What Is Dialectical Behavior Therapy Training?

Dialectical Behavior Therapy is a behavioral therapy founded by Martha Linchan. It adheres to the principle of philosophical dialectics and firmly believes that everyone can find the "cohesion" in conflicts and conflicts and has a wise spirit. It can help people learn dialectical thinking methods, improve their ability to see things comprehensively, and ultimately reduce the possibility of emotional disorders and behavioral abnormalities.

Chinese name: Dialectical behavior therapy
Foreign name: Dialectical Behavior Therapy

Applied discipline: psychology
Application range: Clinical and Counseling Psychology

Origin of Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT), founded by Martha Linchan, is an emerging psychological therapy for borderline personality disorder. Based on the basic principles of dialectics, DBT emphasizes the dialectical balance and coordination between patients and counselors, between reason and emotion, and between acceptance and change. The central approach to therapy is the application of psychosocial skills training and treatment strategies. The uniqueness and superiority over other psychological therapies is that we always adhere to the principle of philosophical dialectics, and firmly believe that everyone can find the "cooperation" in conflicts and conflicts, and have a wise spirit. It can help people learn dialectical thinking methods, improve their ability to see things comprehensively, and ultimately reduce the possibility of emotional disorders and behavioral abnormalities. ^[1]

Theoretical basis of dialectical behavior therapy

Dialectical behavior therapy dialectical worldview

(1) General connection law

This principle emphasizes the systematic nature of reality, thinking that things are relational, and the boundary between things is an illusion, at best temporary. The analysis value of any component in the system is limited, unless the component is related to the whole in the analysis. When applied to the analysis of human behavior, it must link human behavior and environment. Perhaps the most important system in therapy is the therapeutic relationship. DBT therapists pay close attention to how the therapist and the client interact with each other. ^[1]

(2) Law of Unity of Contradictions

Reality is not static but consists of relative forces (themes and their opposites). The synthesis of themes and their opposites leads to the generation of new relative forces. In other words, there is the opposite, or polarity, within each person or system: without dysfunction there is no functional harmony; without distortion there is no precision. There is still normal function in the dysfunction.

(3) Law of movement change

Dialectics emphasizes that the basic substance of reality is change. When the tension between the two polarities is eliminated, a new reality is produced, and at the same time, a new polarity is produced. Repeatedly, there is no end. People and the environment are constantly changing. The goal of treatment is to help patients better deal with uncertainty and change. For example, over time and the development of a therapeutic relationship, the therapist may be willing to make some adjustments that are conducive to treatment and lift some set boundaries. For example, he is willing to receive calls from clients and use himself as a coping mode. We are the same in other relationships. As the relationship deepens, we will give up some restrictions.

Dialectical behavioral therapy

The biological basis may be related to severe disturbances in the physiological processes of the emotion regulation system. The threshold of activation of limbic structures in patients with borderline personality disorder is relatively low. These individuals' emotional responses to environmental stimuli are faster and more intense than those with non-border personality disorders, and their emotions take longer to return to baseline. Usually the patient's response to one environmental stimulus has not yet calmed down, and the response to another environmental stimulus has started again, causing a vicious circle. The non-confirmed environment ignores the behavior's rationality and ignores or denies the behavior for a long time. Marginal personality disorder occurs only when "disabled" (non-confirmed) environmental biological factors are combined with certain socio-environmental conditions. ^[1]

The expression of personal experience in the "disabling" environment, especially those related to emotions, are consistently ignored or denied by important people in life; the difficulty of meeting environmental requirements is underestimated; the problem solving is oversimplified and not Realistic emphasis on positive thinking. Making a failure environment fails to teach individuals how to identify and regulate their emotions, how to withstand stress, and cannot tell them when to determine that their response to life events is effective.

Dialectical behavior therapy

1. Individual therapy: Assess and resolve skills and motivation issues so that visitors have a proper sense of self-efficacy.

2. Group skills training: Training that emphasizes behavioral skills is divided into: core mindfulness, pain tolerance, interpersonal effectiveness, and emotional regulation.

3. Telephone contact: It is helpful for the therapist to intervene patient in time.

4. Therapist supervision / consulting group discussion: The interaction between the therapist and the visitor provides a dialectical balance.

Dialectical Behavior Therapy Phase

Commitment stage before dialectical behavioral therapy

Patients are required to make a commitment to achieve the goals of the treatment, so that the visitor and therapist can establish a strong collaborative relationship before treatment.

Stages of acquiring basic competence for dialectical behavior therapy

By reducing the traumatic behavior and emotional experience of the patient, the patient can obtain a normal and stable reasonable life style.

