In recent years, there has been a shift in societal attitudes toward mental health challenges and seeking therapy from one of judgment to one of understanding and compassion.
According to a poll from the Canadian Mental Health Association, one in four Canadians are seeking help for their mental health. Just two years before that, this number sat at just 9%.
This is a significant difference.
This change has led to an increased demand for mental health counseling, which can come in various forms and methodologies.
One of the most effective and widely used therapeutic approaches used by mental health professionals is Dialectical Behavior Therapy (DBT).
Let’s explore further in this blog what DBT is, how it works, its techniques, its effectiveness in treating diverse mental health issues, and various DBT strategies.
What is Dialectical Behavior Therapy?
Dialectical behavior therapy is a type of therapy rooted in cognitive-behavioral therapy. This therapy can take place virtually and is designed to help individuals learn strategies to manage intense emotions, improve interpersonal relationships, and enhance self-awareness.
The key concept behind DBT revolves around the “dialectical” aspect of its name, which refers to opposites.
In the context of DBT, this means fostering acceptance and awareness of the situation while simultaneously working to change unhelpful behaviors.
Core Components of DBT
DBT consists of four core components that work together to help individuals navigate their emotions and develop more fulfilling lives and relationships.
These components that a counsellor aims to teach a client include:
Mindfulness: Mindfulness is about being present in the moment and recognizing your thoughts, feelings, and surroundings without judgment. This practice allows you to create a pause between your emotions and actions so that you are less likely to act on impulse.
Distress Tolerance: This component of DBT teaches individuals to manage crises and stressful situations effectively without resorting to harmful coping mechanisms.
Emotional Regulation: DBT equips you with tools to identify, articulate, and regulate your emotions.
Interpersonal Effectiveness: This aspect of DBT enables you to communicate more assertively than assertively so that you can build stronger interpersonal relationships.
What is DBT Used For?
DBT was originally designed in the 1970s by Marsha M. Linehan for treating borderline personality disorder (BPD).
Since then, DBT has proven effective in addressing a wide array of mental health and interpersonal challenges, including:
Self-harm Behaviors
Bipolar Disorder
PTSD
Substance Use Disorder (SUD)
Suicidal Behavior
Sensory Overload and Rejection Sensitive Dysphoria in Neurodivergent Individuals
DBT is particularly effective for these conditions, as they all involve difficulties in regulating intense emotions and managing interpersonal relationships.
The Connection of DBT to Neurodivergence
Neurodivergence refers to differences in neurocognitive brain function.
It encompasses conditions such as ADHD, dyslexia, and autism.
Individuals with neurodivergent identities often struggle with emotional regulation and social interactions, making DBT an effective treatment.
DBT's focus on emotional regulation and interpersonal effectiveness can provide practical tools for these challenges.
The Benefits of DBT for Neurodivergent Individuals
DBT provides essential tools to navigate the complexities of neurodivergent experiences. It can:
Enhance emotional regulation
Improve relationships
Increase self-awareness
Build your ability to navigate the challenges you face as a neurodivergent individual.
Techniques and Coping Strategies in DBT
Now that you know what dialectical behavioral therapy is, let’s consider how this could be integrated into your daily life.
Below, we will explore some common DBT strategies.
Mindfulness Techniques
Mindfulness involves living in the present moment and becoming aware of your thoughts and feelings without being consumed by them.
Here are some key mindfulness practices in DBT:
Observing Thoughts
Pick one object within your environment to focus on. Notice the color, texture, and other sensory aspects of this object. As you do so, if negative thoughts come up for you, imagine placing your thoughts on leaves floating down a river. Acknowledge them without judgment and let them drift away.
Breathing Exercises
Practice the 4-7-8 technique. Breathe in for 4 seconds, hold for 7 seconds, and exhale for 8 seconds. During this exercise, focus on your breath to center yourself.
Mental Body Scan
Choose a place that is quiet. Sit comfortably in a chair with your feet flat on the floor. Close your eyes. Focus your attention on each part of your body. Recognize where you are feeling tense. If you feel tension, tense and release these muscles.
Distress Tolerance Techniques
Distress tolerance strategies help individuals cope with crises without resorting to self-destructive behaviors.
Here are some techniques:
STOP Technique
This involves pausing or stopping your current activity, taking a step back, observing your thoughts and feelings, and then mindfully proceeding with awareness instead of from an emotional position.
ACCEPTS
A strategy for building distress tolerance. This acronym helps manage intense emotions effectively.
Activities: Engage in activities that distract you and occupy your mind.
Contributions: Volunteer or contribute to the community, redirecting focus away from personal distress.
Comparisons: Reflect on times when the situation was worse or other individuals who are facing greater struggles.
Emotions: Cultivate positive emotions through humor or uplifting content.
Pushing Away: Mentally distance yourself from distressing situations, allowing time for reflection.
Thoughts: Engage your mind in counting or other mental exercises to divert focus from negative thoughts.
Sensations: Utilize comforting physical sensations, such as holding onto a heating pad or a cool object.
