Dialectical Behavior Therapy (DBT) is an approach to psychotherapy designed to help control intense emotions. It is similar to cognitive behavioral therapy (CBT). But while CBT is primarily focused on thoughts and behavior, DBT is designed around emotions. It is a treatment for those that experience emotions in very intense ways.
How Does DBT Work?
There are many components to dialectical behavior therapy, so we encourage you to talk to one of our therapists at Flourish Psychology if you’d like to gain more insight into DBT and how it works. Some components of DBT include:
Learning how to hold two competing thoughts at the same time.
Learning how to identify and manage emotions as they occur.
Learning how to tolerate stress and setbacks without generalizing the future.
Learning empathy, and how to understand the experiences of others.
All of these are taught through partially structured, partially individualized, heavily researched techniques that have helped DBT adapt to support many different conditions and struggles.
What Does DBT Treat?
DBT can be an appropriate treatment in a variety of different settings. Our therapists that specialize in DBT have worked with hundreds of men and women throughout New York City, and found success in using DBT in many different settings. It was first developed for very specific conditions:
Borderline Personality Disorder
Chronic Suicidality
Over time, research found that DBT was a beneficial treatment for many more disorders, challenges, and experiences. Now, adapted forms of DBT are used to treat:
Other Personality Disorders (inc. Histrionic/Dramatic Personality Disorder)
It is especially useful for bulimia and binge eating. There are also situations where DBT therapy may be a worthwhile choice for other mental health conditions as well. You and your therapist will determine what treatment options are best for your struggles and needs.
DBT in NYC with Flourish Psychology
Flourish Psychology is a Brooklyn DBT therapist that works with many patients struggling with BPD, eating disorders, depression, anxiety, and other mental health conditions. If DBT has been recommended to you, or you believe you may have a condition that dialectical behavior therapy is qualified to treat, contact Flourish Psychology, today. We are based in Brooklyn Heights and have an intimate understanding of the ways that DBT – and other therapy modalities – can help benefit our patients here in New York City.
Trigger warning: Some of the information in this article might be disturbing and bring up negative feelings. Reader discretion is advised.
The global pandemic continues to rage on, with over 435 million cases worldwide and almost 6 million lives lost. With illness and death hitting so close to home for many, research shows that signs of mental illness and strain have increased in people from all age groups. Unfortunately, the presence of different mental health conditions can lead down the path of self-injury as a way to cope with stress, loneliness and negative thoughts and feelings.
For those dealing with self-injury urges, Dialectical Behavioral Therapy (DBT) can prove to be a useful and effective coping strategy. Even if you aren’t ready to begin seeing a therapist, you can learn DBT skills on your own. When you’re ready to begin treatment for self-injury, your therapist can help you to strengthen your skills.
For the past twenty years, March 1 has been internationally recognized as Self-Injury Awareness Day and is represented by an orange ribbon that signifies hope. In the United States alone, yearly self-injury numbers among women and girls are as high as one in five; and one in seven among men and boys with almost 2 million reported cases.
What Is Self-Injury?
Self-injury falls under the group of actions considered self-harm behaviors and occurs when a person deliberately hurts or harms themself. Acts of self-injury can include skin cutting, head banging, ingesting harmful substances, repeatedly punching self or objects, deliberately breaking bones and other forms of self mutilation. This kind of coping mechanism is usually more common in adolescents and young adults with 50% of reported cases starting at fourteen years old. Though it is rare, acts of self-injury can be present in children as well. It’s important to note that self-injury does not always end in suicide nor is it a definite indicator that a person has suicidal tendencies.
There are different reasons for self-injury, none of which you should be ashamed of if you’ve ever chosen to injure yourself. Self-injury can come about as a way to express or deal with difficult emotions, cope with low self esteem, as a result of mental illness or as a way to have some kind of control over one’s own body when it feels like control is not present in any other area of life. In order to be diagnosed as a person who self-injures, it’s recommended that you speak to a therapist or mental health professional and share your experience.
The different mental health conditions that can contribute to thoughts of self-injury include (but are not limited to) personality disorders, post-traumatic stress disorder (PTSD), bipolar disorder, depression, anxiety and schizophrenia. If you suspect you are living with any of these conditions and want to learn more or find out if they are linked to your tendency to self-injure, you can contact us to schedule a consultation.
