DBT Flashcards
(20 cards)
Dialectical Behaviour Therapy (DBT)
- A CBT approach to address pervasive emotion dysregulation
- Marsha developed DBT to address some of the most challenging behaviours seen in health care settings that she believes aren’t being well addressed: chronic suicidality, intense emotional outbursts that are pervasive, and instability in interpersonal relationships as a result
validation vs. invalidation
validation:
- finding the kernel of truth in another persons perspective/situation
- acknowledging that the persons emotions, thoughts, and behaviours have causes and are understandable
- not necessarily aggreeing with the other person
- not validating what is actually invalid
invalidation:
- movie theatre and fire example
- person doesn’t acknowledge how you are feeling (your emotional experience) which amps up your emotions (sets off a fire inside of you)
Why is validation a good thing?
- helps us regulate our emotions
- improves our relationships by showing we are understood and listened to
- invalidation hurts
What should be validated?
- only valid things
- the facts of a situation
- a persons experiences, feelings, beliefs, opinions, thoughts
- suffering and difficulties
Meaning of dialectic:
2 opposites are true at the same time, the suffering occurs by only acknowledging one half
Examples:
- you must work but also rest
- you must be open but also private
- you must take from others but also give to others
- you must trust others but also be suspicious
With DBT we learnt to accept both sides
Borderline Personality Disorder:
A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts as indicated by five (or more) of the following
What is the Biosocial Theory?
Discusses the impact of vulnerable biology and invalidating social environment:
Emotional sensitivity/reactivity (biological) + invalidating environment (social) = pervasive emotion dysregulation
this theory will react with relationships and can affect the way a person acts and responds to certain scenarios
Assumptions about clients in DBT
- clients are doing the best they can
- clients want to improve
- clients can not fail DBT
- The lives of suicidal individuals are unbearable as they are currently being lived
- clients must learn new behaviours in all relevant contexts
- clients may not have caused all of their own problems, but they have to resolve them anyway
- clients need to do better, try harder, and/or be more motivated to change
Assumption about therapy and therapists in DBT
- the most caring thing therapists can do is help clients change
- Clarity, precision, and compassion are of the utmost importance in the conduct of DBT
- the relationship between therapists and clients is a real relationship between equals
- therapists can fail to apply the treatment effectively. Even when applied effectively, DBT can fail to achieve the desired outcome
- therapists who treat individuals with pervasive emotion dysregultion and Stage 1 behaviours need support
Stage 1 behavioural targets
Severe behavioural dyscontrol -> behavioural control
- decrease life thretening behaviours
- decrease therapy-interfereing behaviours
- decrease quality-of-life interfering behaviours
- increase behavioural skills (ex: midfulness, emotion regulation)
Stage 2 behavioural targets
the client is no longer engaging in severe life-threatening or crisis behaviors regularly and has some degree of emotional and behavioral stability. The focus shifts from behavioral control to emotional processing
addressing emotional experiencing:
quiet desperation -> emotional experencing
decreasing:
- intrusive symptoms
- avoidance of emotions
- avoidance of situations and experiences
- emotion dysregulation
- self-invalidation
Video about stop drop and roll for being emotionally on fire
- cold (shocks system and changes emotiions rapidly - ice cubes, cold shower, ice pack over eyes) or sleep
- don’t make decisions in the next 24-48 hours - like whether to live or die, substances, harmful coping mechanisms
- make eye contact with something
diving reflex:
heart rate decreases when in cold water
- turns down the emotional temperature
Mindfulness of Current Thoughts
- observe your thoughts
- adopt a curious mind
- remember: you are not your thoughts
- don’t block or suppress thoughts
SIMILAR TO ACT
Common Addictions List
Module on addictions (behaviours that take up more of ur time than are helpful)
Dialectical Abstinence
Example: “It’s unrealistic you would lever drink again but how can it be more safe?”
- 2 extremes: abstinence and harm reduction
- When your not using the substance you’re abstinent (what you’re working towards), and then when you have a slip up you go with harm reduction to work back to abstinence
Abstinence Sampling
- Committing to 2 days off of an addiction for example and observing the benefits that naturally occur
- Not saying I’m never going to make this decision, but just not within the next day
Behaviour Patterns characteristic of Addict Mind and of Clean Mind
Module that covers 2 types of minds:
- engaging in the addiction often (behavioural) vs. feeling more in control (abstinence)
- common behaviours, thoughts and feelings in these 2 mental states
Alternate Rebellion
- Relacing one rebellious behaviour with another
- Rebelling in another way that would be better than the addiction itself
Opposite Action
- You act opposite to your emotional urge to change how you feel.
- doing something different to shift your emotional state.
1. Identify the emotion.
→ e.g., fear, anger, shame, sadness.
2. Check the facts.
→ Does the emotion fit the situation?
3. Notice the action urge.
→ What do you feel like doing?
4. Choose to do the opposite of the urge.
→ Fully, with your body and mind.
5. Repeat until the emotion changes.
Example:
Fear (avoidance) -> approach the feared situation
Love (attraction) -> stop communication (block the person)
