Dialectical Behavioral Therapy (DBT)

Dialectical Behavior Therapy is a form of cognitive behavior therapy, developed by a behavioral psychologist named Marsha Linehan, as a treatment for individuals diagnosed with borderline personality disorder who engage in chronic, self-injurious and suicidal behavior. Today, dialectical behavior therapy has been validated as a treatment for multiple problems, including: depression, eating disorders, substance abuse, relationship problems, anger management and other problems involving difficulty with emotion regulation.

Enhanced by principles of Zen Buddhism, dialectical behavior therapy expands upon traditional cognitive behavior therapy by placing an emphasis on acceptance and validation of ones thoughts and feelings. When focusing on how to improve one’s life and reduce suffering, understanding and validating one’s experience (thoughts and feelings) is essential. Often times, individuals struggling with disorders of emotion regulation have difficulty balancing the desire for change with acceptance and validation. For example, it is quite common that people urgently want to reduce or escape his or her emotions and prefer to avoid experiencing these emotions. This often leads to problematic behaviors, such as binge eating, substance use, or self-harm. However, this is ineffective as the behaviors themselves then lead to an increase in negative emotion, or other unpleasant consequences. Once someone can accept their emotional experience and if these experiences are validated, gradual change becomes possible.

Dialectical behavior therapy is grounded in mindfulness meditation. Mindfulness exercises teach people to increase their awareness of their thoughts and feelings through increased awareness of the senses. Through practice of mindfulness exercises, which typically last one to seven minutes, an individual gradually develops the ability to accept distressing thoughts and feelings without acting upon them through the use of maladaptive behavior.

Dialectics refers to the balancing of contradictions. The term dialectical behavior therapy refers to this central goal of balancing fundamental acceptance with desired change. In dialectical behavior therapy, as in traditional cognitive behavior therapy, change is brought about through the development and implementation of new coping skills. These coping skills involve behavioral techniques that are applied to minimize the symptoms of psychological disorders and reduce emotional suffering. Within this behavioral skills learning model, dialectical behavior therapy focuses on core mindfulness skills to increase awareness and acceptance of one’s emotions, skills for tolerating distress, skills for regulating emotions, and skills for increasing interpersonal effectiveness.

Comprehensive dialectical behavior therapy includes individual therapy, DBT skills training group, phone coaching and therapist consultation team. Unfortunately, I am not offering comprehensive dialectical behavior therapy at this time. However, as a former member of an intensively trained comprehensive DBT team, I provide DBT-informed Cognitive Behavioral Therapy.