Dialectical Behavioral Therapy: What Is It?

Marsha Linehan of the University of Washington in Seattle Dialectical Behavioral , Washington, developed it. The “dialectical balance” between acceptance and transformation, a notion central to dialectical behavioral therapy, defines the psychopathological core of borderline disorder in the following five areas:

Behavioral dysregulation (such as impulsive behavior, self-harm, and suicidal behavior); cognitive dysregulation (dissociative symptoms and transient paranoid states); interpersonal dysregulation (such as the presence of chaotic relationships, fear of abandonment); dysregulation of the self (such as difficulty in maintaining a stable and coherent vision of one’s identity).

We provide dbt in London to help you overcome borderline personality disorder whether you are dealing with it or any other mental health issue.

Biopsychosocial perspective

According to dialectical behavioral therapy, the combination between factors due to the patient’s unique biological susceptibility and specific aspects of his formative environment is what causes borderline personality disorder. Three factors make up an individual’s biological vulnerability: (a) high sensitivity to stimuli (i.e., low threshold for perceiving events that elicit emotional responses); (b) high reactivity; and (c) slow return to the “baseline” of the activation (i.e., propensity to gradually restore a state of stillness).

Dialectical Behavioral Therapy Fundamentals

Environmental invalidation, defined as any environment that views an emotional reaction as “unjustified” or “not understandable” in light of the situation, with a subsequent tendency to simplify, trivialize, and criticize, is the element that makes biological vulnerability a risk factor for the development of a borderline personality disorder, in accordance with the principles of dialectical behavioral therapy. Trivialization and criticism assume that there is a clear picture of the other person’s mental reality because they frequently lead to normative attitudes or instructions about how one should feel and behave.

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Long-term effects of this attitude include a reduction in the person’s capacity to detect internal experiences, control emotions in an adaptive manner Dialectical Behavioral , and maintain the belief that internal experiences serve as “reliable guides” for conduct. Instead, it will cause the person to “self-invalidate” (seeing their feelings as “inadequate,” “dangerous,” or “unmanageable”) and as a result, they will look to the surroundings for helpful cues rather than the environment itself to guide their behavior and decisions. Being subjected to environmental impairment results in a progressive and persistent deficiency in the capacity to communicate one’s pain to others and to properly express one’s emotions, as well as a propensity to alternate between emotional restraint and outpouring of emotions in an erratic and severe manner.

In a nutshell:

In the biologically vulnerable person, repeated exposure to environmental deterioration causes a change from vulnerability to self-regulation deficit. Being subjected to environmental impairment results in a progressive and persistent deficiency in the capacity to communicate one’s pain to others and to properly express one’s emotions, as well as a propensity to alternate between emotional restraint and outpouring of emotions in an erratic and severe manner. In a nutshell, systematic exposure to environmental impairment causes a person who is biologically vulnerable to change from vulnerability to self-regulation deficit.

Being subjected to environmental impairment results in a progressive and persistent deficiency in the capacity to communicate one’s pain to others and to properly express one’s emotions, as well as a propensity to alternate between emotional restraint and outpouring of emotions in an erratic and severe manner. In a nutshell Dialectical Behavioral , systematic exposure to environmental impairment causes a person who is biologically vulnerable to change from vulnerability to self-regulation deficit.

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Dialectical Behavioral Therapy treatment plan

A therapy team delivers DBT treatment, which is broken down into:

Dialectical Behavioral

  • Individual counseling;
  • A skills development group;
  • Consultation over the phone;
  • Corollary therapies (such as psychiatric treatment and family assistance).

Individual Dialectical Behavioral Therapy therapy

Psychotherapeutic treatment aims to enhance quality of life (or rather, “to achieve a life worth living”) by addressing both the resources and problematic parts of functioning. We can state the following about individual psychotherapy in terms of dialectical behavior therapy:

  • It adopts a behavioral approach Dialectical Behavioral , assisting the individual in recognizing and analyzing problematic behaviors as well as the situations that give rise to them, with the goal of teaching them to be replaced by adaptive behaviors.
  • It is a cognitive treatment since it aids the patient in becoming aware of and altering dysfunctional ideas and expectations acquired during life that prove to be inefficient or punishing (such as thinking in terms of “all or nothing” or “black and white” thinking).
  • By assisting with the acceptance of psychological discomfort and the notion that “real changes” take time to manifest, it teaches how to improve the abilities acquired in the skills training group (see the paragraph below this one).

It necessitates a cooperative connection between the therapist and patient, who gradually learn to function as a team committed to specific, shared goals.

Dialectical Behavioral

The psychotherapeutic intervention in dialectical behavioral therapy also follows a specific order of priority: the first behaviors to be addressed are those that put the patient’s life and safety at risk (such as suicidal and para-suicidal behaviors), followed by behaviors that can invalidate the efficacy of the therapy (such as irregular sessions, disengagement from “homework,” inner ambivalences…), and finally those behaviors that interfere with or decrease the effectiveness of the therapy.

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Groups that teach dialectical behavior therapy techniques

The instruction groups for skills training last for around six months overall and have four to eight participants. They are not psychotherapy groups. You get the following fundamental abilities through them:

Relationship effectiveness

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Or the capacity to use appropriate actions to (a) accomplish one’s objectives, (b) uphold interpersonal bonds, and (c) uphold one’s self-respect. The patient gains fundamental interpersonal skills through this module, such as how to describe his issue, express how it makes him feel, affirm his own desire, appear confident in his ability to realize it, and be flexible in discussing how to do it.

Emotional control:

The capacity to (a) understand one’s emotions and how they work, (b) identify circumstances that make one more susceptible to unpleasant emotions, and (c) lessen emotional suffering. In this module, the patient gains awareness of the connection between his internal states and the external environment as well as the ability to recognize the behavioral impulses connected to each emotion.

Suffering tolerance

It is the capacity to “survive” stressful situations without making them worse; it entails accepting the presence of psychological suffering and integrating it with the prospect of “moving on.” Through this module, the person learns to identify the crisis and to use particular coping mechanisms (such as “stop” skills to support self-control and keep acting consciously, and management skills for intense emotions, acting on the “chemistry” of the body with relaxation and strenuous exercise, for example).

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