Dialectical Behavior Therapy: Accepting Reality & Embracing Change

*Content Note: This post will mention sensitive topics such as suicidal ideation, self-harm, and invasive thoughts.

Do you ever feel like managing emotional dysregulation is a full-time job? Like your emotions are running the show, and it’s hard to function or focus on anything else? When tricky situations happen and the emotions feel overwhelming, do you resort to behaviors you know are harmful, such as cutting, binge-eating, or drinking? If you’ve suffered a serious loss or trauma, or you’re experiencing acute depression or anxiety, Dialectical Behavior Therapy is a method that might help you tolerate stress with healthy habits and access emotional equilibrium.

What is Dialectical Behavior Therapy?

Dialectical Behavior Therapy (DBT) is a type of talk therapy based on Cognitive Behavioral Therapy (CBT) that has been adapted for those who need help managing and regulating intense emotions. Unlike CBT which focuses on changing an individual’s thought patterns, DBT is focused on giving clients skills to manage their emotional dysregulation. DBT is especially effective for people of all ages who suffer from mood disorders such as depression and anxiety, severe PTSD, suicidal ideation, self-harm, substance abuse, disordered eating, or other issues.

Maladaptive coping skills like substance abuse and self-harm are forged from traumatic experiences when healthy coping skills (like talking to a safe adult) aren’t accessible. These maladaptive strategies may offer immediate relief by easing or numbing the emotional pain, but they also pose risks to a person’s emotional, mental, and physical health that further increase dysregulation. Oftentimes, clients want to end these maladaptive behaviors but need help replacing them with healthier coping mechanisms. Dialectical Behavioral Therapy is all about redirecting behavior to better manage emotional dysregulation through:

• Acceptance of reality

• Awareness of emotions

• Healthier coping mechanisms, like mindfulness techniques

Two Things Can Be True

“Dialectical” refers to the act of accepting contradictory ideas. For example, someone who has a severe mood disorder can accept that their brain chemistry makes it difficult for them to feel safe and happy, while at the same time choosing to stop engaging in self-harm behaviors with help from a DBT therapist.

DBT is about “walking the middle path” between two things, i.e., building awareness of the emotions without acting on the impulses. Clients in DBT are coached on how to tolerate intense emotions and accept painful realities without engaging in maladaptive behaviors such as cutting or disordered eating.

Managing Dysregulation with Mindfulness

Of course, ending maladaptive behaviors isn’t as simple as stopping. We have to replace the maladaptive impulse with healthier skills that decrease emotional dysregulation. In Dialectical Behavior Therapy, therapists work with clients on mindfulness activities to help them ride the wave of discomfort without action or judgment. Many of these activities employ acronyms that are easy to recall in the middle of dysregulation, such as the STOP and RAIN methods.

The STOP mindfulness technique stands for:

• Stop

• Take a breath

• Observe your thoughts and feelings

• Proceed, i.e., return to what you were doing before you stopped, but with more awareness

The RAIN mindfulness technique stands for:

• Recognize what’s happening in the moment

• Allow the experience to exist just as it is

• Investigate with interest and care

• Nurture with self-compassion

The Benefits of DBT

Dialectical Behavior Therapy offers many benefits, whether its for individuals, couples, or families:

• Greater self-awareness: individuals learn how to notice their emotions and identify cycles of self-harm.

• Emotional resilience: clients can also learn to tolerate stress through mindfulness techniques, so that when difficult situations or emotions occur, they can stay present and emotionally regulate themselves.

• Interpersonal effectiveness: in couples or group therapy settings, DBT gives clients the chance to practice communicating their emotions, slow down the conversation, and identify what’s important to say and how to say it, so that their needs are met.

Is DBT Right for Me?

As mentioned above, Dialectical Behavior Therapy can be applied in a variety of contexts, from individuals (including children) to couples and families. Here are a few signs that DBT might be right for you:

• You find it hard to stay present when difficult emotions arise

• You struggle with impulsive or compulsive behaviors when feeling overwhelmed

• You have severe anxiety and depression

• You have an eating disorder

• You’re struggling with substance abuse

• You’re struggling with suicidal ideation or intrusive thoughts

DBT Therapy in Chicago:

Suffering happens when we get stuck in a cycle trying to change something we can’t, but acceptance is a skill we can learn. Some things about our lives may always be painful or difficult, but through practicing acceptance and mindfulness, we can end cycles of self-harm and find emotional equilibrium. DBT can be a profound and transformative therapeutic experience that sets people on a path toward peace. If you’re curious about whether DBT is right for you, your child, or your family, reach out today. We’ll connect you with the therapist and therapeutic approach to help you thrive.

