Foresight Mental Health
DBT: Finding Your Way to Self-Compassion
Updated: Apr 3
by Chay Tanchanco, LMFT
Have you heard of DBT?
It's short for "Dialectical Behavior Therapy". If you are seeking out therapy, it would be good to know the different "flavors" of it. DBT is one of them.
I've heard of CBT, but what's DBT?
CBT = Cognitive Behavioral Therapy. Basics of CBT: your thoughts + feelings = behaviors. By changing your behaviors or your ways of thinking, you can also change your feelings (instead of waiting for it to be the other way around).
One part of DBT is actually CBT. The three other components are:
Distress tolerance: being able to hold discomfort in emotions with skill
Radical acceptance: from Buddhism, the ability to experience life as it is, without assigning judgments
Mindful awareness: how to observe and engage with the present moment
What is DBT useful for?
DBT is an evidence-based practice, which basically means that there has been enough research in the psychological medical field to suggest that it is effective in treatment of certain diagnoses. It is most often recommended that DBT be used when supporting a person with borderline personality disorder (BPD). Research has shown that DBT is also effective with ADHD, PTSD, Major Depressive Disorder (MDD), bipolar disorder, and eating disorders.
It is my opinion that expanding beyond the scope of a diagnosis, people are unique and work differently. With the right support and a trust bond with your therapist, you can explore tools within a modality such as DBT and find something useful regardless of what a diagnosis might say.
Okay, so how does it work?
Traditional DBT has four components:
A skills training group
Therapist consultation team
Think of it like a mental health combo. DBT was originally designed to help people with BPD who are often dealing with chronic suicidal ideation and difficulty maintaining relationships with others. By supporting people from all sides (and includes supporting the therapists as well!), everyone can grow together in empathy and self-kindness.
With mental health services and needs quickly expanding, you may be able to find a therapist who specializes in DBT and learn the skills with them, even without all 4 of the components listed above.
I don't know if DBT is right for me.. how could it help?
Let's try this through an example.
You might have one of those horrible, terrible, not-so-good days where everything feels like it's going wrong. Your Internet craps out, the last thing you were supposed to eat in the fridge has magically disappeared, your car won't start, and your phone decided that it's time to start doing weird freezes. Maybe you and your friend have a misunderstanding over text, maybe you can't seem to catch a break and you snap and say something hurtful.
It's easy to tell yourself things like, "I always do this. I am such a terrible friend." You feel that awful pit in your stomach or that chest pain and try to distract yourself with TV or another bag of chips. You wish that this day would just end.
By applying DBT skills and support, we can learn to address this with more intention.
Mindful awareness: This is an experience I am having at this moment in time. I'm observing what is happening using words and feeling what is occurring in my body, noting if judgments arise.
Radical acceptance: It is one of many experiences in my life. It is happening and I am feeling frustrated and discouraged and disheartened and guilty. And these are all acceptable feelings for this moment.
Distress tolerance: I feel what is uncomfortable in my emotions and in my body, and I allow it to be. It will pass, and I will see the clouds clear.
With CBT skills, we can identify our thoughts: "I am experiencing 'all or nothing' thinking. Having a misunderstanding with my friend is not something I have 'always' done. And it does not make me a terrible friend. I have said something hurtful, and my task now is to work on ways to repair that harm."
This promotes self-kindness, understanding and overall de-stresses your system!
This is a basic framework and there is so much more to DBT than what I've included here! Ask your therapist about DBT, even if they're not an expert. They may be able to point you in the right direction.