DBT Therapy in London and Online

What is Dialectical Behavioral Therapy (DBT)?

What Dialectical Behavioral Therapy Can Help With

Who needs DBT therapy

How does DBT Therapy work?

How long does DBT therapy last 

What to expect in DBT therapy

What is a DBT session like?

What are the benefits of DBT Therapy?

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What is Dialectical Behavioral Therapy (DBT)?

DBT is a third-wave therapy approach introduced by psychology researcher Marsha Linehan in the late 1970s initially to treat suicidal individuals or those with borderline personality disorder. Linehan, who herself struggled with these mental health issues, noticed how traditional therapy emphasises either acceptance or change yet doesn’t integrate them.

In DBT, there’s an assumption that some of us have a higher emotional sensitivity, therefore, can react to certain situations in intense and unhealthy ways. That significant difference in arousal levels leads to painful emotional struggles such as extreme mood swings, negative thoughts, or thinking errors.
Another basic premise states that such issues come from a fundamental lack of essential coping skills, which DBT addresses throughout the course of the therapeutical process. In order to cultivate acceptance of what cannot be changed, DBT utilises mindfulness-based techniques. When applying strategies that foster a positive change, it draws inspiration from Cognitive Behavioural Therapy (CBT).

Nowadays, DBT is one of the most common approaches in therapy, treating many different issues. Clients themselves describe how this experience gave them the tools necessary to manage symptoms and helped them take charge of their life.

What’s the difference between DBT and CBT?

Even though DBT originates from CBT, it’s important to remember that the two approaches are not the same. While CBT prioritises changing and altering unhelpful thoughts and beliefs, DBT goes a step further by understanding that before the therapeutic work can focus on bringing positive change, the emphasis needs to be put on accepting the reality, however difficult and painful it might be. That means coming to terms with your life and understanding what steps need to be taken in order to support your well-being rather than surrendering and giving up on yourself. One simply cannot efficiently cope with the present day’s challenges without recognising and accepting them first. That is why moving between acceptance and change is so essential to the whole treatment.

What Dialectical Behavioral Therapy Can Help With

Who needs DBT therapy

DBT is most helpful if you’re struggling with regulating intense emotional states, impulsivity, extreme mood swings, self-harm or suicidal thoughts. Even if DBT isn’t the primary approach used in therapy, some elements of DBT can also be implemented into a comprehensive, personalised therapy approach.

Let’s say you and your partner have a tendency to lash out at each other whenever you have a fight. Throughout the course of your couples therapy, you’re highly likely to practice the skill of interpersonal effectiveness, which comes from DBT, in order to foster healthy communication.

One of DBT’s skills – distress tolerance – can also be weaved in the therapeutic process of a person who struggles with depression. It can help them utilise techniques essential in preventing a downward spiral during times of crisis.

How does DBT Therapy work?

DBT assumes that all people are equipped with the skills necessary to cope with life. What we differ on is the level of those skills. Some of us might excel in certain areas while struggle in other categories in our lives. For example, a highly extroverted person who makes new friends easily can simultaneously experience difficulties with setting healthy boundaries and being assertive within those relationships. This issue, alongside others, is addressed throughout skills training that aims to enhance your ability to navigate between acceptance and change in life.

It’s important to note here that the skills training by no means resembles the experience of going to school. It more so serves as a blueprint for therapists, who adjust it to the individual needs and issues of their clients. They introduce specific skills in the appropriate moment of the therapeutic process, frequently following up with their clients on it.

Mindfulness

One of the first skills introducedfocuses on improving the ability to stay in the present moment. It does so by applying mindfulness-based techniques, which allow you to develop self-awareness and a non-judgmental posture that, in turn, fosters acceptance of things that cannot be changed in your life. Let’s say that you made a mistake a while ago and you keep replaying that moment in your head. Mindfulness can help you observe your thoughts and emotions from a distance rather than dwelling on them or reliving them. It also fosters a better connection to the here and now, which will help you let go of the past (or worries about the future) and focus on the present.

Interpersonal Effectiveness

Another important aspect of DBT is about helping you become more effective interpersonally. That means learning assertiveness and problem-solving skills, which make navigating professional and personal relationships easier, especially when faced with a conflict. Here, you will have a chance to learn, for instance, how to say “no” or set healthy boundaries.

