Week 22 – Dialectical Behavioural Therapy

Week 22! Not far to go now. I thought I would summarise a little bit of what DBT actually involves. DBT is a set of techniques that are designed to calm the symptoms of Borderline Personality Disorder (BPD), Post Traumatic Stress Disorder (PTSD) and Eating Disorders (ED) amongst generally combating unhelpful behaviours that manifest in people who have been mentally ill for a long period of time. These techniques often include mindfulness, emotional regulation, distress tolerance, interpersonal skills and wise mind.

credit: https://www.sunrisertc.com/dialectical-behavioral-therapy/

DBT has been growing in popularity as stigmas around certain types of mental illness have deteriorated. Especially Borderline Personality Disorder. As these illnesses become better understood their treatment becomes more widespread and more competent. Resources are developed which make treatment more effective and this then reduces the stigma even further. Mindfulness is about controlling your inner thoughts. It’s about strengthening your ability to focus your attention on what you want to be focused on. This can allow you to get a better picture of what’s going on in your mind and body and allows you to make better decisions. Mindfulness is useful because it can combat the intrusive thoughts and flashbacks that are commonly experienced after traumatic events. Emotional Regulation is a set of exercises that help you control your emotions, this is useful for sufferers of BPD as it can control the mood swings and give the person more confidence that they can cope with these unexpected changes.

Distress tolerance is a set of skills that allows you to better deal with unexpected events and outcomes in life, circumstances which can send vulnerable people into a crisis. This can involve avoiding certain phrases such as “Everyone“,”Always“,”Never“,”I can’t“,”There’s no way“. Avoiding catastrophising can help with crisis management. Interpersonal Effectiveness usually comes later into the therapeutic process, often once we learn to deal with ourselves other people can be the uncertain element that can often throw us back into old behaviours. This focuses on being able to have a functional relationship with another person, how to listen to their needs but also to protect and respect your own needs. It can be very easy to submit to the needs of others when you feel worthless or that you don’t care, so having a checklist to follow can certainly help avoid that negative behaviour.

One of the core ideas of BPD is wise mind or “Walking the Middle Path“. This is the ability to recognise that you have an emotional mind and a rational mind. This is something that most people accept but many people value one exclusively over the other. Wise mind is the idea that you can take your rational mind and your emotional mind and use them both to come up with the most positive outcome. For example, when you are angry people often put aside their anger entirely as it is seen as a purely negative influence. They then process to make the most rationally best decision without considering their feelings of anger. This repressed anger can often manifest in many negative ways if unresolved like this. On the other hand someone may react entirely emotionally, becoming irrational and behaving erratically, often making poor decisions based entirely on their anger and nothing else. Wise Mind is the middle ground between these, using mindfulness to recognise and control your anger in such a way that you can make healthy decisions.

credit: http://www.pbshealthcare.com/dbt/

Therapy is long term, especially when dealing with illnesses such as BPD, PTSD and ED. Treatment can last for years with different therapies and services being instated at different times. As a result I want my product to support the user in the long term. Therapy is not a straight line, you don’t graduate Stage 1 to never return. You could return to life-threatening behaviours at any time and you need to remember how you were taught to cope with those specific feelings. That’s where my product will record and store your experiences for you to reflect on in good times and times of crisis.