Self-Soothing
Engage your five senses to calm and comfort yourself. This could involve listening to relaxing music (hearing), using a comforting blanket (touch), smelling essential oils (smell), eating a favorite food mindfully (taste), or looking at calming scenery (sight).
TIPP Skills for Relief
TIPP (Temperature, Intense exercise, Paced breathing, and Progressive muscle relaxation) provides tactics for managing overwhelming emotions in acute situations.
Temperature: Change your body temperature (e.g., splashing cold water on your face).
Intense Exercise: Engage in brisk physical activity to release pent-up energy.
Paced Breathing: Use deep breathing techniques to stabilize emotional responses.
Progressive Muscle Relaxation: Tighten and relax muscle groups to relieve tension.
Emotional Regulation Techniques
Emotional regulation aims to help individuals identify and manage overwhelming emotions. Effective techniques include:
ABC PLEASE
Accumulate Positives: Seek and engage in positive experiences to balance negative emotions.
Build Mastery: Tackle small challenges that boost confidence.
Cope Ahead: Anticipate future emotional challenges and prepare strategies to address them.
Treat Physical Illness: Address underlying physical health issues that might affect mental well-being.
Eating: Monitor diet for its impact on emotional stability.
Avoid Mood-Altering Substances: Substances can alter your state of mind and ability to regulate your emotions. Try to avoid mood-altering substances as much as possible.
Sleep: Your sleep is intimately connected to your ability to regulate your mood. Make sure you are getting the recommended amount of sleep for your age.
Exercise: Incorporating physical activity to enhance mood and emotional balance.
Opposite Action
Identify the emotion you are feeling and then intentionally engage in behavior that is the opposite of what that emotion urges you to do.
For example, if you feel sad and want to isolate yourself, the opposite action would be to reach out to a friend and engage in a social activity.
Interpersonal Effectiveness Techniques
Interpersonal effectiveness focuses on communicating needs and boundaries assertively. Two essential skills are:
DEARMAN
Describe the situation.
Express your feelings.
Assert your needs.
Reinforce the positive outcome.
Mindful: Remain aware during the interaction.
Appear Confident.
Negotiate if necessary.
GIVE FAST
Be Gentle: Show respect and avoid aggression.
Act Interested: Engage actively and validate the other person's point of view.
Validate: Acknowledge the feelings of others.
(Use an) Easy Manner: Maintain a light tone and humor to ease the conversation.
(Be) Fair: Be fair to yourself and the other person. Remember to validate yourself and them.
(No) Apologies: Don’t over-apologize. Don’t apologize for being alive or asking for something. Don’t look ashamed by having your shoulders slumped and eyes downcast.
Stick to your values: Be clear on what you believe and “stick to your boundaries.” Don’t sell out your values or integrity for something or someone else.
(Be) Truthful: Don’t lie and don’t make up excuses or exaggerate.
What to Expect in DBT Treatment
DBT is an intensive therapeutic approach that may require your therapist to work in consultation with a treatment team.
You should also expect a course of treatment that could involve weekly group therapy, skill-focused instructional meetings, as well as individual therapy sessions. What you engage in is up to you and what works best for you.
Individual sessions usually last an hour. Each week, for individual therapy sessions, you can complete a diary “card” to track treatment targets related to your mood, behavior, and skills. You can identify and rate the intensity of emotions and indicate the frequency with which they engaged in positive practices.
You’ll work one-on-one with your therapist to learn strategies to manage emotions, improve relationships, and enhance self-awareness. You’ll review difficult situations and feelings you faced the prior week and engage in problem-solving.
Since DBT is present-oriented and skills-based, you will most likely be asked to practice your skills between sessions. For example, you may be tasked with taking specific, concrete steps to practice communicating more effectively in your relationship.
Finding a Dialectical Behavior Therapist
A DBT therapist is a licensed mental health professional who has additional training and experience in DBT.
When seeking a DBT therapist, it is advisable to seek a therapist who has experience using DBT to treat people presenting with concerns such as yours.
It’s also important to ensure a strong therapeutic alliance between you and your therapist. This therapeutic alliance is the relationship between you and your therapist to work toward your goals.
As with all forms of therapy, if you don’t feel comfortable, there may not be a strong therapeutic alliance, and this can be detrimental to reaching your goals.
Here are some important questions to ask a prospective DBT therapist to determine if a strong therapeutic alliance can be formed.
How often have you dealt with concerns such as mine before?
How do you know whether my situation is a good candidate for DBT?
How does DBT work?
What is a typical plan of treatment, and how long is a typical course of therapy?
How do you measure progress?
What is the nature of your training in DBT?
What length of time do you initially ask a client to commit to?
Book a Free Consultation with Blue Sky Learning
If you or someone you know struggles with emotional dysregulation, poor relationships, or other related mental health issues, consider exploring DBT as a viable option.
For those interested in starting your therapeutic journey, book a free 20-minute consultation with a therapist at Blue Sky Learning by emailing hello@blueskylearning.ca, calling 1 (437) 291-8807, or visiting the link below.
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