Dr. Kumar

Dialectical Behaviour Therapy

( ignored area in Indian scenario )
Dialectical Behavioural Therapy ( DBT) is structured, active and directive therapy to handle borderline personality disorder( BPD ). Borderline personality disorder or traits is quite common disorder all over the world. BPD is commonly seen in young adults and more incidence in females.
People with BPD have huge emotional disturbance, difficulty in experiencing, interpreting, controlling and expressing emotions. There is deep sense identity crisis and heightened sensitivity towards negative emotions. Sufferers of BPD have frequent mood swings and constant feelings and fear of rejection in relationships. They tend to have ingrained emotions of perceiving world as unstable and have problems to deal with relationships in all corners of life. Patients can not distinguish or relate emotions according to current situation.
Cornerstone of BPD is unstable sense of being, that create alienation towards self and others. In attempt to seek stable sense of being, patients get dissociation episodes and do repetitive self harm to themselves.
BPD patients tend to see world in extremism, either good or worst and keep swinging in decoding stable and neutral sense of perception.
Impulse outbursts becomes part of their life and there constant chase to get stable self.
BPD patients are amazingly good in starting relationships, tend to give percent to make relationships work. They have inherited tendency to show empathy and always looking to help others. But because of unstable sense of self, they mess up relationships by impulsive acts.
BPD patients have 10 times higher tendency for drug abuse and promiscuous behavior which further damage emotional stability

Dialectical behavioural therapy is especially and carefully designed to treat and manage core aspects of BPD
DBT is very powerful evidence based therapy and it is like solving mathematical equation. If you follows the steps , result will automatically come.
Word “ Dialectical” signifies that two opposite can exist together and with harmony. It means that unstable emotions can coexist in challenging conditions and expression of emotion can be controlled ego ideal.
DPT has four modules as
Mindfulness
Distress tolerance
Emotional regulation
Interpersonal effectiveness.
Four modules work in tandem to solve the mystery of BPD.

Mindfulness is intended to train emotions that emotions are momentarily and to live in that emotions and to identify and name it is basic logic of mindfulness . It has nothing to do with “ budha’s mindfulness.
Distress tolerance is aimed to focus on painful emotions and do involve yourself in active and diverting situation to handle emotions without reaction. It can be learned easily with standard techniques
Emotional regulation is the hardest part of DBT but equally easy to learn. Emotional regulation requires training before facing challenging situations. During training all emotional reactions are accepted and there are active measures to be taken to have ideal expression of emotions
In interpersonal effectiveness, clients are put into imagery and virtual situations and trained to develop acceptance of others emotions and intention. Interpersonal effectiveness is hardest part to achieve in DBT because of diversity of emotions in each human being.

In DBT cognitive restructuring is one part but not much focus upon it. DBT is like, wearing a ego ideal mask to express opposite. With training mask becomes one with original self and emotional disturbance starts getting subtle.

DBT is not magic therapy to treat or cure borderline personality disorder or related emotional disorders, it requires trained therapist, and committed client. DBT work on principle of operant conditioning concept, and reflex training of human brain.

Don’t ignore emotional swings or emotional lability ( if it effecting your personal and professional life) Consult mental health specialist to prevent dire consequences.
There certain algorithms mentioned on web to learn DBT. Be aware of them, read only authentic web pages.

OSHO CLinic Psychiatry & Psychology