Using dialectical behavioral therapy to treat other mental illnesses

Dialectical Behavioral Therapy Effective For Treating Many Different Mental Illnesses.  Marsha Linehan, Director of Behavioral Research and Therapy Clinics associated with the University of Washington where she also served as Professor in the Department of Psychology, developed dialectical behavioral therapy (DBT) to more effectively treat her clients who were diagnosed with Borderline Personality Disorder (BPD).   BPD is an Axis II diagnoses that is known for clients’ inability to regulation their emotions and lack of impulse control which led to self-destructive behaviors.  By teaching her clients DBT skills she was able to help them overcome these problems.  Many researchers began to look at other mental illnesses in which clients demonstrated the same inability to regulate their emotions and exhibited the same self-destructive behaviors.  They began to research the effectiveness in using DBT to treat other mental illnesses.  Linehan, along with other researchers, found that the DBT emotional regulation skills helped clinicians treat clients who were diagnoses with depression, eating disorders, posttraumatic stress disorder, anxiety disorders, adult attention deficit hyperactivity disorder, and substance addiction with or without co-morbid BPD.  The skills also helped clients with self-destructive behaviors such as cutting, burning, or other self-harming actions.  Researchers have also found that mindfulness skills can be used for stress reduction in treatment of medical illnesses.

The researchers found that the four primary skills of DBT were beneficial in helping clients with mental illnesses other than BPD.  These skills are:

·         Mindfulness Skills – which helps clients be aware of and stay in the present moment so that they might enjoy the moment to moment experiences of life.

·         Emotional Regulation Skills – helps the clients recognize their emotional responses so that they can cope with them in alternative behaviors instead of mood-altering behaviors.  They also help them learn how their perception directly impacts emotional response so that they can change thoughts to change reaction.

·         Distress Tolerance Skills – helps clients endure life’s inevitable challenges such as death or other difficult situations.

·         Interpersonal Effectiveness Skills – helps clients learn more effective means of communicating their needs to others.

Once the clients have learned each set of skills they are able to accomplish certain tasks that help them regulate their emotional reactions so that they can respond more effectively. 

Mindfulness Skills help the client to be aware of what is happening to them in the moment utilizing their five senses.  It helps them to be able to describe these sensations and actively participate in the moment.  To be mindful clients are also taught to not judge what they are experiencing, to not be distracted, and to react effectively to the moment.  This is often done with a form of meditation.

Emotional Regulation Skills teaches the client to reduce their vulnerability to reacting to various situations in an ineffective manner.  It helps them build a sense of mastery or capability, to build positive experiences.  These skills teach the client how to respond with the opposite action compare to the action urge of their emotion.

Distress Tolerance Skills are meant to help the client survive a crisis situation in their life by learning to self soothe using their five senses.  The skills are designed to help them accept the reality of what has happened and to weigh the pros and cons of various actions and then chose the action that is most effective.

Interpersonal Effectiveness Skills were designed by Linehan to help her clients in their interactions with other people.  Teaching the clients how to effective use these skills help people to be more effective, objective, and self-respecting in all of their interactions with other people.

Another aspect of DBT was teaching clients that as children their caregivers or other adult role models invalidated their emotional responses through thoughtlessness, insensitivity, abandonment, neglect, or actual abuse.  This leads to them invalidating themselves later on in life.  Linehan called this self-invalidation.  DBT skills help the client validate their emotional reactions and to then modify their behavioral response.  The previous invalidation had lead to faulty perceptions and validation led to more effective perceptions and more effective self-talk. 

All of these skills when combined help the client to cope with their illness and take more effective actions in the treatment of their illness.  This is true whether the client is dealing with a mental illness such as chronic depression, posttraumatic stress disorder, or anxiety; or a physical illness where stress reduction aid treatment.