What Is Dialectical Behavioral Therapy?
Dialectical behavioral therapy is a modified version of cognitive-behavioral therapy. It was first developed by Marsha Linehan in the 1970s. When cognitive-behavioral therapy received popularity in the early 1960s and 1970s with the treatment of borderline personality disorder, Marsha and colleagues developed another version (modified) of cognitive-behavioral therapy which they named dialectical behavioral therapy, which was then used to treat patients suffering from a borderline personality disorder. The word dialect in literary terms means to bring the opposite concept together.
The main aim of dialectical behavioral therapy is to make people understand and help them manage their emotions and stress and also improve their relationships with themselves and others. It also focuses on identifying, treating, managing, coping, and changing the negative thinking pattern and replacing these thought processes with positive ones.
Initially, dialectical behavioral therapy was implemented to treat borderline personality disorder (BPD); however, as it has gained popularity, it is now used for other mental illnesses too. It has shown great results while treating patients with schizophrenia, eating disorders, substance abuse disorders, and post-traumatic stress disorder (PTSD).
Dialectical behavior therapy is not particularly the first step of the treatment plan. Individuals resorting to dialectical behavior therapy are often suffering from severe, complex, and complicated mental illnesses. The therapy includes individual therapy, phone coaching, a skills training group, and counseling by a therapist. Individuals undergoing dialectical behavior therapy have weekly regular therapy and skills training group sessions. After certain experiments, the skills training arena falling under dialectical behavior therapy has proven to be one of the most effective and successful treatment options as it helps in regulating emotions which is the newfound component of dialectical behavior therapy.
What Are the Components of Dialectical Behavioral Therapy?
Dialectical behavior therapy mainly consists of four components. They are:
1. Core Mindfulness: The strangulating stigma behind dialectical behavior therapy that differs from other therapies is developing core mindfulness. Mindfulness stands for living one’s life in the present moment. As one is living in the present, one can access their thoughts, feelings, emotions, impulses, and sensations. In addition, living in the moment also helps the individual to tap into their senses to understand and perceive what is going on, what they see, hear, smell or touch. When an individual is going through a trauma or is suffering from emotional stress, they tend to go to their dark side, or their negative thoughts take over, and this is where developing mindfulness comes in handy as it helps the individual to cope with the stress and manage the pain. As a result it makes the situation less distressed and makes the condition more comfortable and a little less symptomatic.
2. Distress Tolerance: Distress tolerance means tolerating the current situation in a way where an individual accepts the condition and themselves. Different ways in which an individual can develop and learn distress tolerance includes distraction, changing the moment (for betterment), self-soothing, thinking carefully, and understanding both the pros and cons of the situation. Distress tolerance is crucial to help understand the circumstances such as stressful events, the death of a close relative or a family member, near-death experiences, panic attacks, and other mental illnesses. Both the mindfulness and tolerance skills development are in a manner; they are non-judgemental and non-evaluative manner of fashion.
3. Interpersonal Effectiveness: The term interpersonal effectiveness, whilst talking about dialectical behavior therapy, is to develop a more assertive relationship in a manner such as expressing one’s needs, denying things, and the ability to decide for themselves. Under interpersonal effectiveness, an individual develops communication skills and, more importantly, learns to accept and respect oneself. The three crucial interpersonal skills developed under dialectical behavior therapy are self-respect, care, interest, respect for themselves and others, and lastly, assertiveness (over their life and decisions).
4. Emotion Regulation: Regulating emotion under dialectical behavioral therapy helps an individual manage their feelings in a more mature and effective manner. Individuals undergoing dialectical behavior therapy, either suffering from a borderline personality disorder or schizophrenia (or suffering from suicidal tendencies), have symptoms ranging from anger, frustration, depression, and anxiety to panic disorder. Individuals suffering from these emotions regulate their emotions by identifying, labeling, and changing their emotions.
What Are the Techniques of Dialectical Behavioral Therapy?
