Sooo, what is exactly is DBT? And how can Diana help me?

I love DBT. That’s why I offer complete Dialectical Behavior Therapy for clients in Tennessee (individual therapy, group skills training and phone coaching). And I offer online DBT Skills training for anyone who has an individual therapist and wants to learn an incredible set of skills. Please do read the description of this transformative therapy, and contact me. I would love to guide you on your DBT Journey.

For more information about my therapy services and skills training classes, please explore the menu above. Or contact me directly at Sufferingoptional@yahoo.com or text me at (615) 775-3956.

Now….Let me explain what DBT is and why it is so life changing:

Dialectical Behavior Therapy was developed by Dr. Marsha Linehan.  She was looking for an effective treatment for suicide and self-harm.  Before the development of DBT, Suicide and self-harm were considered untreatable by most professionals.  In 1998, after extensive research and a massive creative undertaking, she published her seminal work “Cognitive Behavioral Therapy for Borderline Personality Disorder”, a completely manualized treatment for extinguishing suicidality.  

In her research, she found that the majority of the suicidal population had Borderline traits.  In June 2011, Marsha revealed in the New York Times that she had been applying her genius to try and find a cure for her own mental illness, for she too had struggled with suicide and self-harm.  She described being locked in the psych ward at 18 in a straight-jacket to keep her from hurting herself.  Over the ensuing decades, extensive research has proven DBT to be a highly effective treatment for depression, borderline personality disorder, bipolar disorder, substance abuse and eating disorders.

Dr Marsha Lineman–fondly referred to as “Marsha, Marsha, Marsha” or “What would Marsha do?”

Dialectical Behavior Therapy is composed of three essential elements, Buddhist Psychology  (from a secular perspective, the Buddha was the first great psychologist, as he was dedicated to solving the problems of suffering in this life),  Behavioral Therapy (the learning models related to how we can change behavior in order to change our emotions and our lives), and Dialectical Philosophy (the idea that two opposing truths can both be true at the same time—as a way to break out of the black and white thinking that often plagues suicidal clients.) 

Dr. Linehan found that straight forward Cognitive behavior therapy was simply too invalidating for most suicidal clients.  On the other hand, Humanistic therapies and their quest for unconditional positive regard (i.e., lots of validation) left clients feeling stuck and frustrated, not knowing how to change.  For the DBT therapist, practicing DBT is a bit of a dance between validating the client and pushing them to change.  

Adherent Dialectical Behavior Therapy (meaning therapy as it was researched and developed by Marsha Linehan) is a three-pronged therapy for the client. Clients learn skills in their DBT skills training class (I offer online DBT classes for clients that are interested in doing a deep dive into changing their lives which is a financial investment. Of course, you are also welcome to utilize the resources I offer here for free.)  Then clients learn how to apply those skills in Individual therapy, by examining past behaviors and understanding where they could have applied skills if they had a “do over”, as well as “coping ahead” by applying skills to upcoming events. 

In DBT circles, the classic illustration of the difference between CBT and DBT goes like this:  Client walks into the therapist’s office and says, “Everyone at my office hates me.” The CBT therapist would look to the core beliefs that are driving this irrational thinking and focus on changing them. On the other hand, the DBT therapist will say, “Wow!  That sounds awful.  Do they all really hate you?”  Then the DBT therapist dances between the dialectic that it is actually possible that everyone does hate the client, while on the other hand, irrational thinking could be clouding their perception, but also looking for possible behaviors the client is engaging in that might be alienating their co-workers. And alternatively, looking at the possibility that this workplace is a poor fit.  All options are on the table and explored for opportunities for change, while validating the misery of the situation.   

I think of DBT skills as an invaluable toolkit for building a life worth living.  They give us a way to truly do things differently. 

One of the beautiful things about DBT skills is that they are self-reinforcing. Meaning once you start using skills, you will tend to use them more, because skills work!

However, as Marsha Lineman says, most clients leave the therapeutic environment and promptly forget everything they learned.  This is totally normal! This is why Phone Coaching is such an important part of adherent Dialectical Behavioral Therapy.

When clients are in Emotion Mind (emotions are running hot and guiding decision making), it is incredibly difficult to remember skills (at least initially).  Thus, the third piece of DBT is phone coaching.  When you can’t access your Wise Mind (your deep wisdom, honoring your emotions and potential consequences of your actions) because you are too dysregulated, at least you can remember to call your therapist.  Your therapist can then point you to the proper skills to use in the moment. This is how skills are generalized into everyday life.  Initially this creates a dependence on the therapist, but rather than exhausting friends and loved ones with calls for help and reassurance, the client learns how to apply skills in the moment so that eventually, they don’t need the therapist.  

I do believe that all exposure to DBT skills can be really helpful.  And that is why I have created this blog, my instagram and Facebook pages. And of course, why I offer DBT skills training classes, as well as videos and a forthcoming book about the use of skills called “DBT Stories”, which illustrates the most important aspect of DBT: learning the skills and putting them into practice. As you utilize these resources, I sincerely hope you will look for the familiar and the unfamiliar.  Some DBT skills will be things you have been doing for years and didn’t know it had a name.  Other skills may be ideas you have encountered before.  Then there will be skills that blow your mind and revolutionize the way you do everything.  

As you learn the skills, use them.  And create DBT stories of your own.

Posted by

Diana is a licensed professional counselor based in Nashville. She has been teaching DBT skills for the last ten years after writing her master's thesis about making DBT skills training interesting and engaging. She loves using story telling to help illustrate how skills can be used.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s