Dialectical Behavior Therapy (Week 4)

Developed in the 80’s as a cognitive behavioral approach, in reaction to clients feeling that their suffering was being underestimated by therapists (and maybe that the therapists were also overestimating how helpful they were being!). DBT aims to create a better balance between ACCEPTANCE and CHANGE strategies.


Dialectic means weighing and integrating contradictory facts or ideas with a view towards resolving apparent contradictions. Everything is connected to everything else; change is constant and inevitable; opposites can be integrated to form a close approximation of the truth (which is always evolving).


Learning new behaviors is the focus. People track their problem behaviors in a diary, attend skills groups, do homework and role-play new ways of interacting with people. With therapists, they work to identify how they are rewarded for maladaptive behavior or punished for adaptive behavior. They expose themselves to feelings, thoughts or situations they fear or avoid and change self-destructive thinking. Counselors emphasize validation (‘your behavior makes sense considering…’) not because they agree with it.



Mindfulness: intentional, accepting and non-judgmental focus of one’s attention on the emotions, thoughts and sensations occurring in the present moment


Interpersonal Effectiveness strategies: maintaining a balance of priorities and demands within relationships by clarifying what is desired from the interaction being as specific as you can and identifying what we need to do in order to get the desired results


Distress Tolerance (Learning to Bear Pain Skillfully), including Crisis Survival Strategies (distraction, self-soothing), thinking of pros and cons, acceptance skills


Emotional Regulation: identifying and labeling emotions, obstacles to change, reducing vulnerability to “emotion mind”


-Increasing positive emotional events and mindfulness to current emotions


-Taking opposite actions applying distress tolerance techniques


-Marsha Linehan (founder of DBT)’s site, along with links to finding a therapist: http://behavioraltech.org/

-Free guided meditations as well as classes, events and retreats: http://marc.ucla.edu/

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