Introduction to

DBT

Dialectical Behavior Therapy

Dialectics is the theory that opposites can co-exist.

Dialectical Behavior Therapy (DBT), is a treatment that has been found especially effective for those with suicidal and other co-

occurring severely dysfunctional behaviors. Research has shown DBT to be effective in reducing suicidal behavior, psychiatric

hospitalization, treatment dropout, substance abuse, anger, and interpersonal difficulties.

The Focus of DBT is the Dialectics ofCHANGE & ACCEPTANCE

The goal of DBT is to CHANGE the behaviors causing suffering in our lives

whilesimultaneously

ACCEPTING ourselves and our circumstances in this moment.

Dialectical Behavior Therapy consists of 4 Modules:

Emotion Regulation

Interpersonal Effectiveness

Mindfulness

Distress Tolerance

Each MODULE contains COPING SKILLS that are used to achieve specific

goals.

DECREASES

SPECIFIC Goals of DBT

DECREASES

DECREASES

DECREASES

CORE MINDFULNESS

DISTRESS TOLERANCE

EMOTION REGULATION

INTERPERSONAL EFFECTIVENESS

COGNITIVE DYSREGULATION

IMPULSIVENESS

UNCONTROLLED EMOTIONS

CHAOTIC RELATIONSHIPS

The 4 Modules:

Core Mindfulness

Mindfulness  means paying attention in a particular way:  on purpose, in the present moment, and non-judgmentally.  This increases awareness, clarity and acceptance of our present-moment reality.

Mindfulness can simply be noticing what we don't normally notice, because our heads are too busy in the future or in the past - thinking about what we need to do, or going over what we have done. 

Mindfulness might simply be described as choosing and learning to control our focus of attention to the here and the now.

The 4 Modules:

Distress Tolerance

Distress Tolerance skills are used to help us cope and survive during a crisis, without making it worse.

Distress Tolerance skills help us tolerate short term or long term pain (physical or emotional pain).

The 4 Modules:

Emotion Regulation

Emotion Regulation skills are used to change our emotions or situations.

Emotions are closely linked to our bodies, and each emotion has a particular behavior linked to it.  The word "emotion" can be described as E - MOTION (Elicit Motion). Emotions, thoughts and what we do or feel an urge to do (behaviors) are all linked.

Learning Emotion Regulation skills will help us learn to effectively manage and change the way we feel and cope with situations.

The 4 Modules:

Interpersonal Effectiveness

Interpersonal Effectiveness refers to the skills which help us to:1. Attend to relationships2. Balance priorities versus demands3. Balance the 'wants' and 'shoulds'4. Build a sense of mastery and self-respect

WISE MIND

DBT uses the theory of Wise Mind -the part of our mind where Emotional Mind (thoughts based on our

feelings) and

Reasonable Mind (rational thinking part) merge together.

Creating “A Life Worth Living” & the 4 Stages

The most important of the overall goals in DBT is helping people create “lives worth living.” While that means different things to different people , all clients have in common the task of getting

problem behaviors under control. For this reason, DBT organizes treatment into four stages: Stage I

Moving from Being Out of Control of One’s Behavior to Being in Control

Stage IIMoving from Being Emotionally Shut Down to Experiencing

Emotions Fully

Stage IIIBuilding an Ordinary Life, Solving Ordinary Life Problems

Stage IVMoving from Incompleteness to Completeness/Connection

Willingness Vs. Willfulness

Willingness is the realization that you are part of and connected to some cosmic process.  Not only that, but it's a commitment to active participation in that process. 

Willingness is when you allow the world to be what it is. And, no matter what it is, you agree to participate in the world.

Willfulness is the opposite of willingness.  If willingness is realizing that you are a part of and connected to life, willfulness is when you forget life, deny it, or refuse to be a part of it. 

Willfulness is sitting on the sidelines or refusing to play the game because you do not like the cards you’ve been dealt.

DBT Can Be Really Really Hard!

DBT is not a “quick fix” and often when first using the skills, patients give up because they do not feel any better.

Instead, DBT is a set of skills that are developed and perfected over time, offering the promise of a better life after a substantial amount of work and willingness to try new and difficult ways of thinking and behaving.

After much practice, the DBT Coping Skills will eventually become integrated into your everyday life and your ability to regulate your emotions will become easier and more natural.

Why DBT?Because you’re doing the best that you can, and it’s not working.

Because you want to improve.

Because you may not have caused all your problems, but you are responsible for solving them.