What is "Dialectical Behavior Therapy" (DBT)?

Dialectical Behavior Therapy (DBT) is a structured treatment that integrates cognitive-behavioral therapy with mindfulness, emphasizing the importance of balancing acceptance and change.

I offer individual psychotherapy informed by DBT skills and principles. If we feel that you would benefit from a full DBT program (individual, group therapy, phone coaching) and/or a higher level of care, I'll discuss possible referral options with you.

DBT has been found effective in the treatment of difficulties managing intense emotions, but it has also been helpful with anger management, impulsive behaviors, trauma, relationship distress, and depression.

How does DBT work?

In plain English, DBT works in at least two ways: Skills training and Relationship. They go in hand with DBT's central "dialectic" between 

  • Acceptance: Having compassion for yourself, understanding that while you're doing the best you can, some things are out of your control. And that's ok.

and

  • Change: You want to improve. You may not have caused all your problems, but you have to solve them anyway!

Sometimes we need to let go and move on. Sometimes we need to take a stand. We find the balance to do what is called for in the moment.

Skills training

DBT focuses on four major skill areas: 

  • Mindfulness: Being more aware of the present moment, taking an attitude of acceptance toward life's struggles.
  • Distress Tolerance: How to cope with stress, pain, and difficult situations when we cannot change them.
  • Interpersonal Effectiveness: Asking for what you want and setting appropriate boundaries in school, work, and love.
  • Emotion Regulation: How to change your emotions and exercise control over what you feel, and how you react to situations.

I would teach you a skill, rehearse it with you in our session, and discuss how you can practice the skill during the next week. Then you tell me how it went: "It was super effective!" or "It was ok, not bad." or "Oh my God it was terrible!" 

Through trial and error, we figure out what worked, what didn't work, and how to enhance our work, so you can build more positive experiences into your life, and meet your goals.

Relationship

One of the sources for new learning in DBT is the therapeutic relationship. The therapeutic relationship is the interaction you and I have when we are in the room together. Its clinical power lies in creating an interpersonal laboratory where we can observe firsthand what happens when you:

  • Try to express your thoughts and feelings, and have difficulty being heard or understood;
  • Think you said one thing, but the other person hears another;
  • Become angry or upset. Etc... 

In DBT, the therapeutic relationship can help you "learn to do relationships better," by allowing you to experiment with new behavior in a safe space. The more you try out new behaviors, learn from the experience, and practice them in your daily life, the more they become a part of your repertoire.

What changes can I expect from this treatment?

This form of treatment can help you

  • cope with stress, and be more mindful of when you are reaching your boiling point, and act accordingly so you don't burn out;
  • learn how to say what you want in a way that is assertive without being aggressive, and be flexible without being submissive;
  • learn with which relationships to set stronger boundaries, cut out when they get too toxic, and grow closer to to build intimacy;
  • get more in touch with your emotions, able to sit with your feelings, or engage in effective action to make yourself feel better;
  • develop a more coherent sense of your self, values, and identity.