Fundamentals of Dialectical Behaviour Therapy

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Dialectical Behaviour Therapy combines standard CBT (cognitive-behavioural therapy) techniques for regulating emotion and testing reality with concepts of distress tolerance, acceptance, and mindfulness chiefly originating with Buddhist and other Eastern meditative practices (Wikipedia, 2013). Here are the main features.

  1. DBT is support-oriented. Rather than merely examine what is wrong, the processes help a person to identify her strengths and build on them so that she can feel better about herself and her life.
  2. DBT is cognitive-based. In true CBT fashion, DBT helps clients identify thoughts, beliefs, and assumptions that are making life harder for them. Examples of these could be: “I have to be perfect or I’m worthless”, “I got angry, so I must be a terrible person”. DBT helps clients to replace these with more helpful thoughts and beliefs, ones which make life easier to bear: for example, “I’m quite competent at tennis, but I am still a beginner at negotiation skills” or “Anger is a natural, protective emotion, and most people experience it at some time.”
  3. DBT is collaborative. The goal is to have the therapist as an ally rather than an adversary as the issues are worked through. Thus, the therapist aims to accept and validate the client’s feelings at any given time, BUT – and here is one of the dialectical aspects – the therapist does not shy away from showing the client how some feelings and behaviours are maladaptive and pointing out better alternatives (Wikipedia 2013). Thus, through such a tough-love stance, the therapist achieves the synthesis of two polar opposites, e.g.: “I accept you as you are” and also, “Changing some things can bring you higher quality of life.” Clients are encouraged to work out problems in their relationships with their therapist, and therapists are encouraged to do the same with them. Moreover, therapists are encouraged to support one another in supporting the BPD clients (Psych Central, 2007b).

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