The term dialectical means the practice of combining two radically opposed elements and fusing them. Renowned psychologist Marsha Linehan developed the Dialectical Behavioural Therapy model as a comprehensive cognitive behavioral treatment for complex disorders such as individuals with chronic suicidal tendencies, individuals with BPD, those who struggle with substance abuse, and others who work with intractable emotional dysregulation.
Linehan’s revolutionary new perspective brought about an innovative method to the cognitive behavioral approach, which solely focused on the aspect of change rather than acceptance of one’s current situation and feelings. CBT channels the patient’s energy into reframing their everyday thoughts. In contrast, Linehan decided that introducing the element of acceptance of those thoughts coupled with mindfulness techniques would benefit patients in processing their mental states in a healthier manner. Essentially, the DBT technique introduces the idea of validation and acceptance of the patient’s current state within the opposed context of change. Therefore, it raises the concept that through acceptance, there is change. This approach is fundamental to replacing rigid black-and-white ways of thinking with a more fluid and layered perspective that allows the patient to coalesce negative and positive images of themselves into healthier ones.
The Structure of DBT & Benefits
DBT requires the therapist to teeter between strategies that target the patient accepting their situation and looking towards change. Within the initial stages, the therapist aims at assuming behavioral control and minimizing life-threatening, suicidal behaviors, depending on the case and levels of extremity with the patient. Once that is achieved, the following stages address dysfunctional patterns of behavior that interfere with the patient reaching their ideal quality of life, building distress tolerance, self-regulation strategies, and attempting to resolve internal states of conflict.
In a two-year study of two groups of patients who participated in DBT and others who undertook general psychotherapy, following the two years, participants in both groups displayed positive effects of the treatment, displaying an overall decrease in symptom severity such as suicidal behaviors, self-injury tendencies, improved interpersonal relationships, and an overall increase in quality of life. Therefore, it is clear that this innovative approach in therapy has paved the way for many individuals looking for a strategy to deal with their circumstances through the juxtaposed lenses of acceptance and change.