Many people with Borderline Personality Disorder (BPD) believe no type of therapy will ever work for them. They might feel hopeless that nothing will change or maybe even stuck without seeing even a faint light at the end of the tunnel. BPD can impact relationships with people, how you feel about yourself, mood regulation and your overall identity. Recognizing that this disorder can impact multiple facets of your life, you need a therapy that is going to address just that. Dialectical Behavior Therapy, commonly referenced as DBT, was designed to help people specifically with BPD. DBT is a comprehensive way to address extreme emotions and gaining control of them, allowing for a more effective way to get your needs met. Sounds too good to be true? These skills really do work! Let’s break it down and look a little more closely to see how DBT can be effective for you...
What does Dialectical Behavior Therapy even mean?
Dialectical Behavior Therapy is talking about Dialects and the way our behaviors are impacted by them. Dialects references ‘two opposing things to be true at once.’ Here is a great analogy to understand a little further. What happens when you combine black and white? In the lens of DBT, the answer is plaid, not grey.
A more practical example of this: I’m having a conversation with my partner who I know has been very stressed lately. Trying to show my support and care for him, I ask him if I can come over. To my surprise, he gets somewhat abrupt with me and dismisses the request to spend time with him. Two things are going through my mind, I’m upset by his reaction but at the same time, I know he is stressed and I try not to take it personally. My partner cares about me and wants to see me but doesn’t want to spend time with me right now due to his stress; two opposing things that are true at the same time.
How do I know if I have BPD? Will this even work for me?
Wanting to understand more about yourself and exploring if BPD might be something you identify with, is a bigger conversation to have with your therapist. BPD isn’t something that is just diagnosed upon your first therapy session, but just for the sake of understanding if DBT might be right for you, here are a few symptoms you might experience quite regularly: thoughts of guilt, shame, fear of abandonment, distorted thinking, poor self-esteem, suicidal ideation, extreme emotions/ mood swings, self-harm, substance abuse, sexual promiscuity, and hopelessness.
How do the skills work?
DBT consists of 4 modules broken up into Interpersonal Effectiveness, Emotion Regulation, Distress Tolerance and Mindfulness.
Interpersonal Effectiveness
Interpersonal effectiveness is just another way of saying communication skills. Practicing assertive communication to get your needs met and not feeling guilty about it! Gaining self-awareness of your communication styles, what has been effective in the past or present and what hasn’t been effective. Being aware of how body language or maybe passive aggressive comments have impacted previous relationships.
Emotion Regulation
This module in the most simple term is, how to gain more control of emotions. Here you will explore skills such as, looking at the facts of the situation or choosing to engage in the opposite of our negative coping skills. Gaining back control and reducing the intensity of your emotions is a key goal in this module.
Distress Tolerance
One of the most challenging modules is how to tolerate distress, especially in situations we lack control in. Radically accepting the things we cannot change is a large feat but, when we can master distress tolerance, our ability to reduce the intensity of emotions becomes significantly stronger.
Mindfulness
Mindfulness is not the stereotypical term you might be thinking of. Rather, it is about the awareness of behaviors, thoughts and physical sensations. Mindfulness could be when you are practicing skills that help you to stay grounded to prevent having a panic attack or implementing “wise mind” to observe the emotions vs. the facts to have a better understanding of yourself.
The part where DBT can get complicated with the efficacy of the skills is, it takes practice. If you try “wise mind” once, and never do it again, it’s not going to work, plain and simple. It’s important to practice these skills daily at home, at work, when you are at the grocery store, or when texting your family or friends. Practicing skills daily such as, writing your efforts in a journal or diary card is a great example of what practice looks like in DBT. It’s hard work but as you practice these skills, they become like a routine and sometimes, you will find that you are utilizing a skill without even noticing. DBT skills will become just like driving a car or brushing your teeth.
Now that we reviewed the 4 modules, it’s important to remember the initial question, “I have BPD, is DBT right for me?” If you think about your struggles, stressors and issues you want to tackle, DBT skills can be what you need to start feeling hopeful again.
Brittany Wolfson LPC, ATR-BC