Early on in my career as very young Child Protective Investigator Supervisor, I saw a trend of adolescent females who were very impulsive. I could never really understand their behaviors for the most part but I later was able to connect those behaviors to the abuse and neglect they had experienced. I thought then that I would do whatever I could to make a difference in these young ladies’ life.
I felt that my purpose was to help young ladies see past the abuse and encourage them to live the best life possible because they are more than what happened to them. And guess what? I was thrown right into my purpose, when I was hired as a Program Director at a high risk girls program. These young ladies had serious criminal charges as well intensive mental health concerns. Some were very symptomatic and had daily thoughts of suicide and/or self-injurious behaviors.
Self-injurious behaviors became the norm and even the young ladies who never coped in this manner started cutting. The common denominator was the pain they experienced as victims of abuse. Their identified coping skills were to abuse drugs or others, to numb their pain. We now have to manage criminal behaviors, untreated trauma, substance abuse and self- injurious behaviors.
I later accepted a position at an adolescent psychiatric hospital here in Florida as a Therapist. Not surprised at all, I was assigned to the unit that housed girls that were in the custody of juvenile justice and children and families department . You guessed it, they had all experienced some form of trauma and were very emotionally overwhelmed. Thanks to being employed at this hospital, I was able to get extensive training on a modality called Dialectical Behavioral Therapy (DBT).
Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment that was originally created to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). It was developed in the late 1980s by Psychologist Marsha M. Linehan. It has been shown that it is also effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders.
Dialectical means an integration of opposites. The primary dialectic within DBT is between opposite strategies of acceptance and change. For example, a parent of a child that’s deep in their addiction, accepts their child as they are, while also acknowledging that they need to change in order to reach their goal of sobriety. This by no means, excuses the behaviors of others, it’s just called radical acceptance of who the person is and at the same time encouraging them to change. In addition, all of the skills and strategies taught in DBT are balanced in terms of acceptance and change.
While working with a family whose child was diagnosed with Bipolar, Substance Misuse and borderline features, I explained DBT in layman’s terms. The parent’s initial response was “so I’m supposed to act like this never existed?” My response is of course not but in order for change to occur and for the mother to not stress herself, she has to understand radical acceptance. This is your daughter. She is impulsive. She abuses drugs. She has an addictive personality. So what can you do to change any of that? Nothing but accept her for who she is as a human being and encourage her to take necessary steps to change. That’s a hard pill to swallow, I know, but it’s radical acceptance.
The skills that I teach my clients are easily understood and I’m the queen of homework so I always give worksheets particularly the DBT Diary.
DBT includes four sets of behavioral skills that will help individuals maintain better control over their emotions.
First skill is Mindfulness (Acceptance): the practice of being fully aware and present in this one moment and less thoughts on past painful experiences. It will also give you tools to overcome habitual, negative judgments about yourself and others.
Second skill is Distress Tolerance (Acceptance): helps you to tolerate pain in difficult situations. Builds resiliency and helps you come up with new ways to cope with difficult situation.
Third skill is Interpersonal Effectiveness (Change): helps you to ask for what you want, set limits, ad negotiate solution to problems, while maintaining self-respect and relationships with others
Fourth skill is Emotion Regulation (Change): how to change emotions that you want to change.
There is increasing evidence that DBT skills training alone is a promising intervention for a wide variety of both clinical and nonclinical populations and across settings.
While I haven’t described everything that is involved in DBT, I gave a quick description… According to LaShonda.
If you wan to learn more about Dialectical Behavioral Therapy please visit:
https://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy/