Dialectical Behavior Therapy: Spiritual Traditions Meet Western Therapy Practice

What is Dialectical Behavior Therapy and what does it have to do with Buddhist Monks?

"When you think of meditation, chances are images of Buddhist monks in orange robes spring to mind or mystics on the fringe of society trying to get closer to their God. Probably one of the last things most people will consider is its value as a therapeutic tool in resolving mental health issues. Meditation is known to decrease anxiety and depression and it causes the parts of the brain to fire more that involve self-control when Buddhist monks were studied. However, until the 1990s, meditation techniques were not incorporated into mental health treatment programs. One such program successfully incorporates therapy with mystical techniques." (1)

Dialectical Behavior Therapy (DBT) is a fast-growing treatment option if you're suffering from Borderline Personality Disorder, or BPD. The success rate for certain patients is high: as high as 60% for non-violent patients, and 42% for those with more violent tendencies.

"The goal of the DBT is to bring the parts of the mind together that control emotional and rational thoughts ultimately causing the person to become more aware of his or her thoughts or actions."(1)

Even though this is a new treatment, studies show that people using DBT on a regular basis are less suicidal, retain the treatment well, and are less likely to cause themselves harm through self-mutilation or destructive acts. And success is not limited to individuals diagnosed with Borderline Personality Disorder.

Is Dialectical Behavior Therapy is right for you?

If you have been diagnosed with Borderline Personality Disorder, Dialectical Behavior Therapy is certainly something you may want to discuss with your therapist. But therapist are finding that DBT may also work for other disorders such as Drug Addiction, Alcohol Abuse, PTSD, Bipolar Disorder if the focus of the self-destructive behavior is "inward:" practicing destructive behaviors within your body such as suicide attempts, self-mutilation or cutting, eating disorders, etc. "Outward" behaviors such as stealing may not be thwarted through this type of therapy.

Therapy Type(s):

• Cognitive Behavioral Therapy
• Behaviorism
• Spiritual Concepts from Zen Buddhism and Christian Contemplative Practices

1. "I am doing the best I can, but I'm still engaging in self-destructive behavior." This assumption is based on the fact that your self-destructive behaviors may not be intentional but a way to cope. Due to your upbringing, a traumatic event, or other circumstances beyond your control, your mind created the need for these behaviors as a way to deal with your extreme circumstances. The emphasis is on replacing these negative, self-destructive behaviors with more positive ones.

2. "I am motivated and willing to change, but all other avenues don't seem to be working for me." You may have been trying for months or even years to change your behavior but unable to. This applies to those trying on their own and using professional resources. Don't give up hope; this treatment may be right for you.

3. "I believe I must accept myself just the way I am in order to change my behavior". In therapy circles, this is known as dialectics. Others deeply involved in spiritual traditions call this radical acceptance. No one is perfect. But in order to change into a more positive person, you must first accept yourself the way you are right now, no matter how mentally deficient you perceive yourself to be.

4. "I cannot manage my emotions if I cannot recognize them." Zen Buddhists use a technique called mindfulness to live fully in the present moment. This does not mean to indulge in negative behavior, but in order to transform the self-destructive behaviors into positive ones, you must first become aware of them as they are happening. This process is very complex as it involves observing your behavior as an outsider, even as you are engaging in it.

How Dialectical Behavior Therapy Works

Unlike other forms of therapy, the application of DBT does not vary from one therapist to another. It involves a very specific treatment plan, both in an individual and group environment.

The individual sessions are weekly with a therapist and follow a specific format, first to discuss any self-destructive behaviors engaged in over the week and also behaviors that are damaging to the therapy itself. Next a general discussion follows about the skills training (group sessions) and anything that may be holding you back from improving.

The group sessions, which are commonly called skills training, also meet once a week but for two hours or more. These sessions, which are generally less than three hours in length, teach skills in one of four categories (called modules). These life skills are a mixture of general behaviorism, spiritual axioms and Cognitive Behavioral Therapy.

The Four Skills Training Modules:

1. Mindfulness: All the skills taught in the group sessions incorporate an element of mindfulness into their applications. This module emphasizes two specific types: the how and what skills. The success of your DBT experience hinges on the following two questions:

• How am I using mindfulness to change?
• What specific ways am I using mindfulness to change?

2. Interpersonal effectiveness: These skills help you deal with the outside world. Included are establishing healthy boundaries by learning to say no, asking for what you need, and handling conflict within your personal relationships.

3. Distress tolerance: Because there may be a large amount of chaos in your life, you will need to learn how to handle it without adding to it. This module addresses those needs.

4. Emotional regulation: In order to learn how to regulate your emotions, you must first learn how to properly identify them and recognize when you are in them. Mindfulness helps address particular emotions and your vulnerable areas.

Dialectical Behavior Therapy may not be for everyone but I suspect that as this therapy increases in popularity so will the respect for alternative techniques that have been sucessfull throughout the ages.

If you enjoyed reading this article, Dialetical Behavior Therapy you may also like to read Depression and Food

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