Dialectical behavior therapy is a more evolved form of cognitive-behavioral therapy or psychotherapy. Different techniques of dialectical behavior therapy include:
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Group Therapy: It comes under dialectical behavior therapy that helps to teach behavioral skills in a group manner or setting.
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Individual Therapy: Individual therapy is carried out under the supervision of a licensed professional to teach the individuals different behavioral skills which help them shape their lives.
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Phone Coaching: Phone coaching is a manner of dialectical behavior therapy wherein an individual has the liberty to call the therapist to receive guidance and learn coping mechanisms for the betterment of the situation they are in.
What Are the Uses of Dialectical Behavioral Therapy?
Initially, dialectical behavior therapy was only used to treat borderline personality disorder and suicidal tendencies; however, with current development, dialectical behavioral therapy is also used to treat the following mental disorders:
1. Attention-deficit hyperactivity disorder (ADHD).
2. Bipolar disorder.
3. Eating disorders (including anorexia nervosa, binge eating disorders, and bulimia nervosa).
4. Generalized anxiety disorder (GAD).
5. Major depressive disorder (MDD, chronic depression, and episodes of clinical depression).
6. Self-harm.
7. Obsessive-compulsive disorder (OCD).
8. Post-traumatic stress disorder (PTSD).
9. Substance abuse disorder.
10. Co-occurring disorder.
11. Suicidal behavior (schizophrenia).
12. Addiction.
What Are the Benefits of Dialectical Behavioral Therapy?
The main aim of dialectical behavior therapy is to resolve the contradictions faced by the individual in order to accept oneself and to positively restructure their decisions and lives while undergoing treatment. An essential element of the therapy is validation. Individuals undergoing therapy need constant validation of their emotions, decisions, and steps they took for betterment, and they seek validation from others, especially from their therapists.
Some of the benefits of undergoing dialectical behavior therapy are:
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Accepting Change: Individuals undergoing dialectical behavior therapy are reported to be more open to accepting life changes.
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Development of Behavioral Skills: The focus of the therapy is to develop and improve the behavioral skill set that later on shapes the outlook of life.
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Increased Cognitive Mindset or Thinking: Undergoing therapy also proves to be effective concerning their cognitive skill set; individuals learn to think more positively and deeply about any situation they are stuck in.
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Effective Communication Skills.
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Positive Reinforcement in Their Lives: This is one of the most important and excellent benefits of indulging oneself in dialectical behavior therapy, as positive reinforcement is the stepping stone towards betterment.
What Are the Drawbacks of Dialectical Behavioral Therapy?
With pros come cons. With the benefits of dialectical behavior therapy, there are drawbacks too. Some of the drawbacks of dialectical behavior therapy are:
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Dialectical behavior therapy only focuses on a specific sector. Concurring all the segments of the disorder is crucial to get a complete picture of the disorder and to understand the symptoms, issues, and difficulties faced by the individual. Only tackling one area of the said disorder can be harmful and cause complications as the disorder is yet untreated.
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Involving oneself in dialectical behavior therapy is difficult as the therapy strictly follows the manual and the training prospectus. This is not a proven drawback but is not tailored individually. The licensed professional practicing dialectical behavior therapy needs to undergo a strict training regime to be able to practice the therapy, which takes up a huge amount of time and might not be that helpful or have that good of a result.
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The trials or therapy might last for years rendering both the psychologist and the patient tired and, in some cases, frustrated in cases of unfruitful results. In addition, the spectrum of treatment or the long-lasting effects of treatment is questionable or objectionable as it may or may not last post the therapy sessions.
Conclusion:
Dialectical behavior therapy is also known as the modified version of cognitive behavior therapy but, in reality, is a subtype of cognitive behavior therapy. Dialectical behavior therapy has long been used for treating mental illnesses. It started with treating borderline personality disorder but now is used for many other mental illnesses too. Individuals treated with dialectical behavior therapy have proven to have a positive outlook on their life, and they show assertive behavior while making important life decisions. Dialectical behavior therapy has proven to be a positive reinforcement therapy in the short run.
