Why I love DBT (Dialectical Behavior Therapy)
Dialectical Behavior Therapy (DBT) is a behavioral treatment that was created to treat Borderline Personality Disorder but is now being used to treat a whole host of mental illnesses. It’s a therapy that is designed to help you change thought patterns and so much more. It teaches you how to re-program your brain and I’ve found it to be extremely helpful in whatever ways I’m trying to improve myself. It’s definitely on my list of self-care.
Personally, I think it’s something that we should all learn just because it teaches us really good coping skills.
My anxiety workbook, Breathe, heavily focuses on the different points of DBT to help with anxiety.
Here are the four main points of DBT.
Mindfulness: How to be in the moment instead of what happened a month ago/ year ago/ decade ago. Focus on the present and separating yourself from past baggage. Don’t let how you were treated or felt in the past color what’s happening in the moment.
Distress Tolerance: How to cope with super strong emotions that you feel like you are never going to be able to control. How to get through those feelings without losing your shit.
Interpersonal Effectiveness: How to have good relationships with people without driving them away with your out-of-control behavior that usually manifests itself in extreme neediness and then anger when your needs aren’t meant. Also, how to set boundaries and realistic expectations.
Emotion Regulation: How to identify, then deal with, and eventually change the emotions that you’re feeling in the moment. It also teaches you how to understand your impulses related to each emotion.
In my early 20s, I was an emotional wreck.
I was irrational and jealous. I was like Jekyll and Hyde. One minute I would tell you that I adored you and then if I got mad at you I’d tell you to get out of my life, which I would apologize for five minutes later. I was constantly worried about being replaced in my relationships and in my friendships. If you talked to anyone else I’d get this immediate surge of anger and jealousy and even hatred.
I was at 150% emotion all of the time. I wasn’t just sad, I was ALL THE SAD. Or I wasn’t just angry, I was HULK SMASH. My emotions went from 0 to 150 with nowhere to go in between. I had no way to regulate myself and this turned me into a verbally abusive, suicidal, angry, constantly crying, mess of a person.
My best friend at the time had a talk with me that amounted to: If you continue to act like this, I can’t have you in my life for my own mental wellbeing.
And that was like a kick in the face. It was confirmation to all those parts of my brain that told me that I would always be abandoned. At first, I just didn’t believe it. Then came anger. Then came “Holy crap, my favorite person in the world says that I’m really hurting them.”
And I had to take a really long, hard, look at my behavior. And it was very, very, ugly.
Which made me realize that yeah, the things I put people through are not okay. I did a lot of research on how to fix that. I don’t know if I have Borderline Personality Disorder, I suspect it was actually anger issues + abandonment issues + a lack of healthy coping mechanisms, but at the time I checked a lot of the criteria for a diagnosis.
Frantic efforts to avoid being abandoned by friends and family? Yep.
Unstable personal relationships that alternate between idealization—“I’m so in love!”—and devaluation—“I hate her.” This is also sometimes known as “splitting.” Also, yep.
Distorted and unstable self-image, which affects moods, values, opinions, goals and relationships. Yep.
Suicidal and self-harming behavior. Yep.
Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days. Yep.
Chronic feelings of boredom or emptiness. Yep.
Inappropriate, intense or uncontrollable anger—often followed by shame and guilt. Yep.
That realization that my behavior wasn’t actually normal, that I wasn’t just “a bit dramatic” was a huge turning point in my life. I realized that I was doing serious lasting harm to myself and the people around me.
I’ve done eight years of work, often involving DBT, and it has completely changed my life.
I still have moments when I feel the urges to flip out. There are still sometimes that I do, although not to extent that I did many years ago. Change does happen but it is also a process. I just wanted to write this post as a nod to one of my most valuable self-care tools and DBT is definitely one of them. Caring for your mental health is just as important as everything else.
If you struggle with any of these things check out DBT. Ask your doctor or therapist about it, see if there are any groups in your area, read all of the books you can! Be proactive about your mental health and then create an action plan! I truly believe that we can all benefit from having more healthy coping mechanisms in our lives.
Your info about yourself just made me feel so much relief and hopeful about everything that’s been going on with my ups and down and dealing with my emotions that go from 1 to 100 in Second thx for sharing story and what u did I hope I can learn and heal the same too and find joy and balance
Other than getting to know CBT (Cognitive behavioral therapy, the most common form of talk therapy for depression and anxiety), with learning things like “cognitive distortions” or “automatic negative thoughts,” I also enjoyed DBT which seems to emphasize accepting thoughts and emotions, rather than changing thoughts and emotions as CBT does. I feel a balance between both approaches, though I’m oversimplifying it with this description, helps. I guess the way I’d put it is that with CBT, you question your negative thoughts, and with DBT, you can hear negative thoughts in your brain, but it gives you less of a negative reaction. It feels like the difference between talking back to a bully and just ignoring the bully, and the bully is your inner critic, so balancing both approaches helps me. I read a lot of psychology books on these topics as extra homework too. I also enjoyed a similar one ACT or Acceptance and Commitment Therapy, which is essentially a therapy that focuses on self-love and self-compassion as an emphasis, interestingly. So instead of talking back to the critic or ignoring the critic, ACT is like trying to learn to love, accept, and show empathy to the inner critic or bully, which is an interesting perspective to me. Again, these are all oversimplifications, as all these therapies include these different approaches, they just tend to emphasize one approach over the other.
I have honestly been disappointed with DBT. I have asked five different therapists who allegedly specialize in this treatment to work with me, and they won’t, so I have slogged through the Marsha Linehan workbook on my own this past year and completed one module of an online course. I still struggle with the mindfulness skills, especially radical acceptance. I am a master of distress tolerance skills, but they don’t actually diminish the intensity or duration of my emotions. The emotional regulation skills are pretty much non-existent in my opinion. I use the PLEASE skill, but that is more preventative than curative. If I am legitimately upset about something and not just hungry/tired/overstimulated, nothing in that section of the workbook is helpful. As for the interpersonal effectiveness skills, they really only succeed when the other person isn’t emotionally abusive. I am glad this has made a difference in your life, but I mostly just feel gaslit with a bait and switch.