Dialectical behavior therapy, also known as DBT, is a form of psychotherapy that is founded on the principals of cognitive behavioral therapy (CBT). Psychologist Marsha M. Linehan developed DBT in the late 1980s as a means to help better treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). Although touched upon in cognitive behavioral therapy, DBT places primary emphasis on the psychosocial aspects of treatment.

 

DBT combines standard CBT techniques for emotional regulation and reality testing with concepts derived from Buddhist meditative practice such as awareness, mindfulness and attentiveness to current situations and emotional experiences to encourage acceptance. 

 

On today’s episode of the podcast, I sit down with Daina Haines, MA, LCSW, who facilitates DBT therapy groups at Tri-State DBT Associates in Medford, New Jersey.

 

Some of the topics discussed on this episode:  

 

■ Daina’s first experience with DBT in clinical practice (being thrown into a group DBT session without preparation)

■ A breakdown of the four skills modules in DBT therapy (core mindfulness skills, distress tolerance skills, interpersonal effectiveness skills, and emotion regulation skills)

■ What is “wise mind” in DBT therapy

■ Struggling with suicidal ideation and how Daina handles this with her clients  

■ Quiet vs. “classic” BPD (internalizing vs. externalizing)

■ The four stages of competence (“the competence spectrum”)

■ The link between rage and anger in borderline personality disorder

■ Accepting reality (radical acceptance)

■ Why people with BPD are considered “difficult patients” (turning willfulness into willingness)

■ How re can reframe stigmatizing words often used to describe people with BPD (“attention-seeking” and “manipulative”)

■ Why identifying our unmet needs is so hard for those of us with complex trauma and BPD

■ The cultural differences in emotional expression (Eastern vs. Western thought)

■ Hope for BPD recovery


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