What Is DBT? A Skill-Based Approach to Real Change

As a therapist, I sometimes meet a new client who rolls in on fumes.

They’ve tried therapy.

They’ve told their story over and over again.

They’ve tried different techniques.

And, they’re still not where they want to be.

Having worked at nearly every level of care at this point, I know two things that are crucial in the therapy process:

1)    Finding the right therapist for you

AND

2)    Finding the modality that clicks

Being able to finally get to that “click” is like fireworks (for both of us!).

I specialize in a specific type of therapy known as Dialectical Behavior Therapy or DBT.

DBT was developed in the 90s as one of the first truly effective interventions for people navigating Borderline Personality Disorder, and it has since been applied to many other diagnoses including ADHD, binge eating disorder, mood instability, and substance use disorders. And, it can be used for adolescents all the way through adulthood as well as in group therapy and/or individual therapy.

How does it work for so many different diagnoses, struggles, and ages?

DBT isn’t just about diagnosis; it’s about SKILLS.

DBT helps manage symptoms including reducing impulsivity, navigating intense emotions, coping through mood swings, addressing executive dysfunction, and building skills to address challenges in interpersonal relationships.

DBT is a structured, skill-based therapy focused on developing our mindfulness muscle to improve focus and concentration, building self-compassion and accepting ourselves as we are working to make change, and fundamentally improving our ability to self-regulate.

There are four pillars to DBT:

·      Mindfulness- building the skill of being able to focus on the present and attend to what is happening in the now without judgment

·      Emotion Regulation- recognizing your emotions, navigating their intensity, and feeling less out of control of your own actions even in the midst of big feelings; accepting reality as it is even when you don’t like it

·      Distress Tolerance- the challenge of accepting uncomfortable thoughts and emotions before trying to change them; also, building the skill of being able to live in the both/and instead of all or nothing or BUT (also known as dialectics)

·    As your therapist, my role in DBT is to help guide you to find the balance between acceptance and change. That’s where the dialectics come in; you are able to come to see that two things that may seem opposite can be true at the same time.

·      Interpersonal Effectiveness- helping you understand your needs in relationships, identify, set, and maintain healthy boundaries, and being able to hold your needs and the needs of others without abandoning yourself or abandoning or betraying others to get your needs met; this looks like respecting yourself and others, listening and communicating effectively, repairing relationships, and being able to say yes when you mean yes and no when you mean no

So, what does DBT look like in practice?

It might look like coming into session processing the complicated feelings you have about a job you initially loved, now dread, but are hesitant to leave because of the relationships you’ve built.

With DBT, we will focus on identifying and validating how you are feeling in the here and now (not how you used to feel or what you worry could happen in the future but what you are actually currently feeling), accepting the complexity of your thoughts and feelings, and working to identify how to honor and hold onto the relationships you have built while not abandoning yourself to stay in this role that no longer serves you.

Or, another example might be you are a new parent, and your ADHD symptoms are ruining your life. You can’t keep track of anything, always feel overwhelmed and behind, and are starting to feel hopeless about your ability to even be an effective parent. You’ve noticed more arguments with your partner and feel completely disconnected from the self you were before.

As your therapist, I would first VALIDATE and acknowledge the changes you are experiencing, normalize how this can amplify ADHD symptoms, focus on the present versus projecting into the future, and spend time in session working with you to write a text/letter/email/talking points to share with your partner explaining how you have been feeling as well as what you value about the relationship and asking for key supports to help you get back on track.  

If any of this resonates with you, I would strongly encourage you to give DBT a try! You deserve more than to just manage your symptoms. You deserve a life worth living.

To get scheduled with Ashleigh, please reach out to us

at engage@honeybeepsychotherapy.com to be added to her calendar!!