Is DBT Right for Me?

Jessica Pontis, LCSW

A modified version of cognitive behavioral therapy, dialectical behavioral therapy, or DBT, was created in the late 1970s by Dr. Marsha Linehan for the treatment of borderline personality disorder. Over the years this treatment modality has been expanded to also treat depression, anxiety, eating disorders, suicidal ideation, and substance use disorders. DBT was also the first therapeutic modality to incorporate mindfulness-based practices for the use of mental health treatment. DBT is a treatment aimed at helping people cope more effectively with stress, regulate their emotions, and improve their relationships with others (Vaughn, 2021).

When thinking about engaging with a provider who is familiar with DBT, it’s helpful to familiarize yourself with some of the key concepts and goals of this type of treatment. While this is a well-researched treatment method, it can be a time commitment and tends to come with quite a bit of homework that a therapist may ask you to complete outside of the session. Practicing some of the skills that this treatment method encourages can also be challenging for some, so it’s important that the provider is skilled in processing and guiding you through those emotions gently.  

Having outlined some of the benefits and things to consider when thinking about starting DBT, let’s take a look at some of the key strategies used in this treatment process.

Mindfulness  

Mindfulness works to help individuals stay in the present moment, particularly when it comes to connecting with the immediate feelings, thoughts, and reactions someone may be having. Not only is this important to learn about what’s going on inside of you, but it’s also helpful in attuning to what’s going on around you. This strategy is helpful in navigating challenging feelings and not immediately engaging with negative thoughts or behaviors.

Distress Tolerance  

Distress Tolerance is exactly what it sounds like, it’s all about learning how to better tolerate intense and difficult feelings. Learning tools to better prepare for distress, as distress is an unfortunate and inevitable part of life, we learn to better cope at the moment, and again work to avoid engaging in negative behaviors. Some distress tolerance tools can be distracting when appropriate, self-soothing, and reflecting on the perceptions a person may have about the distressing event.

Interpersonal Effectiveness  

Interpersonal effectiveness is all about self-advocacy, assertiveness, and healthy boundary setting, all things necessary for the preservation of self and relationships. Communicating effectively in a way that feels constructive and safe is a core component of DBT.  

Emotional Regulation

Emotional regulation is similar to distress tolerance in that it’s all about how we move through big and powerful emotions. Where emotional regulation differs is that it’s not only about tolerating intense emotions, but it’s also about challenging them to learn to change their emotional and behavioral response.  

An example of this could be, “I’m feeling very unheard by my friends, and they don’t seem to be paying attention to me.” A behavioral response we may have demonstrated historically might look like isolating from the friend group, becoming aggressive, or raising your voice. Utilizing emotional regulation skills may help you acknowledge your feelings, work to stay in a space that feels more even, and respond in a way where you can have a conversation about feeling ignored/unheard, as opposed to isolating.  

As mentioned DBT is a direct and structured form of therapy that can be helpful for many under the right conditions. It very well may be a treatment that could be helpful if you want to work on the skills that DBT focuses on building.  

If you’re interested in working with someone to help you through this process, or would like to connect with someone to walk with you on this journey reach out to one of our Chicago counselors at Symmetry Counseling. We also provide in-person counseling services and tele-therapy in Arizona, Missouri, Texas, Virginia, and Washington D.C. You can reach out to us online, or by calling us at (312) 578-9990 to set up an appointment.