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Dialectical Behaviour Therapy (DBT) was developed in the 1980s by Dr. Marsha Linehan, a psychology researcher at the University of Washington. It derives from the acknowledgement that some people are more likely to react in an intense and out-of-the-ordinary manner when faced with certain emotional situations, primarily those found in romantic, family and friend relationships. DBT has primarily been used to treat patients with Borderline Personality Disorder, but it has proven beneficial in all situations where people are exhibiting impulsive behaviours – including addictions, eating disorders, anger problems, self-harm, and severe depression and associated suicidal thoughts.
A modified version of Cognitive Behavioural Therapy, DBT places emphasis on two concepts – validation and mindfulness.
The process of validation is a powerful tool whereby the therapist and patient work on “accepting” uncomfortable thoughts, feelings and behaviours, rather than struggling with them. Once these thoughts, feelings and behaviours have been validated, working to change them no longer feels impossible. It is this aspect of DBT that involves dialectics – a philosophy that concerns itself with examining and discussing opposing ideas in order to find the truth. Acceptance and change are opposite ideas, and DBT seeks to find an acceptable balance between them.
DBT’s emphasis on mindfulness has its roots in Eastern meditation and yoga. Individuals are taught to become increasingly conscious of their thoughts and feelings, through the observation of bodily sensations. This allows patients the time and insight needed to change their thoughts, feelings and behaviours. Therapists often speak of patients’ need to use their “wise mind” to make better choices.
Dialectical Behaviour Therapy is often described as support-oriented, cognitive-based and collaborative. When it succeeds, it allows the patient to identify their strengths and build on them and change their thought processes – like Cognitive Behaviour Therapy, DBT takes patients from “I have to be perfect at everything” or “If I get angry, I’m a terrible person” to “I don’t need to be perfect at all things for people to care about me” or “Everyone gets angry, it’s a normal emotion.” The collaborative aspect of DBT is seen in the relationship between patient and therapist. In DBT people are encouraged to work out problems in their relationships with their therapist and the therapists to do the same with them.
When successful, DBT can provide formative change. It can decrease the frequency and severity of self-destructive behaviours, it can instill a new arsenal of coping skills, and it can be a huge motivator for self-improvement.
National Alliance on Mental Illness (2013). Dialectical Behaviour Therapy Fact Sheet. Retrieved from: http://www.nami.org/factsheets/DBT_factsheet.pdf
Psych Central. (2007). An Overview of Dialectical Behaviour Therapy. Retrieved from http://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy/0001096