Addressing Effects of Childhood Trauma with Dialectical Behavior Therapy : PART 1-Introduction.

I have already written one post about the very promising new therapy for treating the effects of childhood trauma called DIALECTICAL BEHAVIOR THERAPY (DBT); this therapy has been found to be particularly effective in treating those who, in part due to their childhood experiences, have gone on to develop BORDERLINE PERSONALITY DISORDER (BPD).

Five skills are central to DBT; these are as follows:

1) CORE MINDFULNESS
2) TAKING THE’MIDDLE PATH’
3) DISTRESS TOLERANCE
4) EMOTIONAL REGULATION
5) INTERPERSONAL EFFECTIVENESS

In this introductory post, I will concentrate upon 1 and 2 above. I will go on to examine 3,4 an5 above in later posts (to be published very soon). So let’s start by looking at 1:

1) CORE MINDFULNESS: DBT describes the mind as having 3 components (these are concepts, not actual distinct physical part of the brain, obviously). The 3 components are:

a) the reasonable mind
b) the emotional mind
c) the wise mind

Let’s examine each of these in turn:

a) the reasonable mind: this can be summed up, according to DBT, as the part of the brain which acts according to reason, logic and rationality

b) the emotional mind: according to DBT, this is the part of the brain which operates on the basis of our feelings (when the ‘heart controls the head’)

c) the wise mind: ideally, according to DBT, we should allow this part of the brain to guide us; it is A BALANCE BETWEEN 1 and 2 above, when the reasonable and emotional brain are operating in effective HARMONY.

If we are able to operate in ‘wise mind mode’, this will mean we can maintain control and prevent ourselves from becoming a victim of our own intense emotions. In order to see the importance of this, we need only consider times in our lives when our behaviour has been dominated by our emotions and the negative effects this may have led to. Indeed, not learning to control emotions can leave our lives in ruins, not least due to the frequent self-destructive effects of our emotional outbursts.

2) TAKING THE MIDDLE PATH: This is a metaphor for avoiding the trap of constantly seeing issues in terms of BLACK AND WHITE (eg all good/all bad and a marked tendency to perpetually think IN TERMS OF EXTREMES). DBT stresses the importance of teaching ourselves to FOCUS MORE ON THE GREY AREAS and to try to take A BROADER RANGE OF PERSPECTIVES when considering issues, to think more FLEXIBLY and to THINK LESS IN ABSOLUTE TERMS.

Taking the middle path, according to DBT, also involves BOTH VALIDATING OUR OWN THOUGHTS/FEELINGS AND THOSE OF OTHERS. Even if others don’t understand, DBT stresses that we need to comfort ourselves when distressed by reminding ourselves that how we are feeling is real and makes sense under the current circumstances we find ourselves in. We can remind ourselves, too, that no matter what others may think, NOBODY UNDERSTANDS US AS WELL AS WE UNDERSTAND OURSELVES (others can’t understand what it is ‘to be in our heads’; we should not be ashamed of how we feel). By applying this compassion and understanding to ourselves, as part of ‘taking the middle path’ it seems fair that we should extend similar understanding to others – we can accept what they feel, as non-judgmentally as possible, irrespective of whether we approve or not.

My next posts will look at the other 3 key skills DBT teaches us (3,4 and 5 above, namely: DISTRESS TOLERANCE, EMOYIONAL REGULATION and INTERPERSONAL EFFECTIVENESS.

I hope you have found this post of interest. Please leave a comment if you would like to; I’ll respond a.s.a.p.

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Best Wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).


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