Distress Tolerance

Crises in life and a heightened amount of stress from time to time are unavoidable. That’s why distress tolerance is a very important focus in DBT. This aspect of the treatment focuses on equipping you with essential survival strategies that will help you go through difficult times skilfully without making things worse. Different techniques will allow you to accept and cope with pain and discomfort healthily.

Let’s say that you’re going through a difficult period in your life and you’re experiencing a lot of stress. During your sessions, your therapist might guide you throughout a self-soothing technique that engages all of your senses, moving your attention away from the stressor and towards the various smells, sounds and colours of the present moment. 

Emotion Regulation

Originally, Marsha Linehan wanted to help people with borderline personality disorder regulate their challenging emotional states such as recurring anger issues, frustrations, depression, anxiety and suicidal behaviours. Therefore, this part of the therapy can educate you on the impact of emotions on your thoughts and behaviours, introducing a variety of emotion regulation skills that, when applied correctly, can lessen or prevent self-destructive tendencies.

How is DBT different from traditional psychotherapy?

DBT initially was created for individuals for whom traditional therapy simply didn’t work, as It mainly focused on changing the dysfunctions of clients without acknowledging their current state. Marsha Linehan realised how invalidating and judgmental that approach could feel for clients and introduced an alternative approach, where clients were always treated with radical acceptance. 

The framework, though, still focused on problem-solving and skills training. Coping with the hardships of one’s reality as well as learning and implementing new skills simultaneously can be too challenging in traditional therapy. However, DBT addresses that issue by splitting the treatment into different components, which altogether help clients move towards change while having their emotional needs met.

How long does DBT therapy last

Individual therapy sessions take place once a week and focus on reinforcing those skills, discussing any issues or the events of the past week and boosting the client’s motivation.
The length of DBT therapy can vary greatly, from 3 months to 2 years. It all depends on the nature and severity of the issue that you are experiencing.

What to expect in DBT therapy

DBT therapy is a specific form of treatment that might not be for everyone. It can often be quite demanding and time-consuming. Even though traditionally it consists of both group sessions and individual therapy, we provide the latter, ensuring a personalised 1:1 therapeutic context.

Throughout the whole process, you can expect to work in between sessions with worksheets and practice your skills, for example, by meditating. It is also common to keep a journal and receive homework to do outside of your sessions, which are a very important driver for positive change. Undoubtedly, the practice of specific skills might be challenging, especially exploring past trauma or becoming more aware of your emotional pain. It is beneficial to have a certain willingness to open up and discuss difficult topics, especially when done in the context of a non-judgmental and radically accepting therapeutic relationship.
That relationship is what makes DBT Therapy stand out from the crowd. Treating one another with acceptance and respect is a crucial aspect of the treatment. A lot of effort and attention goes to strengthening the alliance between therapists and clients.

What is a DBT session like?

DBT sessions differ from traditional talking therapy because they’re filled with much more exercise and practice time. For example, it is very common to have homework of filling out diary cards where you track your emotions and behaviours. Then, with your therapist, you can discuss their content as well as emerging patterns or any triggers connected to them. Based on those cards, both sides decide then what to discuss and work on during each session. Throughout the whole treatment, you learn and enforce different acceptance and change techniques with your therapist, who might challenge your unhelpful thoughts, encourage you to cope healthily and assist you along the way. Depending on your personal situation, you might practice meditation in order to stay in the moment, use imagery to self-soothe, role-play to increase your social skills, etc.

What are the benefits of DBT Therapy?

Dialectical Behaviour Therapy is not only highly effective in reducing unhelpful behavioural patterns, but also it can help you:

• Accept yourself and your life circumstances:
  e.g. cultivating self-compassion and self-love instead of self-loathing
• Recognise and understand your emotions:
  e.g. succesfully managing your anger or low mood
• Challenge your unhelpful thoughts:
  e.g. preventing a downward spiral
• Observe and replace your unhealthy behaviour:
  e.g. no longer engaging in self-harm behaviours
• Effectively interact and communicate with others:
  e.g. resolving conflicts in your relationship healthily and setting healthy boundaries
• Introduce a long-lasting positive change in your life,
  e.g. pursuing your passions regularly, achieving personal and professional satisfaction