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Dialectical Behavioral Therapy is a treatment method with roots in Cognitive Behavioral Therapy and Zen Buddhist philosophy. Here we tell you more about what DBT is and who it can help.
Dialectical behavioral therapy (DBT) is a form of cognitive behavioral therapy (CBT) originally developed to treat people with more severe problems such as emotional instability and self-harm.
It combines principles from CBT with elements of Zen Buddhism and Eastern philosophy, and has been shown to be effective for many difficult-to-treat clients. DBT is also helpful for addiction, eating disorders, depression and post-traumatic stress. Psychologist Marsha Linehan, who developed the treatment method, has had problems with severe self-harm herself, so there is a lot of hope for those who are struggling to feel better.
Please note, at Lavendla we do not work specifically with DBT as it is a treatment that is comprehensive and given at a specialist level in psychiatry. In Ireland, to attend a DBT programme, you need to be recommended by your consultant psychiatrist and their treatment team (community mental health team).
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DBT therapy is a comprehensive treatment that includes both individual and group sessions with a therapist. You can also have telephone contact with your therapist between sessions to get support in dealing with self-destructive behavior.
Treatment lasts about a year and includes weekly skills training aimed at learning how to manage and cope with difficult emotions. It includes training in mindfulness, social skills, emotion regulation and coping in crisis. Individual therapy involves working on current issues and dealing with any self-harming behaviour.
As with CBT, behavioral analysis is used to identify the situations, feelings and thoughts that trigger certain behaviors, the alternative strategies that could be used and the barriers to their use. DBT uses chain analysis to understand situations and events over time. Trauma treatment is also a component of the treatment, as many people also need this type of intervention.
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The main goal of DBT is to help individuals develop skills to manage their emotions and relationships better. The therapy focuses on four main areas:
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Emotionally unstable personality syndrome (also known as borderline) is a severe condition in which the person often has problems with emotion management, self-image, trust, self-harm and suicidal thoughts, among others. Adolescence is a time to develop one’s identity, but in EIPS there are problems that are not transitory. EIPS often begins in late adolescence or early adulthood, and about 1-2% of the population has the syndrome. You may have feelings of emptiness, feelings of unreality and be impulsive. Personality disorders often improve with age, but many also need treatment.
It is not possible to work with DBT via video, unfortunately, as the treatment is more extensive and includes both individual and group sessions.
Dialectical behavioral therapy (DBT) is a form of cognitive behavioral therapy that was originally developed to treat people with more severe problems such as emotional instability and self-harm.
DBT therapy is a comprehensive treatment aimed at learning to manage and cope with difficult emotions. It aims to increase the patient’s understanding of themselves and how to manage relationships.
Treatment includes both individual and group sessions with a therapist, as well as additional telephone support between sessions. Treatment lasts about a year and includes weekly skills training.
It has been shown to be helpful for personality disorders such as emotional instability and suicidality, but also addiction, eating disorders, depression and post-traumatic stress.
Emotionally unstable personality syndrome (formerly known as borderline personality disorder) is a severe condition in which the person often has problems with emotion management, self-image, trust, self-harm and suicidal thoughts. Treatment often requires specialized interventions through psychiatry.
The ICD diagnostic system uses the diagnosis Emotionally Unstable Personality Disorder, which corresponds to Borderline Personality Disorder in the DSM-5 diagnostic system that is widely used in Irish psychiatry. The term borderline has been stigmatised for a long time, which is why it is more commonly referred to as EIPS.
If you have experienced trauma and have symptoms of post-traumatic stress disorder (PTSD), it is important to get a thorough assessment and treatment for your PTSD symptoms. It is possible to get help with trauma as part of the treatment.
DBT is a later development of CBT but they are based on the same foundation of learning theory and thoughts, feelings and behaviors. DBT also includes more mindfulness-based elements that have been inspired by Zen Buddhism.
It is equally common for men and women to be diagnosed with EIPS, with about 1-2% of the population having it. However, women are much more likely to seek treatment and receive DBT, with around 75% of patients being women.
Skills training is a part of DBT treatment developed to teach patients how to better manage emotions and relationships.
There is family therapy for those who are close to people with EIPS, for example.
If you think you may be in need of DBT, you can seek care through your health center and get a referral to psychiatry. We also have licensed psychologists at Lavendla who can help you with an initial assessment and referral. If you have acute suicidal thoughts and feel very bad, contact 112, 999 or go to the nearest emergency psychiatric clinic.