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How DBT Reshapes Your Thinking Patterns

How DBT Reshapes Your Thinking Patterns

Dialectical Behavioral Therapy (DBT) is a psychotherapeutic approach that emerged from Cognitive Behavioral Therapy (CBT) in the 1990s. University of Washington professor Marsha Linehan, who experienced personal mental health struggles herself, found that patients with borderline personality disorder (BPD) and histories of self-harm were less responsive to CBT techniques. She developed DBT to reach these patients and later applied the approach to addiction, trauma and other mental health issues. In 1999 Dr. Linehan published a study in the American Journal on Addiction about the effectiveness of DBT for female addicts with BPD, and she later introduced DBT for Substances Abusers in journals such as Addiction Science & Clinical Practice in 2008. As explained by the National Association of Cognitive-Behavioral Therapists, the premise for both CBT and DBT is that maladaptive thought patterns and beliefs influence perspective, attitude, emotional reactions and general behavior. By reshaping thinking patterns, the therapies help patients recover from both addiction and mental health disorders.

What Is Dialectical Behavioral Therapy

In the 1950s Albert Ellis created the first widely recognized behavioral therapy, rational emotive behavior therapy (REBT), and helped launch a cognitive revolution in the decades that followed. Stanford professor David D. Burns popularized CBT in the 1980s book Feeling Good: The New Mood Therapy, and the National Institute on Drug Abuse (NIDA) backed studies in the 1990s to test its applications for substance addiction. DBT and CBT share many of the same foundational ideas including the following:

  • Irrational thoughts and beliefs produce negative emotions and motivate adverse behavior.
  • The maladaptive behavior then creates a cycle that produces more negative thoughts.
  • Patients benefit from reconstructing their cognitive profile in positive and rational ways.
  • The process involves a collaboration between the patient and therapist that challenges irrational fears and analyzes automatic mental responses.

In working with emotionally distressed females, Dr. Linehan found that an immediate call to change tended to produce higher dropout rates and further emotional turmoil. Many of the patients had serious self-worth issues and extreme sensitivities to criticism, and they often responded more positively to change after the therapist addressed the BPD, trauma, suicide attempts and other severe behaviors. Dr. Linehan called her variation dialectical because it seeks to balance two seemingly contrarian ideas, self-acceptance and change, in therapeutic harmony. Speaking in specifics, DBT differentiates itself from standard CBT in several ways, which include the following:

  • Prioritize efforts to discourage self-harm and keep the patient alive as necessary.
  • Build the patient up with acceptance-based interventions, validation and reassurance.
  • Utilize Eastern practices like synthesis and holism to promote harmony and balance.
  • Present change as an extension of self-acceptance that is mutually enhancing.
  • Address dysfunctional emotions and encourage full emotional experiencing.
  • Treat addiction as a quality-of-life issue and request realistic short-term abstinence goals.
  • Regularly ask patients to renew the period and seek out patients who skip sessions.

Therapists might apply CBT and DBT simultaneously as they are not mutually exclusive treatments, but DBT is particularly helpful for patients with certain anxieties, insecurities, traumas and mental health issues.

How DBT Helps Reshape Thoughts

DBT treatment can include homework, emergency phone coaching and both group and individual sessions, and it can help reshape maladaptive thoughts in various potential ways including the following:

  • Explore basic emotional needs that are unmet and may fuel the negative thought patterns.
  • Validate the patient by listening, observing, reflecting and restating key nonverbal points.
  • Target issues like minimizing positives, amplifying negatives and overgeneralizations.
  • Connect behavioral causes from the past and present to the current addiction and disorder.
  • Create plans of action that incorporate positive activities into the patients’ daily routines.
  • Teach positive life tools like relaxation, positive distraction and motivational self-talk.
  • Instill coping skills that allow for greater adaptability and healthier emotional responses.

The American Journal of Psychiatry in 2005 explained that behavioral therapies present addiction and mental health disorders in the context of real-life antecedents and consequences. Sessions might explore potential positive and negative outcomes, and patients learn new skills to identify, avoid and neutralize cues that might trigger a setback or relapse. DBT, however, recognizes that it must take a different approach for patients who relapse. Balancing total abstinence and pragmatic approaches to relapse, therapists teach positive strategies for dealing with a setback that minimize the effects a relapse might have on the patient’s self-image and motivation.

Substance Abuse Help

Addiction is a disease of the brain reward system, and memories, thoughts and beliefs all play a role in triggering alcohol and drug cravings. While detox might cleanse the substance from the system, the dopaminergic pathways need time to heal. Behavioral therapies like DBT help restore healthy neurobiological functioning and neutralize craving-inducing triggers, and studies show that they are an effective tool for treating addiction in many patients. Nevertheless CBT and DBT are just two of many therapies that rehab centers potentially include in multi-faceted recovery plans customized for each patient according to his or her specific needs.

If you or a loved one is battling addiction or mental health issues, we can help. Our admissions coordinators can answer questions and provide information about treatment methods, rehab facilities and financing options, and we can even check health insurance policies for coverage. We are available to talk 24 hours a day, so please call our toll-free helpline now.