Dialectical Behaviour Therapy (DBT)

Treating any kind of psychological oriented disorder has to include some therapies for trauma and mental health. Often people who have developed an addiction have done so by “self medicating” another condition. In many cases this condition is either a psychological trauma or some form of physical discomfort such as pain. A psychological trauma can be from a childhood experience, such as a divorce or death or accident. Many people still carry these scars and have emotions that they are unable to cope with so they , develop unhelpful and maladaptive coping strategies such as drinking or using drugs to numb the pain. In any case , these emotions will crop up in their everyday relationships and interactions with other people and clients benefit from learning how to identify these problems and manage the emotions and reactions within these relationships in a healthier manner.

The skills taught in DBT are balanced between acceptance and change. The acceptance-oriented skills are mindfulness and distress tolerance, while the change-oriented skills consist of emotion regulation and interpersonal effectiveness. DBT is divided into four stages of treatment. In Stage One the client is not in control of certain thoughts or behaviors and is self-harming, in the case of addiction by using drugs and/or alcohol or other unhelpful processes. The goal then becomes moving past this stage to one of behavioral self-control. In Stage Two the client may be experiencing emotional inhibition, discomfort, or suffering due to a past trauma and invalidation. The goal in Stage Two is to pass beyond this state to one-of full emotional experience. In Stage Three the challenge is to learn to live by setting goals, building self-respect and finding inner peace and happiness. The Fourth Stage is concerned with finding deeper meaning through a spiritual existence, or a sense of connection to a greater whole, such as humanity or the universe, however the client needs to define it, thereby moving into a sense, or feeling of completeness towards life that includes an ongoing capacity for experiencing joy, happiness and connection.

Dialectical Behavioral Therapy, or DBT, enables people to identify their individual strengths and to build on them. Therapists also use DBT to help clients to identify thoughts, beliefs or assumptions that make their lives harder. For example, someone who thinks they have to be perfect is setting themselves up for eminent failure. Not one single person is perfect. Someone who feels they’re a bad person because they get angry sometimes is going to need to understand that everybody gets angry sometimes, anger is a regular human emotion. If there is an unusual level of anger or it happens too often, this may be indicative of another issue. However, under normal circumstances, it’s how the person processes their anger that counts. By identifying these thoughts and feelings, the process of learning how to deal with them can begin, and allow the client to have more healthier coping strategies to deal with their emotions.

With DBT we first focus on any form of self-injurious behaviours which may include drug and alcohol use, followed by any behaviours that may get in the way of the therapy process. Clients learn to pay close attention to relationships and to work out problems in their relationships with their therapist, including within the therapist-client relationship itself. Individual sessions in DBT also focus on improving the quality of life in general and dealing with any post-traumatic stress responses that may occur, along with helping clients enhance their self-esteem and self-image. At Samarpan we use DBT in both individual therapy sessions and group sessions.