Dialectical Behavior Therapy (DBT)

One of the techniques I use with some regularity is Dialectical Behavior Therapy (DBT), a therapy approach created by Marsha Linehan to help people with Borderline Personality Disorder. What I have found is that it works with a wide range of clients and is especially good for people who struggle with depression, anxiety, self-injury, and addictions. DBT focuses on helping people learn four types of skills: mindfulness skills, interpersonal skills, emotional regulation skills, and distress tolerance skills. To give just a brief introduction to these areas:

1. Mindfulness. Practicing mindfulness helps you to live in the moment rather than getting lost in fears about the future, or in regrets and bad memories in your past. Sometimes what is going on in the moment is not pleasant; mindfulness also helps you to do what is needed to respond to the stress you are experiencing now, in a way you will feel proud of later.

2. Interpersonal skills help people to ask for things they need and say no when necessary, all in a way that promotes self-respect and is respectful of others.

3. Emotional Regulation. When someone is emotionally dysregulated, they have a difficult time managing the intensity level of their emotions. They may be experiencing a high level of depression, anxiety, or anger; they may also shut down emotionally and be unable to feel much at all. In contrast, someone who is emotionally regulated can experience a wide range of feelings without being overwhelmed by them.

4. Distress Tolerance skills are practical ways people can calm themselves down when experiencing intense negative emotions. It is common for people to act impulsively to try to get rid of emotions--for example, they may use drugs and alcohol to numb the pain, spend too much money, or engage in self-harm activities (i.e. cutting, scratching, etc.). Distress tolerance skills give people other ways to deal with distress so that they don't make choices that make the problem worse.