For more information about Dialectical Behavior Therapy, watch this video of ECC Founder Danielle Zawadski discussing it on PHTV4’s Living Well segment!

About ECC:

Empowered Connections Counseling is a practice of licensed therapists providing quality, multidisciplinary counseling for adults, children & teens, relationships, and families in Chicago and across Illinois. Whether by in-person session or via telehealth, we work with clients to find the therapist and treatment methods that best suit their needs. Connect meaningfully with your life by booking an appointment today.

Building and Repairing Trust in a Parent-Child Relationship

Recently, in the heart of a heated conversation, my child admitted to me: “I don’t trust you.”   

Ouch.  

But also “WHAT? HOW? WHY NOT?!”  After all, not only did I give them life, but I do everything in my power to make their life possible, the kid doesn’t even know half the stuff I do for them.  

The lack of trust, not only made me mad, but more importantly hurt my feelings.

The hurt often muffles other feelings, so I needed to put it aside if I was going to understand what my child was really trying to tell me.  I NEED my kid to trust me,  I worry who they will go to with all the voices in their life.  TRUST.

One evening, after my child had a fit of anger, the stomping, the slamming of doors and the yelling, all of which I reacted to, we were finally talking calmly under the cover of darkness right before they fell asleep:  “Mom, when you got mad at me tonight, that is why I don’t trust you. I don’t know how you are going to react to me when I am upset.”

I have spent a lot of time thinking about what this means.  I did not see my reaction to their fit of rage as “getting mad”, but I did react. It is my own feelings in which I am reacting, and my child cannot predict how I will feel and therefore, cannot trust.  

I am starting to do a better job with just being in the moment, being in the pain of the moment with my child.  What they are feeling – I have no idea.  Much like when we are feeling, we often cannot explain what it is or why we feel it.  As grown-ups, most of us have learned to outwardly control our rages, but we often feel them inside.   

Our children need anchors – by reacting – I move the anchor.  If I can stay steady in the storm of their feelings, if they can know, and predict, my steady reaction, the anchor does its job, and we can be caught in any passing storm–but remain safe.   

When I am steady, they can be whomever they need to be at that moment.  When they can safely be themselves, they learn to steady their own boat. 

How can you be an anchor?  

1. Just listen, do not react, beyond a head nod for affirmation.  No matter how wild the storm, know it is going to pass.  

2. Let time work its magic.  Time heals and distracts.  Leave space for your child to process on their own.  They will talk to you when ready.

3. Trust–you may not ever know specifically what caused the storm, but know the storm was real for your child.  

Checking in With Your Children's Mental Health

Summer is here! A time to slow down, take in the warm air, and spend time with our children while summer vacation is still in gear. In the constant state of trying to create a balance in our new and ever changing environments, I think to myself, “how are our children handling this as well?” I am reminded of this within my own family, and the big changes we are facing with an out of state move. We have had our ups and our downs of the common stressors of a move and selling our home, and the transition of getting to our new home. 

Reflecting on past years of our own family changes and the unexpected changes we've had as a society, it's a reminder that our children have gone through a lot of their own stressors. I personally do mental health check ins with myself, review if I am feeling off balanced and what is needed to get back into that balanced feeling. Why not do the same checking in with our children's own mental health? Here are some quick tips to help start the conversation:

• Gently lead in with an open ended question for example,

“there have been so many changes going on, like us moving to a new state, and selling our house. What feelings do you have about that? What has that been like for you?”

• Ask specific questions based on observations you’ve made, something like,

“I’ve noticed you're easily upset or frustrated lately since we moved out of our old house, is there something I can do to help you not be so frustrated or upset?”

• Stay present, it is important to be in the moment with your children and the conversations you are having. When we are in the moment with our children, we are able to have honest conversations and genuine connections. 

• Remove distractions like technology while having the conversation. Also anyone that could cause your child not to open up, like a sibling. 

• Provide active listening, through eye contact and physical movements. This shows them you're listening. Something like a head nod, as well as relaying what your child said back to them. 

There are many ways to start a conversation with your child, tailoring how you start a conversation is beneficial based on their age and development. Conversations are a great way to build connections, practice listening skills, model healthy relationships, and gain trust. The more conversations we have with our children the easier they become when we face harder topics. 

Additional resources for children’s mental health support

Big Life Journal: Free, low cost mindful strategies, journals, and lessons for all ages and for parents as well.

Child Mind: Free resources for parents that are geared toward specific needs and support like anxiety, depression, and much more!