DBT Should Help, Not Hurt
In its purest form, Dialectical Behavior Therapy (DBT) is very regimented and time consuming. Clive J. Robbins and Zachary Rosenthal describe the therapy, originally developed by Marsha Linehan, as requiring multiple group and individual therapy sessions weekly, skills training, phone coaching, and meetings among a person’s team of therapists. I do not subscribe to this definition, described in the DBT section of Acceptance and Mindfulness in Cognitive Behavior Therapy. DBT is, essentially, whatever dialectical behavior skills a person needs in order to improve their life.
Marsha Linehan (as relayed to me by clearviewtreatment on borderlinepersonalitytreatment.com) found that there are five different types of dysregulation that occur in patients with Borderline Personality Disorder (BPD). These are emotion dysregulation, interpersonal dysregulation, self dysregulation, behavioral dysregulation, and cognitive dysregulation. On the whole, each type is characterized by some sort of dysfunction in each aspect of a person’s life. DBT was created to treat this dysregulation, which, though commonly found in patients with BPD, can affect anyone at any time.
According to the website of Sierra Tucson, there are four main principles of DBT; these are “1. The primacy of the therapeutic relationship, 2. A non-judgmental approach, 3. Differentiating between effective and ineffective behaviors, and 4. Dialectical thinking.” These principles, specifically the first two, apply to both patient and therapist, assuring that all parties are comfortable with and prepared for what is to come. The third and fourth dictate what the patient will learn. Dialectical thinking leads to radical acceptance by teaching patients to become aware of their own judgements and accept them, according to Rachel Gill of ilovedbt.com.
There are also four treatment modules that go along with DBT’s principles. They are “1. Mindfulness, 2. Distress Tolerance, 3. Emotion Regulation, and 4. Interpersonal Effectiveness.” These go hand in hand with the principles, teaching patients through various methods to accept and handle the reality in front of them. Mindfulness leads to learning distress tolerance and so on, each skill building on the next, teaching patients how to handle their life’s dysregulation.
The workbook Don’t Let Your Emotions Run Your Life for Teens breaks down DBT perfectly to fit most people’s lifestyle. The book teaches individual skills and outlines which situations call for which skills, giving exercises on how a person is going to apply said skills. It builds upon itself, starting with the basics that apply to everyday life and getting more specific as it goes. That is how DBT should be, and that is how I learned to apply it to my own life.
For a person with BPD, life is hard enough already. The disorder is almost entirely made up of life-interfering behaviors such as impulsive actions, dysregulated relationships and emotions, and some symptoms of depression such as lack of motivation. We cannot expect such individuals to keep up a schedule like Robbins and Rosenthal require. However, we should supply them with the skills necessary to improve their daily lives.
For someone without BPD, say, a college student who still shows many signs of dysregulation, life is incredibly busy. No college student has time for class, homework, and a social life in general let alone when paired with multiple therapy sessions a week with phone coaching in between. Along with the lack of time, society still stigmatizes going to therapy as a sign of weakness, which may deter many college students from such a regimented form of DBT. Students will still need to go to therapy, but at a more relaxed pace, giving them more time for it and welcoming less judgement.
A less intense form of DBT is an effective compromise for all recipients of the therapy. Going to therapy once a week and working from a book like Don’t Let Your Emotions Run Your Life for Teens was enough to make a difference in my life, and could do the same for many others. For BPD patients, it requires less effort and is not as overwhelming. For college students, it takes up less time and welcomes less stigma. DBT can be redefined, and this new definition will help many people.
Works Cited
@DbtPeers. “An Introduction to Dialectical Thinking According to DBT.” DBT Peer Connections. N.p., 18 Oct. 2013. Web. 21 Nov. 2016.
Clearviewtreatment. “Five Areas of Dysregulation in People with BPD – Borderline Personality Treatment.” Borderline Personality Treatment. N.p., 12 Oct. 2011. Web. 21 Nov. 2016.
“Dialectical Behavioral Therapy & Treatment – Clinical Excellence at Sierra Tucson.” Sierra Tucson. N.p., n.d. Web. 21 Nov. 2016.
Robbins, Clive J., and Zachary Rosenthal. “Dialectical Behavior Therapy.” Acceptance and Mindfulness in Cognitive Behavior Therapy. John Wiley & Sons, n.d. Web. 30 Oct. 2016.
Van Dijk, Sheri. “Don’t Let Your Emotions Run Your Life for Teens.” Google Books. Instant Help Books, n.d. Web. 30 Oct. 2016.
Rowan Counterintuitive 