DBT Is An Effective Tool for Preventing Self-Injury
There are several different ways to manage the negative feelings that lead you to think about harming yourself. Dialectical Behavior Therapy or DBT is a kind of therapy done collaboratively to bring about positive changes in the life of the affected person. Essentially, DBT combines a number of different core strategies and actions to help you manage difficult emotions and improve your coping skills, relationships and quality of life. This kind of therapy can be done individually (in person or over the phone) or in a group. Effective DBT can bring about acceptance and change in behavior, cognition and skills.
If you opt to undergo DBT, you may need to dedicate time to learning and improving upon skills like mindfulness, distress intolerance, emotion regulation and interpersonal evaluation. All of those can be used when the urge to self-harm arises. Each component of DBT has a variety of methods to help with grounding.
Mindfulness – In order to practice mindfulness, it’s best to use the 6 main mindfulness skills. These are observation, description, participation, non-judgment, single-tasking and focusing on effectiveness. When you take the time to observe, this means you are taking in what’s happening around you and trying to find the root of your trigger. After you have done so, it’s time to move on to describing what you are experiencing. These two actions can happen at the same time and are key parts of the mindfulness process. Participation will have you being present and fully immersed in the activity you are doing to calm yourself, whatever it may be. Reducing judgmental thoughts is also key in the mindfulness process, as releasing the idea of good and bad emotions can help you to see your feelings as they are instead of assigning a meaning to them before you’ve figured them out. Single-tasking or the ‘one mind technique’ is focusing on one thing at a time instead of overstimulating your mind and thoughts. Finally, focusing on effectiveness means that you should stick to the techniques and actions that work for you when you are in distress.
Distress Tolerance – This part of the therapy teaches you how to cope in times of stress through acceptance. If you’re easily overwhelmed, you might feel that you need to run away from the issue when negative feelings start to come up. While there are times when removing yourself from the situation that distresses you is the best way forward, there are other times when there is no other choice but to go through the experience. For example, if you are stuck in traffic and there is no other way to your destination, distress tolerance can help you to understand that this was not your fault and insert feelings of patience. By going through the motions with acceptance and grace, you can eventually learn how to manage intense or overwhelming feelings.
Emotion Regulation – The practice of emotion regulation aims to help you understand your emotions, reduce emotional vulnerability and reduce suffering due to emotional distress so you can have more good and positive experiences. Non-judgment and acceptance play major roles here. In order to regulate your emotions, you will need to accept that negative ones are natural but they don’t have to consume you or control the situation you are in. Once you are able to understand and label your emotions, you are on your way to being able to regulate them. Actively letting go of negative thoughts and taking action to create positive ones is also a big part of emotion regulation.
Interpersonal Evaluation – The skills learned here helps a person to become more assertive in relationships through introspection and self-awareness. By learning what your needs are through self-evalution, you mayclear and honest communucation, you may be better able to let the people around you know what you need while working on reducing whatever emotion that would have pushed you to harm yourself in the first place.
Dialectical Behavioral Therapy is a very effective therapy treatment that is well researched and evidence-based. DBT can help not only with self-injury, but also with improving your way of being in relationships and can help you learn ways to soothe yourself when you feel distressed. The therapists at Flourish Psychology are trained in Dialectical Behavioral Therapy and other treatment modalities. We can help you see that you’re stronger than your self-injury urges and teach you tools to use such as mindfulness, nonjudgmental thinking, and acceptance. Contact us to schedule a consultation.
If you’ve been thinking about starting therapy, you may have come across the terms “CBT” and “DBT” in your research. Though they may sound similar, there are many important differences between these two kinds of psychotherapy. Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) are two of the most common treatment modalities used by clinicians to treat mental illnesses, improve your thoughts and behaviors and equip you with the skills needed to handle the various challenges in your life.
Because these two forms of therapy work in very different ways, it’s important to understand the key differences between them so that you can choose the one that’s right for you. Here at Flourish Psychology, we want to get you matched with the clinician who best meets your needs. After a free consultation, you’ll begin seeing your therapist, who will determine the best type of therapy based on your unique needs.
