Do you sometimes find it hard to control your emotions? Do you feel very sad about even the smallest things, or do you feel like you're getting angrier than you think? Living with such intense emotions is not easy. But there's good news. There is a special treatment that can help with these situations. Today we're going to talk about it. It's called DBT, or Dialectical Behavior Therapy.
Simply put, what is DBT?
DBT, or Dialectical Behavior Therapy, is a type of psychotherapy that is delivered through talking. It is actually based on another popular treatment, Cognitive Behavioral Therapy (CBT) , and is specifically designed for people who experience intense emotions.
The word "Dialectical" in this means "bringing together two contradictory ideas." Imagine, this therapy method helps you, on the one hand, accept the truth of your life and your behaviors as they are (validation/acceptance). And, on the other hand, it helps you change the behaviors that are causing you problems and improve your life (change). Maintaining a balance between these two ideas of acceptance and change is the essence of DBT.
This treatment method was developed in the 1970s by an American psychologist named Marsha Linehan.
Who does DBT therapy help the most?
Anyone who has a challenge managing and controlling their emotions can benefit greatly from DBT. Research has shown that this treatment method is highly effective for a wide range of mental health issues.
- Borderline Personality Disorder (BPD)
- Self-harm behaviors
- Suicidal thoughts or attempts (Suicidal behavior)
- Post-Traumatic Stress Disorder (PTSD)
- Substance use disorder
- Eating disorders, especially binge eating and bulimia
- Depression
- Anxiety
The important thing is that underpinning all of these conditions are failed and unhealthy attempts to control intense, negative emotions. DBT teaches you healthier, better ways to deal with emotions, rather than the ways that create those problems.
How does DBT therapy work?
In DBT treatment, your therapist's main goal is to create a balance between accepting you and your challenges as they are (validation) and encouraging you to make positive changes (change). This treatment method usually consists of four main parts.
1. DBT Pre-Assessment: Before starting treatment, the therapist will talk to you to see if DBT is a good fit for you. After explaining everything, and if you agree, they will ask you to commit to this treatment for a specific period of time.
2. Individual therapy: In this, you will meet with your therapist once a week for about 40-60 minutes alone. You may also be asked to keep a journal of your feelings and behaviors. This will help both of you identify problem patterns.
3. Skills training in groups: This is not group therapy. Just like in a classroom, the therapist teaches four important skills to a group. Rather than talking about your problems, the focus here is on learning these skills.
4. Telephone crisis coaching: This is a very important part. If you have a sudden distressing thought, such as self-harm, during a therapy session, you can call your therapist and get immediate help. However, there are set times and restrictions for this.
The four main skills taught in DBT
DBT therapy focuses on four key skills that help you successfully manage your daily life. These are the heart of the therapy.
| The Skill | Simply put... (What it means) |
|---|---|
| Mindfulness | To be fully present and aware of what is happening in the present moment, without regretting the past or fearing the future. To practice observing one's thoughts and feelings without judgment. |
| Distress Tolerance | Learning to understand and manage emotions in uncomfortable, painful, or stressful situations without resorting to harmful behaviors is like learning how to cope with sudden anger. |
| Interpersonal Effectiveness | Learning to clearly communicate what you want and don't want (boundaries) in a way that respects yourself and others. This includes being able to say "I can't" when you need to. |
| Emotion Regulation | Becoming more aware of your emotions, understanding them, and having a greater ability to control them. Learning to control emotions rather than being a slave to them. |
How do I find someone suitable for DBT therapy?
This can be a bit challenging, but don't give up. The best way to do this in Sri Lanka is to ask your family doctor or a doctor you trust about this, and then refer you to a qualified psychiatrist or psychologist.
Make sure the therapist you are seeing is a state-certified and licensed mental health counselor . Also, see if he/she has experience treating your condition (e.g., BPD, eating disorders).
How long does DBT treatment take?
DBT treatment usually takes at least 6 months to a year . But remember, everyone is different, and mental health issues are complex. Sometimes, especially for conditions like BPD, treatment can take several years.
The important thing is not how long the treatment takes, but that you have asked for help and started the journey. Any small improvement is a big victory.
When should I see the doctor?
Don't miss any of your treatment sessions. It's very important to attend every one of them.
If you suddenly experience severe depression, such as suicidal thoughts , talk to your therapist if possible. If you cannot reach him/her, do not remain alone. Immediately talk to someone you trust, or go to the Emergency Department (ETU) of the nearest hospital.
DBT is a very effective treatment for those struggling with intense emotions. It can take some effort to find a therapist who is right for you, but it's worth it. The sooner you start treatment and commit to it, the sooner you can start living a better life.
Take-Home Message
- DBT is a special form of psychotherapy that helps manage intense emotions.
- This involves balancing the two aspects of "accepting" your situation and "changing" it for the better.
- Four practical skills, such as mindfulness and distress tolerance, can be learned through this.
- Commitment and patience are very important for DBT therapy. It may take some time to see results.
- If you have a problem like this, don't suffer alone. Talk to a trusted doctor and get referred to a qualified professional.
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