Dialectical Behaviour Therapy: Riding out the storm with our wise mind
Updated: Nov 9
Dialectical Behaviour Therapy (DBT) is a therapeutic modality that was originally developed by Dr. Marsha Linehan as a treatment for borderline personality disorder. Since then, it has evolved and expanded significantly, and it is now being used to treat a variety of conditions. It’s particularly useful when experiencing strong emotions and urges, so it can also help with eating disorders, substance use disorders, self-harm, suicidal ideation, depression, and anxiety. It’s the first therapy to formally incorporate mindfulness in treatment. In this blog, we’ll take a look at DBT in more detail and see examples for some of the tools it offers.
More Info on DBT
The word ‘dialectical’ in Dialectical Behaviour Therapy refers to the idea of bringing opposites together. We can see how DBT helps unite opposites in the following example.
John is feeling overwhelmed about a decision. He says he wants to quit his job because the work isn’t meaningful to him, but he also expressed that the job provides him with financial security. John both wants to quit and wants to stay in his job. With DBT, a therapist can help John understand that the emotional mind’s intelligence is urging him to quit his job, while his rational mind’s reasoning is urging him to stay. A therapist will validate both of these perspectives and help John access ‘Wise Mind’, which uses emotion and reasoning to make healthy decisions. Using his Wise Mind, John sees other potential solutions, such as volunteering outside of work, having a conversation with his boss, or retraining to work in another field.
With Dialectical Behavior Therapy, therapists validate clients’ experiences while helping them access their own wisdom and learn to trust themselves.
The goal of DBT is to help clients create a life worth living, where clients move beyond surviving and learn to thrive. DBT offers four modules to give clients a strong foundation.
Four Modules of DBT
There are four modules in DBT that aim to help build skills across different areas.
· Mindfulness helps us observe our thoughts without getting attached to them. We can learn to notice what thoughts are coming up, how to describe our emotions, and how to be aware of our negative judgements and how they make us feel. We can also learn how to make decisions from our Wise Mind, which brings together our rational thinking and our emotional intelligence.
· Distress Tolerance offers us a range of tools when difficult situations or strong emotions occur. We learn skills like Radical Acceptance, which help us to recognize reality as it is. We learn about healthy ways to distract ourselves, and how to become more grounded and to self-soothe using our five senses.
· Emotional Regulation is all about dealing with our emotions. We can learn how to stop blocking negative emotions, how to validate our own feelings, and how to solve problems to become more effective and confident in our own abilities.
· Interpersonal Effectiveness teaches us how to have healthy communication by asking for what we want, setting boundaries, listening to and validating others, and building trust in our relationships.
DBT in Action: Self-Soothing using the Five Senses
In the Distress Tolerance module of DBT, clients learn to self-soothe. We can do this by engaging the five senses, which help us become aware of the present moment. Here are some examples:
Sense of sight:
· Go for a nature walk and observe the trees, the sky, and other people.
· Look at art in a museum or online.
· Watch a beautiful and soothing movie.
Sense of hearing:
· Listen to soothing or interesting music.
· Find an audiobook or a podcast.
· Call a friend or family member.
· Try singing a familiar song.
Sense of smell:
· Bake bread or cookies.
· Have a relaxing bath or shower.
· Light a candle.
Sense of taste:
· Mindfully eat a piece of candy or chocolate.
· Make a cup of tea.
· Share a nice meal.
Sense of touch:
· Put on soft, comfortable clothes.
· Hug a loved one.
· Give a self-massage.
· Pet an animal friend.
Dialectical Behavior Therapy offers therapists and clients a wide range of skills and tools to help with mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. No one has to feel out of control and overwhelmed by strong emotions and urges forever. It is possible to thrive. If you’d like to know more about DBT and to talk with a therapist who can help find the right therapy plan for you, click on the link below.