Dialectical Behavioral Therapy (DBT)

DBT is an offshoot of Cognitive Behavioral Therapy.  DBT provides a terrific way to reframe the way you approach upsetting situations in your life.  DBT has four major components:  Mindfulness, Distress Tolerance, Emotional Regulation, and Interpersonal Effectiveness Skills.

DBT’s first premise is that you have to be mindful of, or notice, what is going on around you.  What are your triggers?  How do you feel about something?  Frequently, we are so far removed from admitting what makes us angry or sad, that we don’t understand why we are reacting the way we are reacting.

If we don’t know what is causing us distress, we can’t do anything about it.

DBT uses mindfulness meditation to help with this.  We learn to identify things that tick us off.  We also learn to identify when we are engaging in “black and white” thinking, and not appreciating the shades of gray.  If you have many rules in your head about how you should always or never do something, examining the validity of these rules can really be life changing.

Once we figure out what is bothering us, we learn Distress Tolerance Skills to calm us down so that we don’t do anything that we will regret when we are upset.  Basically, we learn how to soothe ourselves, much as a parent would soothe an infant.

DBT also recognizes that there are things we need to do on a regular basis to make sure that we are living our most emotionally healthy life.  For example, in order to regulate our emotions, we need to get enough sleep.  Possibly there are foods that make us reactive.  Maybe drinking, or at least drinking to excess, makes us short-fused.  Maybe if we do not incorporate enough fun in our lives, we will be bitter and resentful, and snap at the people we love.

Finally, DBT assists us in learning Interpersonal Effectiveness Skills.  We learn that in order to have a healthy relationship we must have appropriate boundaries with others.  Sometimes this involves saying no; other times, this involves explicitly asking for what we want.  And we learn effective ways to do this, so that we can maintain our self-respect and honor our relationships with others.

Using the DBT framework is an excellent way to learn how to implement the serenity prayer:

God, grant me the serenity to accept the things I cannot change,

The courage to change the things I can,

And the wisdom to know the difference.