Guest Blog Post by Dr, Nerine Tatham… What is Dialectical Behavior Therapy or DBT?
DBT is a fancy way for what I like to call Mindfulness or Mind-Fitness. It’s a process in which you build and develop skills that help you overcome the challenges and dark emotions of mental illness.
Dr. Marsha M. Linehan, the expert and the creator of Dialectical Behavior Therapy (DBT), a type of psychotherapy that combines behavioral science with concepts like acceptance and mindfulness told her story in public for the first time before an audience of friends, family and doctors at the Institute of Living, the Hartford clinic where she was first treated for extreme social withdrawal at age 17 according to an article in the NY Times.
“So many people have begged me to come forward, and I just thought — well, I have to do this. I owe it to them. I cannot die a coward.”
“No one knows how many people with severe mental illness live what appear to be normal, successful lives, because such people are not in the habit of announcing themselves. They are too busy juggling responsibilities, paying the bills, studying, raising families — all while weathering gusts of dark emotions or delusions that would quickly overwhelm almost anyone else.”
The purpose of this blog post is to share this highly effective therapy that is now being used by psychologists with you as well as explore the 4 core elements of how this can work for you.
One of the ways in which I like to explain this therapy is using this example. When we want to get our bodies physically fit, we start paying attention to diet and nutrition and maybe get an exercise routine going and maybe take vitamin and mineral supplements. It is easy to see the correlation with taking these steps and and “getting stronger.” Well, similarly, we can get our minds “stronger” by developing a fitness plan for it too. That’s how I would characterize Dialectical Behavioral Therapy (DBT) Skills training: a fitness program for our minds or mind-fitness.
When dealing with mental health, it is important to take a comprehensive approach. Medications may be essential to address biological causes of conditions but they are often not enough by themselves to get our brain to optimal fitness and optimize our quality of life. We wouldn’t take a pill, skip the workout and healthy eating and expect to develop a six pack or even a two pack, would we? Same deal with brain. DBT skills training is brain training and gives us four sets of mind fitness skills.
The first, #1 Core Mindfulness: helps us understand how our mind processes facts and emotions, sharpens our ability to observe all the information from our internal and external environment and then helps us learn how to process all this data in a non-judgmental way so we can see things as they are and increase our chances of acting with intention instead of reacting reflexively, what we call wisely and skillfully. This is the foundation and a huge boost for mind fitness.
Now I will share the other three skills that give us the actual tools for taking wise-mind action.
Skill # 2 | Interpersonal Effectiveness: This builds fitness in the areas of asking for what you want and saying ‘No’ when necessary in ways that maintain healthy relationships, keep your self-respect intact and help you meet your obligations and personal goals in a balanced way.
Skill # 3 | Emotion Regulation: Emotion Regulation is about understanding what triggers your emotional responses, from events, to thoughts, to the physical and psychological, the urges that come with these emotions and what we can do to remain skillful in our actions regardless of what emotions are present.
Skill # 4 | Distress Tolerance: Distress Tolerance is the skill we use when we have a crisis that we cannot immediately resolve using our available resources or usual skillful behaviors. It gives us tools for hunkering down safely, riding out the emotional storm without making things worse for ourselves.
In my opinion it is one of the best mind fitness programs available and just like any fitness program it takes practice, time, and support. But when you begin to see those mind muscles that you did not think you had flexing and strengthening and working for you, it’s an incredibly validating and liberating feeling.
Seeing people get fit in this way has been one of the most fulfilling parts of my practice as a psychiatrist. I am unabashedly enthusiastic about DBT and Skills Training! Mindfulness! Mind fitness!
So, what is the next step for you or someone you love? You can start here by looking at additional information and resources for both clients and clinicians at the official Linehan/DBT website Behavioral Tech.
And for local resources visi the the Triangle Area Dialectical Behavioral Therapy or DBT website.
Wishing You Mind-Fitness,
Dr. Nerine Tatham
Dr. Tatham has openings in her practice and she can be reached at 919-272-5417.