Dialectical Behaviour Therapy (DBT) is essentially a skill-based therapy, offering clients more practical and effective coping techniques. DBT uses a cognitive behavioural approach and includes a strong emphasis on acceptance of the person as they are, combined with the expectation that current behaviours need to change. The tension that arises, between this need for both acceptance and change, is known as a “dialectical tension.” Dialectics refers to finding the middle ground between two opposites.
DBT works by teaching clients specific skills in order to deal effectively with themselves and the world around them. Treatment focuses on:
Core Mindfulness – mindfulness is central to DBT. The skills taught are psychological and behavioural versions of meditation practices drawn from Eastern traditions. It focuses on states of mind known as “emotional mind” and “rational mind” and attempts to balance these two to produce a third mental state known as “wise mind”.
Interpersonal effectiveness – involves learning how to be effective in obtaining what you want, saying no and dealing with conflicts within relationships whilst maintaining self respect.
Emotion regulation – involves learning skills which enable you to deal with intense and painful emotional states. Suicidal and self-harming behaviours, as well as substance abuse, are viewed as dysfunctional behaviours, which the individual has developed as a way of dealing with these difficult emotional experiences.
Distress tolerance – concerned with tolerating and surviving crises and accepting life as it is at this moment.
Although DBT was originally developed as a treatment for Borderline Personality Disorder and individuals with self-harm behaviours (e.g. self-cutting, suicidal thoughts, urges to suicide, and suicide attempts), it is now being used to treat other personality disorders, eating disorders, adolescent depression, and persisting depression in the elderly.