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Dialectical Behavioral Therapy (DBT) -

What is DBT?

Dialectical Behavioral Therapy is a therapy that was originally developed for the treatment of a personality disorder called “borderline personality disorder”. The primary idea with DBT is to encourage emotional regulation and being present using mindfulness-based techniques. DBT is a branch from the ever-famous Cognitive Behavioral Therapy (CBT).

DBT is a very popular treatment that most mental health practitioners are at least familiar with by the time they graduate from their graduate school programs. After using some of the skills you may see why it is popular: because it works quite nicely!

The core of DBT is the truth regarding dialectics, which is that two seemingly conflicting truths can exist in the same space, as well as ongoing emotional regulation and distress tolerance. An example of a dialectic may be something like you love your partner and want the best for them, but you feel violated by them when they yell at you. This and other dialectics can make certain realities difficult to navigate due to mixed emotions.

If you have ever had a mixed emotion (you most definitely have) then you can benefit from DBT!

What are some DBT Skills?

As a skills and strengths-based cognitive therapy (meaning using the tools your brain has to heal itself) DBT can be an effective therapy for your managing your distress in day-to-day situations.

5 Senses

This skill is one I began my career using quite a lot–mostly because it is easy and you can do it anywhere! Start by noticing that you are in the room you are in. Next, you want to focus on identifying any number of things you can see, smell, hear, taste, and feel with your body.

The idea here is that you are using your senses to experience your surroundings more wholly, which can in turn help you through a difficult emotional state you may be in such as panic or anxious thoughts.

Regulate Your Temperature

Sometimes 5 senses is only enough to get us into the room. If you are finding that you are still struggling with the big feeling you are carrying, consider trying to change your body’s temperature. Your temperature is usually directly related to the mood you are currently experiencing.

For example, anger is usually associated with a higher body temperature. DBT suggests lowering your body temperature with a cold shower or simply putting your head in cold/icy water. By bringing your body’s temperature down you can change from a more highly activated “fight or flight” state and move to a calmer, restorative state.

Meditation/Mindfulness

You will have to go 20 lifetimes before you find a therapist that doesn’t believe in meditation and mindfulness on some level. It’s, of course, because it is a great skill that every person can do! Meditation is a more specific form of mindfulness where you are increasingly raising your awareness to your thoughts and bodily sensations without judgment with the purpose of self-regulation.

The beauty of meditation is that you can practice it in any way or setting that is the best fit for you. Sit in a quiet room and choose to focus on your breathing to start. Feel where it is in your body without trying to alter it. Then slowly move it to your belly once you have sat with it for 5-10 breaths.

Once your breath is in your belly you can now notice what your body or thoughts are doing. Are your thoughts perseverating on anything in specific? Maybe they are mostly negative or focusing on stresses. The key here is to let them happen and simply notice them. Think of a babbling brook with them coming and going with the flow of the water.

You can use this small meditation with any imagery you choose, but the overall goal is the same: to be present and non-judgmental of your current state. I highly recommend this if you are mostly psychologically in a good place. If you struggle with trauma or severe depression with suicidality and don’t have the ability to regulate yourself in the moment when triggered, you should address that first before trying to sit with those thoughts.

Anything Pleasuring to You

My favorite thing about DBT is with it being a strength-based psychotherapy you can use anything that gives you pleasure (in proper moderation) to help you self-regulate. This is usually done in the context of an absence of daily activities that bring you pleasure.

When I was learning about DBT in my grad-school internship the social worker that was teaching me about it gave my class a long list of random things adults can do to feel pleasure in order to emphasize that anything can be a DBT skill if you need it to be. Essentially anything you can think of was on that list: exercise, cleaning, walking, sleeping at odd times during the day, sex, talking to a stranger, even buying yourself something nice. My personal favorites usually were consisting of stepping outside of your comfort zone like “saying a random nice thing to a stranger”.

These may sound like overly-simple fixes for your low mood, but that is really the beauty of all of this–sometimes we just need to feel good. Of course, we don’t want to over-rely on pleasure to make us feel good in the moment. These suggestions are simply for you if you realize after some thought that there is a significant absence of these activities in your life. So go and feel good with anything that makes you feel good!

What can DBT do for You?

You may struggle to hold certain truths that create conflicting feelings within you or you may be trying to advance to the next level of looking out for your mental health. DBT is a highly versatile and useful therapy for just about every person. Who wouldn’t benefit from self-regulation and a higher ability to navigate life?

Because of this, you may find that some truths or situations in your life are not as scary as they may seem. You may also learn that your emotions don’t control you and that feeling anything is absolutely normal and okay (believe me, this was a tough one to digest at first). Learning these truths about your emotions is such a freeing experience and I invite you to learn these truths and how they apply to you!

If you are wanting to learn more about your emotions and how to cope with some of the bigger ones through online mental health counseling, feel free to reach out using my contact form!

References

https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy

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