Managing the mind with DBT

Do you find yourself experiencing intense negative emotions that can consume you? Do your thoughts and emotions make it difficult to maintain stable relationships, focus at work or school, or even get out of bed?

Dialectical behavioral therapy (DBT) can help. Mental health professionals are using DBT to aid patients who are experiencing extreme, life-draining emotions, depression or anxiety.

DBT is a form of cognitive behavioral therapy, in which patients learn to restructure unhelpful thinking patterns and improve their emotional resilience and ability to manage life’s challenges. DBT teaches coping skills, such as:

• Mindfulness

• Emotion regulation

• Distress tolerance

• Interpersonal effectiveness

DBT is typically used to treat serious mental health illnesses, such as borderline personality disorder, or help people with suicidal ideations. However, it may also be beneficial for anyone struggling with intense negative emotions, conflict in relationships or stressors in life.

The power of acceptance

According to Lori Alford, a licensed social worker with Sharp Grossmont Hospital for Behavioral Health, DBT leans heavily on the philosophy of acceptance.

“DBT teaches us how to broaden our perspective, while also learning healthy ways to accept and cope with the situation,” she says. “It is adopting a state of mind where you recognize and accept reality, even if it’s unpleasant. You acknowledge whatever painful emotions come up and use techniques to get through the intense emotions without making the situation worse.”

Such acceptance and distress tolerance can reduce inner turmoil and create an opportunity to also let go and move forward. Alternatively, fighting or ignoring reality can aggravate the situation.

DBT techniques may include healthy activities to distract yourself; self-soothing methods, such as listening to calming music; or practicing meditation, positive visual imagery or prayer to get through a distressing moment. Over time, and with the application of mindfulness and other skills taught in therapy sessions, patients can regulate emotions and respond more effectively to life’s stressors.

“It is about thinking in color, rather than in black and white,” says Alford. “Learning and applying the skills taught in DBT prevents us from dealing with life in inflexible and rigid terms. Rather, it provides us with tools to regulate our emotions in productive ways.”

Getting comfortable with opposing ideas

Dialectical behavioral therapy also teaches you how to accept who you are while learning ways to deal with life’s problems. This means adapting to “opposing ideas,” for instance, being comfortable with the idea that you or your situation is not perfect, while also identifying healthy ways to accept yourself and cope with life’s challenges. “You can learn to hold two opposite views in your mind at the same time and realize they can coexist,” says Alford.

Alford incorporates DBT into the intensive outpatient group therapy sessions she leads. She recalls a patient who, at times, felt his circumstances were “all bad,” but at other times, could find them reasonable and manageable. “The patient realized both were true because there were the bad parts, but there was also some reason to it — accepting both parts led to steps to be able to move forward in life,” she says.

DBT, Alford believes, can be helpful for many people. “Dialectical behavioral therapy provides a specific toolbox for handling crises and pulling back from intense and overwhelming emotions, developing a mindfulness practice, and learning conflict resolution in order to get along with others,” she says.

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