Dialectical Behavior Therapy Reduces Post-Traumatic Stress Stage

Using exposure, church visitors rationalize their emotional response to clues related to traumatic events.

Dialectical Behavior Therapy addresses problems in life and improves self-esteem

Reduce or solve a series of obstacles or problems that are not fully accepted in the visitor's life and cultivate them to have a reasonable sense of self-efficacy and independent self-esteem.

Stages of Dialectical Behavior Therapy for Continuous Pleasure

Helping visitors deal with feelings of incompleteness to improve quality of life.

Dialectical dilemma of dialectical behavior therapy

Dialectical Behavior Therapy Emotional Vulnerability and Self-Acknowledgement

The patient's dialectic dilemma: (1) Who is responsible? (Patient or environment) (2) Who is right?

The therapist's dialectic dilemma: (1) the use of transformative technology means that the problem comes from the patient's self-confirmation; (2) the use of receptive technology, the patient will feel that his problem can never be solved.

Dialectical Behavior Therapy Active Passive and Apparent Capable

Patients: (1) Patients need to rely on the environment to help self-regulation; (2) Patients are ashamed of dependence and learn to suppress their sense of helplessness and negative emotions.

Therapist: (1) Just seeing "capable on the surface" will place too much demands on the patient, and seeing the patient's incompetence will be wrong and think that this is "impedance"; (2) if you do not see the patient's true ability, Will fall into the active and passive mode.

Ongoing crisis and suppressed sorrow for dialectical behavior therapy

Patient: (1) The ongoing crisis prevented him from going through the mourning process; (2) The suppressed mourning process was not long-lasting, which would lead to drinking, profligacy, promiscuity and other behaviors, and would not receive social support.

Therapists: (1) Provide support and encouragement during ongoing crises; (2) Teach patients to deal with mourning processes and expose patients to trauma and loss. ^[1]

Dialectical Behavior Therapy Strategy

Dialectical strategy

(1) Entering the paradox: Emphasizing paradoxical contradictions in the patient's own behavior, in the treatment process and in reality, without using logical or rational explanations in an attempt to help patients get rid of their struggles.

(2) Metaphors: Applying metaphors, analogies, anecdotes, stories and mythical fables to open up the possibility of new thinking, new feelings and new behaviors.

(3) Devil's advocate technology: The therapist puts forward an extreme position and situation and asks the patient if he believes that he plays the role of the devil's advocate (anti-theme) to antagonize the patient's defense of the anti-theme (theme) to achieve integration.

(4) Extension: Take the patient more seriously than the patient himself. "If you don't arrange an extra treatment for me, I will commit suicide." Aikido technology is similar to "four or two pounds."

(5) Stimulate "intelligence": Urge patients to integrate their emotions and rationality, to approach intuition and spontaneous reactions. First, the therapist should help the patient determine that he can enter the comet, and everyone has it, just like the heart. Second, when the patient experiences a comet, point it out in time. Third, experience the comet through breathing mindfulness. The comet is at the bottom of the breath.

(6) Lemon juice squeezed out of lemons: turning bad into good. See the opportunities in the problem. Without problems, there will never be a chance to exercise your skills.

(7) Allow natural changes: Allow natural changes and instability in therapeutic relationships.

(8) Dialectical Assessment: Continuously seek out what comprehensive assessments are missing from the individual's interpretation of behaviors and events, rather than just biological or psychological assessments of bio-social-psychology. ^[2]

Core strategies of dialectical behavior therapy

Linehan (1993) found that the previous over-emphasis on the change of treatment methods could easily frustrate the patient's self-efficacy, which led to a high clinical drop-out rate. In response to this situation, she proposed that there is a difference between change and acceptance in treatment. Dialectical balance. Acceptance is similar to "let it go" in Zen, referring to the therapist's rational identification of the visitor in terms of emotion, cognition, and behavior, aimed at creating a sense of self-efficacy; and using behavioral analysis and problem solving to change Patients with adverse cognitive and behavioral responses. ^[2]

Dialectical Behavior Therapy Communication Style Strategies

Communication style is a strategy used to ensure a balanced communication between the consultant and the visitor. There are two types of interaction: tough and interactive. The former refers to the therapist's use of enthusiasm, sincerity, self-exposure, etc. Feel an appropriate and equal mode of interaction; the latter refers to the communication method used to promote problem solving when the visitor's thinking has been stagnated for a long time. In practical applications, it should be used in a balanced manner.

Case management strategies for dialectical behavior therapy

When the patient's living environment interferes with the course of treatment, the therapist instructs the patient to manage his or her living environment to help achieve life goals and promote the smooth progress of treatment. There are three main management strategies: consultation with the patient, intervention of the environment, and supervision / Consultation discussion.