Dialectical behavior therapy (DBT) is a type of Cognitive behavioral therapy. The main goals of DBT are to teach people how to develop healthy ways to cope with stress, live in the moment, Improve relationships with others, and most importantly regulate one’s emotions.
There are 4 modules; Mindfulness, Distress tolerance, emotional regulation, and interpersonal effectiveness.
This type of therapy was originally to treat BPD (Borderline Personality disorder) and traits of it, but it was adjusted to treat other issues such as eating disorders, substance abuse, self destructive behaviors, anxiety disorders, and more!
I started out in CBT therapy with a psychologist after I have been using self destructive behaviors when I was 14. That went on about a year and I eventually didn’t need therapy anymore so I got terminated!
After 8 or 9 months I slowly started to see my mental health decline. I decided not to do much about it and rub it off with playing a season of basketball for a team.
I hit high school and everything just went upside down. Just one day not feeling like getting out of bed to having intrusive thoughts. Everything has different levels of severity, and at first I didn’t realize how bad they were till I was actually following through with it. When I finally got to see a therapist I knew what I did before with the therapist was not going to work out. I went from therapist to another and another. I was not able to find the right approach.
Finally, after a couple of months I was using behaviors and having so many symptoms I ended up in the hospital a couple of times. I would say that it is the worst place. It was just for stabilization, so I never stayed there for longer than a week.
The doctor finally noticed what the problem was. Since I was only 15 he could not diagnose me with anything that requires you to be an adult. He just told me and my mom that I have traits of BPD and if I do not fix it now I will actually get the disorder and it cannot be cured. I mean all of this was overwhelming. I literally had no clue what he was really saying. Actually I was more in denial than actually not knowing.
He recommended that I see an intensively trained DBT therapist. I did not want to go, but that was the only way to stay out of the hospital. I went two times a week and some weeks every day. It just depended on the situation at that time. The good part was that I had access to the therapist’s number anytime and if I had any urges I can call or text her. She would guide me through any skills.
One of the best skills was the STOP skill where you use your 5 senses. It had tons of physical coping skills such as the cold water skill. You just put your face into cold water. Also you can put ice on your forehead and bend down to your heart level. I know those sound so dumb but they actually work. I was never really such a big coping skills person.
One of the big things that really everyone needs to learn is Radical acceptance, a distress tolerance skill. It helps not to turn the pain into suffering. It is not approval, but it is accepting the present, feelings, and facts, and that we can not change present facts even if we do not like them. Also that you can not change what you cannot control. I think this was the most eye opening skill for me. That is the one skill that I use a lot. It is very hard sometimes to come in terms with reality but accepting it is very helpful. At that time I used that to accept what situation I was in and what I have gone through and what was happening with me. I currently use it to accept the fact that I struggle with an eating disorder. I also use it to accept facts like if there are consequences to behaviors. Accept it and make changes to what you can.
There were times of denial. It takes a lot of time and effort to really use that skill. Sometimes I have to accept the reality of my eating disorder, what it is doing to me and what can happen in the future. Sometimes acceptance is a motivating factor. DBT is so helpful and a lot of hospital and therapy programs use the modules.
My sophomore year I got hospitalized one more time. Good thing that I stayed out of it for long. After I got out, I started seeing an intensive in-home therapist. Yes it is what it sounds like. A therapist would come to my house 4 hours a week. We would work on a lot of things and in the comfort of my home. We would have outings if I made progress, even if it was small or big. I remember my therapist would literally just pick me up from school and we would go out to lunch or to a mall. We would just interact and talk. I know it sounds weird but it is way different than going out with a friend. It was very therapeutic and she helped me with a lot of stuff in different types of settings. She especially taught me how to use DBT skills when you are not at school or home, and especially without people noticing.
This program was a different one and I did improve a lot. They had different rules than a standard therapist you would see in a private practice office. I eventually did not need it and then when COVID hit, things started to drop again and the program was very different this time. It was virtual. I didn’t think it was that effective, but I kept practicing skills and implementing them where I needed to.
I feel that DBT skills need to be taught to everyone at one point of their life. You may not have severe problems, but it will help you live your life to the fullest. There’s no way you can feel happy everyday. There are moments of anger and sadness. It will help you with your future if you bump into a pretty huge problem and it can also help you prevent a lot of things. Not saying this is like a magic pill that will fix everything over an instant. Nothing can! If you are recovering from something please know that recovery and growth is not linear! You will have times where you do relapse and what is important then is that you recognize it and go from there to do what is best for you!