call ‘psycho-babble’. But today, and for the next few week, I’m going to do a series that will hopefully dispel some of the mysteriousness which surrounds DBT.
But why this series? Why now?
A backstory is involved:
I have gone to counseling about 4 years now. 6 months of that included group therapy. Now, some people can’t understand the purpose of counseling, or why you would ever ‘try that’. I can understand that. It’s scary to ask for help. Some people don’t want to talk about regular doctor visits – much less discuss mental health and emotions with a stranger. Much less tell friends what it is actually like to visit a therapist. So the picture remains, gray and foggy as it is, of couches, Freud, and creepy psychiatrists asking “how does that make you feel?” There are so many myths in our culture about mental illness, and its treatment, and how to maintain mental health. Part of this post series’ goal is to pull back the curtains, and share what counseling and therapy and coping skills REALLY are – not what the television or goofy memes say they are.
I was pretty open to one-on-one counseling. But group therapy – ridiculous! What could that offer me? I thought it sounded silly.
Actually, I thought it sounded scary. Include more people in my life’s equation – could I handle that?
I tried it anyway.
I ended up loving it. I learned so many practical skills, the material we worked on was fabulous, my group leader was a sensitive and warm person, and managed the flow of the group superbly. And, surprise! I actually made friends, which was the best part of all.
Anyhow, what was this ‘material’ we discussed in group therapy? What was our homework and skills practicing all about?
Well, the group I joined was a DBT skills group. So every week our leader would present some of the new skills in a DBT handbook to us. He would also assign us some homework usually over the week and when we met back together we would discuss our failures and successes using these skills. What’s interesting about many of these DBT skills is that many people use some of them automatically. A healthy person, (physically, mentally, emotionally, and spiritually) actually makes use of all of them, often without thinking about it. But we all have areas we could work on. Some of us are better at one skill than another. Plus, an addiction, or trauma, or a difficult childhood or mental disorder can make it even more difficult for a teenager to learn and implement some of these life skills and coping mechanisms. Hence the need for a group to hold you accountable, and a leader or therapist to guide you as you basically learn self-care and how to live a healthy life.
I no longer do group therapy. But I decided recently to go back and review my old skills book. Realizing just how helpful these skills really were, I decided not only to try to review them regularly, but to also share them on my blog. Because, really, everybody could use a little help living a healthy lifestyle. I hope this series:
1 helps me remember to continue reviewing DBT skills
2 helps you learn something new, something you could even implement into your regular life, and
3 make the world of group therapy and mental health less scary, and more approachable
So to end this post, I’m going to give you, faithful reader, a little more information about DBT, with the help of Kafka and Conrad, before I sign off for the rest of Monday afternoon:
DBT stands for Dialectical Behavioral Therapy.
Though we can’t expect to have a stress-free, annoyance-free, easy life with no high-highs or low-lows, the goal of DBT, I was told, was to go from extreme emotions and dysregulation, and dysfunction:
to a stabler, healthier, and thus generally happier life.
So, in my handbook (by Marsh M. Linehan) there is a general goal for DBT:
‘To learn how to change your own behaviors, emotions, and thoughts that are linked to problems in living and are causing misery and distress.’
The behaviors we desire to decrease, according to the book, are:
- Mindlessness – essentially, being out of touch with self and others, unawareness, judgmental mindset
- Interpersonal conflict, the amount of stress in our relationships
- Absence of flexibility
- Extreme emotions
- Mood-dependent behavior, and difficulties regulating emotions
- Impulsive behaviors; acting without thinking
- Refusal to accept reality
I found my personal goals, that I wrote down in the fall of 2015:
Behaviors to decrease:
Sleeping, isolating, numbing myself with screen time, letting my thoughts take me on a downward spiral, assuming all my thoughts are true, avoiding certain people
Behaviors to increase:
Being non-judgmental towards myself and others; leaving time in calendar for seeing friends and self-care (like eating!), being able to communicate clearly, kindly, and effectively, evaluate my thinking, learn to be ok around people.
So I hope this intro to DBT has intrigued you! There are four main components of DBT: Mindfulness:
and Distress Tolerance:
Next week, I will introduce mindfulness – because if you are not mindful, you cannot use the other 3 sets of skills. Have a great week guys! Love you all!