Marsha, Marsha, Marsha (the Story behind DBT)
Chances are, you’ve heard of Dialectical Behaviour Therapy (DBT) and its applicability to a wide range of mental health issues. DBT is, to therapists, the most powerful tool for soothing emotional dysregulation. The story behind how DBT was created captures the interest in therapists and clients alike. Read on to learn more about Dr. Marsha M. Linehan, the “zen master” of clinical psychology and suicide research and prevention.
Marsha Linehan’s Journey
After struggling with her own mental health for many years, Linehan knew first hand how the current therapies (in the 1960’s) were not effective in treating chronic suicidal thoughts and emotional dysregulation. She was subjected to many leading psychiatric treatments at the time, including electroconvulsion therapy and seclusion, both in inpatient and outpatient settings. After graduating from her PhD in psychology in 1971, she became a clinical psychologist herself and spent the next decade trying to apply standard Cognitive Behaviour Therapy to problems of adult women with histories of chronic suicide behaviours. CBT had gained prominence as an effective psychotherapy for a range of serious disorders and issues, but Linehan was keen on investigating whether or not it would be helpful for individuals whose suicidality was in response to extremely painful problems. Over and over again, CBT fell short in helping these people. She and her research team found numerous issues applying standard CBT and in response made significant changes to the technique.
Acceptance-based interventions (including an emphasis on ‘mindfulness’) were added to empower the clients to understand themselves as perfectly acceptable as they were. Therapists would learn to highlight for clients when their thoughts, feelings, and behaviours were “normal” to help them discover that they were perfectly capable of trusting themselves. However, Linehan coupled this concept with the fact that clients must also change if they want to build a life that’s worth living. This meant there needed to be a balance between acceptance of change and acceptance of who they were. This is the essence of Linehan’s newly created therapy, aptly named ‘Dialectical (the acceptance of life’s contradictions) Behaviour Therapy’.
Dialectical Behavour Therapy Today
A standard DBT program requires a 6 month to one-year commitment and usually contains five components: A DBT skills training group, individual psychotherapy, in-the-moment coaching, case management strategies, and a DBT consultation team for the therapists. The goal is to combine all these elements in order to help a person build a life they feel is worth living. DBT was originally developed for those with high suicide risk but has since been broadened for those with borderline personality disorder, substance abuse, post-traumatic stress disorder (PTSD), depression, and eating disorders. Although full DBT programs are preferred for some clients, DBT has been adapted in many ways to be delivered in individual and smaller group settings.
It is important to know that Brookhaven Psychotherapy does not offer a full, comprehensive DBT program. However, many of our clinicians have previously worked on comprehensive DBT teams and are certified in delivering DBT therapy. We also run a DBT skills group for those who prefer a group atmosphere or are looking for a budget-friendly package. Contact our clinic today for more information.
Learn more about Dialectical Behaviour Therapy here
