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Hiking Path in Forest

Dialectical Behavior Therapy

You’ve been told your whole life that you’re “too sensitive” and somehow, no matter how sternly you criticize yourself about how ridiculous your emotions are, they only seem to intensify. So you’ve turned to all sorts of solutions that do seem to help, but are also actually making you more miserable in the long run. Over-shopping, over-eating, not eating, sex, substances, exercise, endless TV binges, dramatic life changes, avoiding people, fantasizing about dying, self-injury, over-working… you name it! Sometimes you are killing it and hustling your best hustle. And other times you are so deep in the Pit of Despair that even true love can’t help you escape (Princess Bride, anyone?) The thing is, your hustle and your despair are two sides of the same coin: you’re in tremendous pain and you’re trying to escape.

Dialectical Behavior Therapy (DBT) is all about helping you build a life worth living in the face of that very pain you’ve been working so hard to avoid. A skills-based approach, DBT uses skills training and individual therapy to help you shift from unrelenting crises, extreme emotional ups and downs, and suffering to mindfulness and meaning, rich relationships, and stability.

How Does it Work Exactly?
Comprehensive DBT treatment consists of a combination of DBT skills training and individual therapy sessions. Skills training is available in group or individual settings.

Individual therapy focuses on changing the behaviors that cause so much suffering and conflict. You set the agenda by identifying what needs to change and then we steadily work on these goals to get you back in control of your life. Individual therapy helps you remain motivated so you can stay the course, and addresses the obstacles that inevitably pop up. The message at the heart of DBT is acceptance and change. We will work on accepting the thoughts and feelings that feel so unwelcome (by us and others) and changing behavior so you get to be who you want to be in this world.

In skills training, we learn skills in four areas:

  • Mindfulness – Being present in the current moment.

  • Distress tolerance – Most people try and keep themselves safe from all painful emotions. Distress tolerance is geared toward increasing your tolerance of your pain.

  • Emotion regulation – Offers strategies to manage intense emotions that are the root cause of problems in your life.

  • Interpersonal effectiveness – These techniques allow you to communicate with others in a confident, assertive way that maintains self-respect and strengthens relationships.

When is DBT Used and What Can You Expect?

While DBT was initially developed to treat those with borderline personality disorder, research has since shown that DBT can successfully treat people with depression, bipolar disorder, PTSD, eating disorders, and substance abuse.

First, I like to chat with folks on the phone for a free 15 minute consultation. You can schedule one on the link below. This gives me a sense of what you’re looking for help with and allows you to ask any additional questions you might have.

If we decide to move forward, we schedule an initial assessment session. This time is for me to hear about your life more in depth and really get a picture of what’s prompting you to reach out for therapy.

After that, I offer you my clinical recommendations. My recommendations are based on your symptoms and might include comprehensive DBT (described above) or another treatment modality. Sometimes folks benefit from a DBT-informed approach, which means we use part of the DBT model in our work together.

If we decide together to move forward with comprehensive or informed DBT treatment, we’ll start orientation. Don’t be scared! DBT is just really different from most other therapies and I’ve found that my clients appreciate knowing what they’re getting into. It helps us get on the same page, which is essential for any therapeutic relationship. During orientation, we’ll discuss skills training. I am available for individual skills training or I know a wonderful DBT group facilitated by trusted colleagues that we can sign you up for. If you have any hesitations or concerns, this will be the time to talk it through.

I know all of this can seem daunting. Some of you are like YES, I LOVE IT SIGN ME UP and others are panicking and about to close this tab. Don’t close the tab! I won’t leave you adrift, I promise. I’ll be right here, helping you navigate this rocky road to healing. DBT is not a magic wand to fix everything, but it can be magical and I hope I get the chance to show you what I mean.

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