DBT (Dialectical Behavior Therapy) Offers the Leading Edge in Cognitive Retraining

“Traumatic events, by definition, overwhelm our ability to cope. When the mind becomes flooded with emotion, a circuit breaker is thrown that allows us to survive the experience fairly intact, that is, without becoming psychotic or frying out one of the brain centers. The cost of this blown circuit is emotion frozen within the body. In other words, we often unconsciously stop feeling our trauma partway into it, like a movie that is still going after the sound has been turned off. We cannot heal until we move fully through that trauma, including all the feelings of the event.”    Susan Pease Banitt

From Behavioral Tech: “What is Dialectical Behavior Therapy (DBT) ?”

“Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment developed by Marsha Linehan, PhD, ABPP. It emphasizes individual psychotherapy and group skills training classes to help people learn and use new skills and strategies to develop a life that they experience as worth living. DBT skills include skills for mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.”

‘Problematic behaviors evolve as a way to cope with a situation or attempt to solve a problem. While these behaviors might provide temporary relief or a short-term solution, they often are not effective in the long-term. DBT assumes that clients are doing the best they can, AND they need to learn new behaviors in all relevant contexts. DBT helps enhance a client’s capabilities by teaching behavioral skills in areas like mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. These skills help people develop effective ways to navigate situations that arise in everyday life or manage specific challenges.”

From Wikipedia: “Dialectical Behavior Therapy“:

“All DBT can be said to involve 4 components:

  • Individual – The therapist and patient discuss issues that come up during the week (recorded on diary cards) and follow a treatment target hierarchy. Self-injurious and suicidalbehaviors, or life-threatening behaviors, take first priority. Second in priority are behaviors which, while not directly harmful to self or others, interfere with the course of treatment. These behaviors are known as therapy-interfering behaviors. Third in priority are quality of life issues and working towards improving one’s life generally. During the individual therapy, the therapist and patient work towards improving skill use. Often, a skills group is discussed and obstacles to acting skillfully are addressed.
  • Group – A group ordinarily meets once weekly for two to two and a half hours and learns to use specific skills that are broken down into four skill modules: core mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance.
  • Therapist Consultation Team – A therapist consultation team includes all therapists providing DBT. The meeting occurs weekly and serves to support the therapist in providing the treatment.
  • Phone Coaching – Phone coaching is designed to help generalize skills into the patient’s daily life. Phone coaching is brief and limited to a focus on skills.”

From jamesmatter: “Pay Attention When I’m Talking to Me!“:

“The thing is, when we think, we are talking to ourselves. Thinking is not an automatic pronouncement of absolute truth, a description of absolute reality, or anything else. It might be a pronouncement of absolute truth, a description of absolute reality– but most likely not. What it usually is, is an inner monologue. Sometimes, it’s true, we may think in music, or think in images, but mostly we are talking to ourselves, either consciously and deliberately or not.”

“Cognitive therapy involves looking at this inner monologue and challenging the cognitive distortions. So if I’m feeling depressed over a failed relationship I might tell myself, “All my relationships fail. I’ll never have a successful relationship.” One cognitive distortion there is fortune telling. Another one is all/nothing thinking. In this case, the two overlap. Even the assertion that “All my relationships fail” may be suspect– perhaps if I review my relationship history I’ll realize I have sometimes dumped other people, or we called it off mutually. Even if I determine that I was dumped every time, I will likely have to admit that the relationships worked for a while. In short, the statement was not a statement of absolute truth, it was a judgment call– and I may have slanted the judgment against myself!”

“But the hardest part for so many people is to recognize that what I’m looking at here is my own inner monologue, not a statement of objective truth or reality.  The best statement I ever heard about this process came, as so many pearls of wisdom have, from a client. She said, “When I’m talking to myself, paying attention is a form of self-respect.” Listening carefully to the inner monologue and recognizing it as my own voice, talking to me, is a sometimes difficult but invaluable step in being able to change.”

DBT works so well because it helps clients learn what triggers his/her mind to choose destructive responses. At the same time, the client learns which coping skills help the most. Each of us is an individual so these triggers and coping skills will be unique for who we are.

Photo credit.

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