Genesis Counseling Center
What is Dialectical Behavior Therapy (DBT)?

Elisa Litchfield, M.A.

Jodi is a 35 year old woman who has been married for 10 years. She struggles with anxiety, depression, and mood swings in her marriage, with her two children, and at work. She has been in therapy for about a year, but she still feels like she doesn't have the ability to cope in a crisis and she feels like her therapist just doesn't understand how hard it is for her. When she was growing up, her father didn't spend much time with her and her mother just told her to 'deal with it' when she had problems. She doesn't feel understood, she feels overwhelmed with her emotions, and wishes she knew how to better deal with her husband, kids and boss.

Jodi is a woman who might be interested in Dialectical Behavior Therapy, or DBT. She needs help in many areas of her life and she needs to learn different ways of dealing with her strong emotions. DBT is a kind of therapy that helps men and women of all ages and life experiences. It teaches them how to deal with problems like Depression, Anxiety, Posttraumatic Stress Disorder and Borderline Personality Disorder. It was originally created by Marsha Linehan, PhD at the University of Washington. She developed DBT to help her clients learn how to keep their emotions from being a constant roller coaster ride, and to stop using the same ineffective ways of coping they've used for a long time.

DBT is usually done in a group that runs for about 6 months, once a week for two hours. The group is similar to being in a class because there is homework, a chance to talk about what you learned or didn't learn from homework, and a lesson about skills you can use to help yourself.  People who are interested should know that they will need to be in individual therapy while they are in group because it helps them have a place to explore issues in more depth than they will have time to explore in group. They also need to meet with the group therapist before committing to the group to make sure it is a good  fit for them.

The group is structured so that group members learn about 4 different types of skills. The first is called Mindfulness Meditation, and it helps people learn how to experience the present moment fully and completely, rather than living in the past or the future. This is an important part of DBT because it helps a person observe, describe and participate in  their thoughts and feelings without being judgmental about if the experience is a "good" or "bad" experience. It teaches people to learn to accept that "it is what it is." Jodi may learn how to stop her mind from focusing on a million different things, and simply focus on her breathing, which helps her be more calm and able to deal with stressful situations.

The next set of skills helps the person learn how to get along with others in a way that doesn't hurt the relationship and still keeps one’s integrity. Some common problems DBT members deal with are how to negotiate a conflict with someone so that he or she achieves the goal they have set for themselves. Jodi might want to learn about how to get her husband to listen to her without having to scream at him and get into fights. Instead of doing something based on feelings, she learns to do what works or what is effective for that situation.

The third set of skills are called Distress Tolerance Skills and they teach Jodi how to accept and tolerate how she feels when she can't do anything about the situation. For example, if Jodi wants to talk to her husband but he won't answer his phone she may get very angry and leave him a mean voicemail. Instead of doing this, she could have chosen to focus her attention to her job or kids until she is able to talk with him. These skills could also help her take good care of herself when she feels depressed as she learns how to soothe herself through listening to music, enjoying a hot cup of tea or watching a funny movie.

The fourth set of skills are called Emotion Regulation Skills and they help Jodi even out her moods. Rather than feeling like she is on a rollercoaster of emotions most the time, Jodi learns how to take the extreme anger, sadness or anxiety she feels and "turn down the volume" from a 10 to a 5 so she can get the things done she needs to.
For those folks who are concerned about if DBT is in line with what the Bible tells us, there is nothing that is taught in class that goes against the word of God. The focus of the meditation aspect of DBT is on calming oneself through deep breathing or repeating a statement. Some people can choose to mediate on God's word (God loves me as I am) or on a beautiful scene of nature.

If you want more information, please call contact Genesis Counseling at 757-827-7707. You can also  type “Dialectical Behavior Therapy” into your search engine, or go to http://bpd.about.com/od/treatments/a/IntroDBT.htm