DBT is closely related to CBT, and was
initially developed by Marsha Linehan for individuals with Borderline
Personality Disorder who cope with distressing emotions and situations by using
self-destructive behaviours such as self-harm, substance abuse and eating
disorders. DBT is now being used for treating other mental health
conditions.
Individuals learn more helpful
coping skills to deal with distressing emotions and situations, and to improve
their relationships.
Dialectics is the theory that opposites can co-exist. In therapy,
different points of view are discussed, and clients are then helped to select
appropriate skills to either change or
accept situations.
DBT uses the theory of Wise Mind
(Linehan 1993)
- the part of our mind where 'Emotional
Mind' (thoughts based on our feelings) and 'Reasonable
Mind' (rational thinking part) merge together.
Emotion
Mind
Wise Mind
Reasonable
Mind
Thinking and behaviour controlled by emotional state
Thoughts are unhelpful and distressing
Difficult to think logically and rationally
Facts are distorted to fit with current distress
Opinions
Strong emotions drive strong behaviour
What I want to do
Integrates Emotion Mind and Reasonable Mind
Adds intuitive knowing to emotional distress and logical analysis
The calm that follows a storm
Sees or knows something directly and clearly
Grasps the bigger picture, rather than just parts
Ensures needs of both Emotion Mind and
Reasonable Mind are met: Reasonable Mind is right, but Emotion Mind
needs to be soothed
What's the most appropriate and effective
skills that I could use for this situation?
Intellectual, scientific
Logical and rational thinking
Factual thinking, based on evidence
Able to plan how to respond
Focuses attention
Cool in approaching problems
What I should do
When
we feel upset or distressed, we normally react automatically, without thinking
about the consequences. And we can often get into the habit of using
unhelpful and often self-destructive behaviours to help us cope. These may
include:
Self-harm including cutting
or taking ‘overdoses’
Manipulating others (we’re
often unaware of doing this)
Under or over-eating
Using or relying on drugs
and alcohol
Depending on physical
exercise
Sleeping too much, or opting
to sleep rather than address problems
Focusing on illness and
physical pain rather than the ‘real’ issues
When we use
these self-destructive coping behaviours, we often then get caught up in
thinking we’re bad for doing them, which makes us feel even worse, and may make
us more likely to keep on doing them. A vicious cycle.
In order to
break that cycle, we can learn to do doings differently, including learning new
healthy coping skills which will help us feel better about ourselves and others,
and learning to understand and see our thoughts differently.
This website suggest introductions
to alternative, healthier ways of coping, but like with anything else in real
life, it’s not easy or a quick fix – it has to be worked consistently hard at,
and the only certainty is that it takes a lot of practice, practice, practice!