Dialectical Behavioral Therapy (DBT) was developed by a lady who has Borderline Personality Disorder (BPD), Marsha Linehan. The reason she developed DBT is because traditional therapy was not effective in treating her BPD. According to research 65% of people with BPD are treatable and the other 35% will benefit from management with therapy.
DBT is essentially a type of Cognitive Behavioral Therapy and incorporates some of the techniques you are already familiar with.
The 4 corners of DBT are distress tolerance, mindfulness, emotional exposure, and interpersonal skills. Today let’s just focus on distress tolerance.
The way I look at it, there is a process before using coping skills that is focused on increasing one’s tolerance to stressful situations. Most of us do this automatically and then can use a coping skill to help us through a difficult time. Common coping skills you many have heard include music, coloring, and going for a walk. Therapists often encourage people to utilize breathing techniques.
You may have heard from someone, “The breathing stuff doesn’t work for me,” or “How am I supposed to think before I act when I can’t think? It just happens.” My general response to this used to be psycho-education about the autonomic nervous system, triggers, warning signs, and coping skills. Sounds easy peasy, but when it doesn’t work one might call the client “resistant,” when in all honesty, they may just be unable to utilize their knowledge outside of session because they have such a low tolerance for distress.
I think of distress tolerance like an alcohol tolerance (except in a healthy way). With a high tolerance more often and the amount you drink, the more it takes to feel the effects of the alcohol. With distress tolerance, the higher it is, the more manageable a situation. Low tolerance means emotional instability which can present a myriad of ways but most often in the form of panic attacks, uncontrollable crying, and anger outbursts. This is why DBT has been not just effective for treating BPD, but also other disorders. I use a combination of mostly DBT and CBT in my sessions. The combo seems to produce better results for those with mood disorders.
If you suffer depression, anxiety, trauma, bipolar disorder, or borderline personality disorder then DBT might be for you.