Let’s explore some of the differences between these two kinds of talk therapy.
What is CBT?
Cognitive Behavioral Therapy is a form of talk therapy that’s considered to be a fast and reliable way of addressing negative thought patterns caused by cognitive distortions. Cognitive distortions are habitual ways of thinking that are inaccurate and usually negative. It’s an exaggerated thought pattern that is not based in fact, causing you to view things a lot more negatively than they really are. For example, you may believe that an unanswered text message means that your friend is upset with you when in reality, they misplaced their phone. CBT teaches you the skills needed to slow down, identify cognitive distortions and challenge them. This can lead to a more positive outlook on life.
CBT teaches you how your thoughts, feelings and behaviors are all linked to each other. By changing your thoughts, CBT also allows you to change your behavior and develop more positive habits and ways of living. CBT is a structured, short-term and goal-oriented form of therapy, used to address a specific challenge or issue in your life.
What is DBT?
Dialectical Behavioral Therapy was developed as a form of talk therapy to help people cope with extreme, overwhelming or unstable emotions. With this form of therapy, the emphasis is on emotional regulation. DBT is actually a modified form of CBT that is more focused on coping with stress, anger and difficult relationships with other people. DBT was originally developed to treat borderline personality disorder (BPD), but is now commonly used to treat other mental health conditions or to help people who have difficulty in regulating their emotions. DBT is excellent for curbing self-destructive behavior and is particularly effective in treating substance abuse disorders.
Differences Between CBT and DBT
They’re Used to Treat Different Concerns
A key difference between CBT and DBT is that they’re used to treat different mental health concerns. DBT was developed to treat borderline personality disorder (BPD), but has proven to be effective in treating patients who have difficulty managing their emotions, such as persons with anger management concerns. On the other hand, CBT is more focused on challenging negative thought patterns and cognitive distortions. CBT helps you to change unwanted behaviors by first managing your thoughts. CBT is usually used to treat a specific concern in a relatively short period of time
2. They Equip You with Different Skills
Both CBT and DBT equip you with important skills that stick with you long after you’ve completed your treatment. With CBT, it’s all about teaching you how to identify and challenge cognitive distortions and reframe your thoughts. One of the most common cognitive distortions is “all or nothing thinking” or “black and white thinking.” This is when your brain sees things in two extremes and fails to acknowledge all the possibilities in between. With all-or-nothing-thinking, things are either perfect or a complete failure. CBT teaches you to recognize that things are never black and white.
DBT skills focus on distress tolerance and teaching you to regulate your emotions during difficult times. When you are able to recognize your emotional triggers, you can prepare yourself to react more rationally in times of distress.
3. They Have Different Treatment Times
Cognitive Behavioral Therapy is a short-term, goal-oriented form of talk therapy. Patients begin their CBT journey with a specific concern or goal in mind. CBT lasts a few weeks and is proven to be effective in this relatively short time period. DBT is a longer-term form of therapy that is more generalized in nature. DBT can continue for as long as the patient wishes to continue
4. They Take Different Approaches to Relationships
CBT is more focused on your relationship with yourself and the way your own thoughts impact your emotions and actions. With DBT, the focus is on how external triggers impact your emotions and behaviors. CBT is more of an “inside job” because it teaches you to pay attention to your thoughts, identify negative thought patterns and change them into more positive ways of thinking. DBT, on the other hand, helps you to respond more rationally to the challenges that arise in your daily life based on your environment or the relationships with the people around you.
CBT OR DBT – Which Is Right For You?
By understanding the differences between CBT and DBT, you’re better able to determine which type of therapy would be most beneficial for you. Here at Flourish Psychology, our clinicians are trained in both forms of therapy and stand ready to help you achieve your goals. When you schedule a free consult, you’ll share your main concerns challenges and goals so we can get you matched with a therapist who best meets your needs. After your initial sessions with your therapist, they’ll be able to determine which form of therapy is right for you. Some patients have even found it beneficial to learn skills from both treatment modalities to help address multiple challenges in their lives.
To learn more about CBT or DBT, or to schedule a free consult, contact us today.
