Dialectical Behavior Therapy (DBT) is a highly effective evidence-based treatment that was originally developed by Marsha Linehan in the late 1980s for the treatment of Borderline Personality Disorder (Linehan, 1993). Today, it is used for the treatment of a variety of mental health issues such as depression, bipolar disorder, PTSD, substance dependence, and eating disorders.
What is DBT?
DBT is a cognitive-behavioral approach that places its emphasis on the psychosocial aspects of treatment. DBT focuses on the synthesis of opposites as a cornerstone of its philosophy, the balancing of acceptance and change. DBT teaches clients four sets of behavior skills: mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.
Whether you struggle with mental health issues or not, everyone can benefit from these basic DBT skills. By incorporating them into your life you can learn to reduce overall stress, better manage your emotions and have a better overall quality of life.
Mindfulness means being fully present in the moment. This sounds easier said than done. Most of us spend time multi-tasking, allowing our thoughts to wonder to multiple topics, living in the present or the past.
So â€œwhatâ€ do I do when to practice a mindfulness skill? Observe, describe, and participate fully in the present moment. For instance, if you are getting caught up in your thoughts or worries, take a moment to redirect your mind to your present moment. Maybe focus on your physical sensations, observing and experiencing them without thought or judgement.
So â€œhowâ€ do you practice mindfulness? Non-judgmentally, one-mindfully, and effectively. When I was first learning mindfulness (and often even today) my mind would wander to other topics, my to-do lists, things I was worried about etc. Then I would often judge myself saying â€œI canâ€™t believe I canâ€™t just breathe for 60 seconds without distraction.â€ Mindfulness teaches self- compassion. To not judge. To allow ourselves to be imperfect. If my mind wanders, okay, I bring it back.
Practice not Perfection
Many of us have problems coping throughout the day. Some of this may be a result of our inability to see joy in things. Often in life we spend a lot of time focusing on how to fix whatâ€™s wrong, â€œif it ainâ€™t broke donâ€™t fix it.â€ Ultimately, reducing and addressing unhealthy behaviors
and attitudes is great, but we have to build more positive ones to truly see how long term results have improved our overall quality of life. Here are some suggestions to build pleasant activities:
- Actively engage in enjoyable experiences every day, being mindful of the joy it brings you
- Work towards small achievable goals each week. One problem people encounter when trying to accomplish goals is feeling overwhelmed. Instead try listing out the steps needed to achieve the goal and tackle them mindfully.
- Attend to relationships in your life
- Be mindful of positive experiences in your life. Take note of things to be grateful for. Try taking a few moments each night to focus on what went well, what you are glad that you have. Acknowledging the good makes a huge difference and attracts more positive energy into our lives.
One option you have to any problem is Radical Acceptance (Linehan, 1993). Radical acceptance is about accepting life on lifeâ€™s terms and not trying to change what is outside of your control. It is about accepting life as life is.
Fighting reality or avoiding reality heightens pain. Imagine for instance, you are sitting in traffic on your way to work. You have a couple of options, you can get angry, yell, swear, let it ruin your day or you can use this as time for self-care, practice breathing skill, accepting that nothing you do will be impacting the traffic or change what time you arrive to work.
Another example: you get an email from your boss, subject line: Staff meeting this Friday. You think to yourself â€œanother staff meeting, I canâ€™t believe this. I have way too much to do and these meetings are always a waste of time. Just a way for management to feel important.â€ Or you can think to yourself â€œIâ€™d prefer not to go and this is what it is. There is nothing I can do about it. Just breathe.â€
Overall, all of us can benefit from becoming more aware of our thoughts and feelings and being centered in the present moment; engaging in more pleasurable activities, and accepting life on lifeâ€™s terms. These skills will certainly lead to a happier and healthier life.
Linehan, M. Cognitive-Behavioral Therapy of Borderline Personality Disorder. New York: The Guilford Press, 1993