Dialectical Behavior Therapy

Dialectical Behavior Therapy

セラピーセッション

DBT stands for Dialectical Behavior Thearpy.  DBT was developed by Dr. Marsha Linehan to treat individuals diagnosed with borderline personality disorder.  The research has since shown that DBT works for many other condistions including eating disorder, addictive behaviors, bipolar disorders, ADHD and anxiety. 

Who is this for? 

 

It is for individuals who are struggling with 5 areas of dysregulation:

Emotion:  High sensitivity to stimuli, high intesnsity of emotional expression, and slow come back to the emotional base. 

Bahavior:  Impulsivity to highly riskly or undesirable behaviors (including self harm) on one hand, and avoidance of painful experience on the other. 

Cognition:  Polarization of thoughts such as black and white thinking, inflexibility, paranoia, or disociative responses. Often suicidal ideation. 

Interpersonal: Chaotic relationship with someone very close to you on the one hand, and the fear of abandonment on the other. 

Self:  Difficulty dealing with a fragile image of self and rigid self-imposed rules (such as perfectionism) that goe with the image. 

 

Diagnosis does not matter, if your can relate to one or more of above descriptions of behaviors, DBT may work for you.  

If you are under a psychiatrist’s treatment, you would need an authorization from your doctor to start DBT.     

what are the 4 modes of Therapy?

 

Individual therapy:  It is like a therapy that you would imagine. You can talk about events in your life and your reactions to them.  At the same time, you can practice how to use a particular DBT skill in your very specific situation.

 

Group skills training:  It is a biweekly training with your peers.  DBT is a behavior therapy:  i.e. you will learn different sets of skills that you might not have tried before and practice it until they become automatic response to certain situations.  We understand that you are doing the best you can already, but at the same time, we believe that you can use some of the new skills in various instances of your life.  

 

Phone coaching:  We want you to use the new skills in the most opportune way.  In the beginning, even with your  knowledge and intention, they might not come available to you in the moment that you need them most.  If you are participating in comprehensive DBT*, you can then call your individual therapist, who will, in turn, rehearse the skills with you.  (*Only available for those who are participating in all modules.) 

Therapists’ consultation:  DBT is a demanding therapy for therapists, too.  To support you most effectively, therapists meet every week to improve our practice.  This is our commitment to make DBT work for you.  

 

What are the 4 modules of skills training? 

 

Core Mindfulness:  Core mindfulness helps individuals to be aware of their subtle feelings, thoughts, and urges  as well as their connection to the world in the present moment. It also helps you to focus on one thing at a time. 

Distress Tolerance:  Distress Tolerance helps you enhance adaptive strategies to cope with crises so as not to make the situations worse than they already are.   This module also help you develop the acceptance of reality as it is.   Strategies for addictive behaviors fall in this module, too. 

 

Emotion Regulation:  Emotion is a full system response to a stimulus. Understanding your own emotions from all angles is the first step to regulate them in your favor.  In this module, we also learn how to stay positive in your daily life so that you can manage the crisis better once it hits. 

Interpersonal Effectiveness: Interpersonal skills are extremely important to balance getting what you want in life, maintaining important relationships, and reserving self-respect.   In this module, we learn to validate others and ourselves.  It is also important that we heal from past invalidations.