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What is Dialectical Behavior Therapy?


Philosophy of DBT


DBT is based on the theory that clients have internal distress.  Clients are emotionally intuitive and sensitive and, as a survival mechanism, many clients have learned to pick up on how others feel about them.  While this can be inaccurate, it is close enough to reality for clients to engage in control behavior based on their assessments of how people feel about them.  Clients use this ability to manage their relationships and behaviors.


The idea behind DBT is that there is no absolute truth.  Most things can be seen in many, sometimes opposite ways.  DBT is about finding the balance in life.  Things are not all “good” or all “bad.”  Things are often good and bad.  For example: right now, you are doing the best you can and you need better skills to be more effective.  You have not caused all of your problems but you have to solve them anyway.  DBT is about accepting what “is” and moving towards change.


Your present circumstances don't determine where you can go; they merely determine where you start.


Meaning of "Dialectical"


Dialectics represent the mind’s way of understanding concepts by understanding and appreciating their polar opposites.  Dialectics are one of the important unifying concepts that reflect how the mind fundamentally understands and perceives most core concepts and ideas. 


Dialectics provides us with a way of looking at every situation and being able to understand that there is no “one way” to see the truth.  Each situation can be seen in many ways, including ways that can be total polar opposites, such as:


Black and white

Night and day

Good and bad

Hot and cold


All of these things exist on a continuum, and there are elements of both in most cases in each situation.  So, when we see things only in “absolutes” we deny ourselves the opportunity to make meaning of these things that allows us more flexibility in our responses to them.  Using dialectical thinking can help people understand where others are coming from and enable them to make attempts at finding an integrated, middle ground when conflict arises.  Dialectical thinking can also help us to evaluate our own feelings and reactions to things and make better choices for ourselves.


The Four Modules


Behind each and every bit of DBT-work are these four modules…


Mindfulness: The capacity to pay attention, non-judgmentally, to the present moment. Key is experiencing one’s emotions and senses fully, yet with perspective.  Mindfulness helps individuals accept and tolerate the powerful emotions they may feel when taking-on their habits or exposing themselves to upsetting situations.


Distress Tolerance: This isn’t a matter of changing distressing events and situations. In fact, it’s an issue of accepting, finding meaning in, and tolerating distress. DBT places emphasis upon learning to bear pain skillfully. One may not like or approve of their circumstances, but they’re real and present. The mission is to learn how to make prudent action-decisions.


Emotion Regulation: This is a task of identifying and labeling emotions and obstacles to change, reducing vulnerability, becoming aware and non-judgmental of self, and taking the opposite action of what first comes to mind.


Interpersonal Effectiveness: The work here is grounded in assertiveness and interpersonal problem solving. It’s all about learning how to ask for what one needs, saying no, and coping with interpersonal conflicts. Simply – developing the skills to change, or resist harmful change.







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