A Look at Dialectical Behavior Therapy

In the 1970s, a psychologist named Marsha M. Linehan was treating numerous female patients for borderline personality disorder (BPD). She relied mainly on cognitive behavioral therapy (CBT) but without much success. Her patients still struggled to overcome phobias of rejection and abandonment. They also continued to suffer from a distorted self-image, general instability, and rocky relationships that often disintegrated. These issues prompted Linehan to restructure her approach. 

CBT stresses the premise that we are all deserving of a rewarding life, and we can and must change to experience it. The CBT approach trains patients to change their thinking patterns, which will then alter behaviors and rewire automatic responses. 

However, Linehan’s patients found the inherent emphasis on change too difficult to grasp. It’s possible that they felt unworthy of change even as they demanded to be accepted as they were. Linehan began to see that CBT simply didn’t have the scope for BPD’s wide range of symptoms: from excessive anger and emptiness to extreme anxiety and suicidal thoughts. 

It wasn’t long before she infused interventions that were acceptance-based and relied on validation strategies combined with CBT methods. She wove concepts of acceptance and change together within the following frameworks:

• Individual therapy
• Inpatient care
• Group therapy
• Phone coaching
• Continuing and outpatient care

These are all options that we offer our Miramont Behavioral Center patients. The crucial point to remember is that we’re here for you—if you feel something isn’t working, we’ll honor that and find an alternative.

Cognitive To Dialectical: The Final Product

Through the balancing act of helping patients work toward both self-acceptance and change, a dialectical strategy appeared. Essentially, it provided a more synthesized, holistic approach and focused on building up the person’s self-image. Rather than simply attacking the crisis of the week with applied behavioral techniques, the dialectical component stressed the connection between the person, their experiences, and their responses. It was a success, and dialectical behavioral therapy (DBT) was born.

What Dialectical Behavioral Therapy Does and Who It’s For

DBT teaches people how to develop healthy responses to stress, cope with triggers, self-regulate their emotions, and preserve and deepen their relationships. The therapy moves in stages:

1. Address the most dire, life-threatening symptoms like suicidal thoughts, self-harm, or dangerous substance abuse.
2. Address quality-of-life factors caused by mental illness, like interpersonal communication, emotional regulation, and stress and distress tolerance. 
3. Address all of the influences that inform the patient’s deteriorating relationships or low self-esteem.
4. Address ways to pursue passions, preserve relationships, and find happiness in love.

DBT helps people with BPD, post-traumatic stress disorder (PTSD), eating disorders, and substance use disorders (SUD). It’s also highly effective for anyone who suffers from the following:

• Chronic feelings of emptiness or hopelessness
• Chronic self-hatred and low self-esteem
• Intense or frightening mood swings
• Dangerous, risky, or impulsive behavior
• Instability in finances and relationships
• Suicide attempts or self-harming behaviors

Each of these ailments can be combated by self-acceptance, distress tolerance, emotional-regulation skill building, and the improvement of interpersonal relationships. 

Overcome Self-Destructive Habits With Miramont Behavioral Health Center in Wisconsin

Both of our locations in Waukesha and Middleton, WI, offer DBT treatment options to all of our patients who require it and find it useful. We also go above and beyond to make sure that you’re supplied with every educational resource available as you advance through DBT’s four main stages. You’ll learn to tolerate distress, mitigate stress, and enjoy life, even when coping with and explaining to others what it was that brought you to therapy in the first place.