Unpacking the Zen of DBT
In our world of ubiquitous talk about mental health, there's an acronym that seems to be getting a lot of attention: DBT aka Dialectical Behavioral Therapy. What used to be the singular therapy for Borderline Personality Disorder is now used to treat a slew of issues, including treatment-resistant diagnoses such as depression, bipolar disorder, PTSD, eating disorders and substance use disorders. Of late, celebs like Selena Gomez and Lady Gaga are even touting the benefits of this evidenced-based therapy. What exactly is DBT and why are so many people talking about it?
Dialectical: Balancing Act of Opposites
Dialectical is a term borrowed from philosophy that essentially means finding harmony in opposing forces or ideas. Think of it as the yin and yang of mental wellness. Developed in the late 1970s by psychologist, Dr. Marsha Linehan, DBT takes this concept and applies it to therapy.
Linehan's inspiration came partly from her own personal struggles as well as her appreciation for Zen Buddhism. In Zen, one strives to achieve a sense of balance and acceptance in every moment, much like the dialectical approach in DBT. It's no coincidence that DBT borrows mindfulness techniques from Buddhism, urging patients to stay present, observe their thoughts and let them pass without harsh judgment.
Radical Acceptance: Embracing Your Reality
One of the core concepts of DBT is radical acceptance, which according to Linehan, is a “complete and total openness to the facts of reality as they are, without throwing a tantrum and growing angry” (2021, p. 503).
Imagine you're stuck in traffic, and there's absolutely nothing you can do about it. You can either fume with anger or practice radical acceptance, acknowledging the situation and letting go of your resistance. It's about accepting the unchangeable reality, even if it's not what you want.
Radical acceptance encourages individuals to accept themselves, their emotions, and their circumstances without judgment. After all, it's tough to make meaningful progress in life if you're constantly at war with yourself or your past. Radical acceptance is about making peace with what you can't change and making room for growth.
Acceptance with Change: The DBT Dichotomy
In DBT, the therapist helps the client understand the harmonious blend of acceptance and change. In essence, the client works toward accepting imperfection, uncertainty and discomfort while also acknowledging that they are responsible for making changes if they want their life circumstances to improve. It's the "dialectical" dance between these two concepts that makes DBT so therapeutic.
The Four Core DBT Skills
DBT equips individuals with four core skills to help them navigate the natural ups and downs of life:
Mindfulness: This skill encourages paying attention to the present moment without judgment and with self-compassion.
Distress Tolerance: This skill helps the client understand that they’re capable of sitting with negative emotions. Rather than acting out when uncomfortable, they’re encouraged to adopt healthy coping strategies such as practicing mindfulness.
Emotion Regulation: This skill helps you manage emotions instead of being managed by them. It can also help reduce vulnerability to negative emotions and help cultivate positive emotional experiences.
Interpersonal Effectiveness: This skill helps improve self-awareness of negative behaviors that may be affecting your relationships. It helps improve communication with emphasis on assertiveness, self-respect, negotiation and maintaining relationships.
Lemi is proud to offer DBT, a practical, evidence-based therapy that can be used to help anyone improve mood, increase self-respect, learn mindfulness, improve communication and boost well-being. Our therapists are trained in traditional DBT and can also use DBT skills with other types of therapy. If you have questions about whether DBT is right for you, contact us.