Dialectical Behaviour Therapy

Dialectics

“Dialectical” means combining opposite ideas such as acceptance and change. DBT focuses on helping people accept the reality of their lives and their behaviors, as well as helping them learn to change their lives, including their unhelpful behaviors.

Using dialectics as a perspective, we can turn our focus to how this point of view and nature of reality influence solutions within DBT.

Bio-Social Theory: The bio in biosocial theory refers to biological elements that influence our daily lives. This includes things we are born with, both as individuals and as human beings, as well as how our brain develops in early childhood.

Social refers to our social environment, especially our family, but also includes friends, community, and culture.

There are a handful of biosocial elements that are specifically involved in the development of emotional regulation, including:

High emotional sensitivity
High emotional reactivity
Slow return to emotional baseline
Validating or invalidating social environments

Emotional sensitivity is the ability to receive this communication, and emotional reactivity is the ability to act on this communication. Some people are born with a greater ability to perceive and act on emotions. Some brains are also able to return to a neutral emotional state otherwise called as emotional baseline, whereas other brains keep a person in a particular emotional state for longer. These elements are mostly biological in nature, whereas validation is a product of our social environment. Validation is checking or proving the validity or accuracy of something. Determining the accuracy of our private experiences, such as thoughts, feelings, and sensations, is critical in navigating the world around us and plays an especially important role in childhood.

In an optimal family, public validation of private experiences is given frequently. For example:

When a child says “I’m thirsty,” parents give him or her a drink rather than saying “no you’re not, you just had a drink.”
When a child cries, parents soothe the child or attempt to find out what’s wrong rather than saying “stop being a crybaby.”
When a child expresses anger or frustration, family members take it seriously rather than dismissing it as unimportant.
When a child says “I did my best,” the parent agrees rather than saying “no you didn’t.”

Given a child’s natural dependency on their family for survival, the absence of accurate feedback can make the world a very confusing and scary place. Each of these elements can make a person vulnerable to developing not only emotional dysregulation, but also impulsivity, unstable self-image, and relational issues.

Techniques:

To address the above-mentioned issues given in the key concepts, DBT teaches the following skills:

Mindfulness – it is about being in the present moment without judgment.
Interpersonal effectiveness — Finding the ways to identify and get what you want from an interaction such as validation for your emotions, ways to effectively relate to others while maintaining self-respect.
Emotional regulation – Encouraging a better understanding/labelling of our emotions, ways to change our reactions, and reducing vulnerability to our emotion mind.
Distress tolerance – Getting crisis survival skills, such as how to regulate our body chemistry and reality acceptance skills.