DBT FOR EMOTIONAL REGULATION AT
EMOTION WISE COUNSELLING

Dialectical Behavioral therapy is an evidence-based therapy that was created by Dr. Marsha Linehan in the 1980’s  out of a desire to help people suffering with the with most severe mental health issues, especially those with suicidal ideation, especially those with Borderline Personality Disorder (BPD) but its applications have since expanded to a variety of mental health conditions, including depression, anxiety, eating disorders, and substance use disorders.  DBT’s ultimate goal for clients is to create a life worth living, for those who felt hopeless. 

 

As Dr. Linehan initially attempted to help suicidal patients using CBT (Cognitive Behavioral Therapy) and found that people would change but that would feel invalidated or uncared for in using strategies to change their thoughts and actions alone.  Subsequently she shifted to trying client-centred care, and her clients complained they were not changing.  DBT was the solution to this problem of meeting two opposing needs at the same time by incorporating both acceptance and change strategies.  

 

Dialectics is explained as that two opposing concepts can be held as true at the same time.  Many people who come to DBT therapy struggle with black and white thinking and can find themselves seeing themselves and others as all good or all bad.  Dialectics teaches the client to understand that there is always more than one way to see a situation, that people are all connected, and the world and even each person is always changing. 

 

DBT is best known for its skill training which happens primarily in Skills Group (check out our Trauma-Informed DBT Group offerings) but also individually.  DBT skills training has  4 modules: Mindfulness, Emotion Regulation, Interpersonal Effectiveness and Distress Tolerance.

 

1. Mindfulness: In DBT mindfulness entails learning to pay attention to the present moment and learn to observe and describe without judgment what is happening inside and outside of them.  This skill is the foundational skill of DBT upon which all skills are built.  DBT therapy draws extensively from Dr. Linehan's experiences with Zen Buddhism in its concept of mindfulness but also draws on and acknowledges mindfulness practices that are found around the world in all religions and cultures.

2. Emotion Regulation:  Skills to change or reduce the intensity of emotions.  Skills in this module include naming and understanding emotions, taking care of underlying vulnerability factors, cognitive skills (check the facts), and behavioral strategies to build a life worth living.

3. Interpersonal Effectiveness: Skills to help people navigate and strenghten current relationships effectively and build new relationships.  This module also helps people learn to say no (set boundaries) and ask for what they want.

4. Distress Tolerance: Skills to help people deal with distress that cannot be prevented without making things worse.  These skills are often short term in nature but are essential to help people deal with overwhelming situations they will inevitably encounter in life.

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DBT is considered to have 4 stages, but it is most well known for its 1st stage work of skills training which we offer in our Trauma-Informed DBT Groups (www.emotionwise.ca/groups).

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Stage 1: A person feels miserable, overwhelmed and out of control. This stage is focused on stabilization and developing behavioral skills to address destructive behaviors and emotions regulation issues, as well as improve relationship skills.  This stage often includes attending DBT skills group concurrent with individual therapy

Stage 2: In this stage clients address PTSD, childhood traumatic invalidation, and emotional avoidance to move from a life of quiet desperation to one of emotional health and connection within themselves.  They may use skills from various modalities not limited to DBT for example: CBT, EMDR, and Internal Family Systems.

Stage 3: In stage 3 the goal is to address problems of living including feelings of being incomplete and unfulfilled.  The therapist works with client to build life goals (eg. career, relationship, hobbies), self-respect and experience ordinary unhappiness and happiness in their life.

Stage 4: Is marked by a deeper quest for happiness and spiritual meaning and connectedness. This may include a deeper quest for fulfillment through spiritual practices and exploration of meaning.  This stage of therapy may draw on various modalities and approaches.

 

Contact us today to meet with a DBT Therapist or sign up for one of our Trauma-Informed DBT Groups!