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DBT and Mindfulness-based Approaches

I teach most of my clients mindfulness-based approaches, because they are shown to be effective in managing painful internal experiences (rumination, self criticism, etc.), and allow our minds to be present and focused. You are not your thoughts, and you can learn to observe your experiences, and bring a new intentionality to your life. Dialectical behavior therapy is the treatment of choice for intense and fluctuating emotions, and is a powerful tool for healing.

You may have heard of Dialectical Behavior Therapy. It is the treatment of choice for individuals that struggle with managing intense emotions. Some individuals can feel calm and relatively content in one moment, and then can be startled by feeling something intensely different only moments later.  Situations that some might identify is “no big deal” may be experienced very differently with those who are more emotionally sensitive. Emotions that are unpredictable and that fluctuate rapidly from one extreme to another can create a pattern of instability of emotional experiences that is at the core of borderline personality disorder: this is called emotion dysregulation.  Dysregulated emotions can be understood to drive many of the challenges experienced by individuals diagnosed with borderline personality disorder (difficulty controlling emotions, challenging interpersonal relationships, impulsivity, and chronic suicidal ideation), and research has consistently shown it’s effectiveness in offering control over one’s emotions.  There is no question that the arrival of DBT to clinicians toolboxes is saving lives for individuals who present with symptoms of borderline personality disorder.  It has been so impactful that when you google “DBT” or “Dialectical Behavior Therapy” the initial few pages of results will reference suicidality, borderline personality, and the efficacy research. The thing is— intense emotions are also a significant part of the presentation of a number of other mental health challenges.  I am going to suggest here that most mental health challenges involve feelings of significant discomfort with intense emotions. People who are struggling with depression often struggle with intensely negative moods. The intensity of such extreme sadness is difficult to manage, and such intense sadness can lead to painful thoughts and urges for suicide.  Anxiety is such a physiologically uncomfortable experience that those that struggle with it often will typically try to avoid anything that might trigger intense anxiety or panic. Discomfort with intense emotions is also implicated in binging, purging,  alcohol and substance use, and much more. Whether in a deep depression, trying to manage panic attacks, or struggling with painful memories of past trauma, intense emotions are challenging to manage and can lead to impulsivity, urges for self-harm, difficulties in interpersonal relationships, and a range of emotions including emptiness, anger, and despair. At Guilford Psychological Services we specialize in working with individuals who want to learn strategies for managing intense emotions. Our clinicians practice Dialectical Behavior Therapy and teach DBT skills groups. Skills training covers four primary modules: 1) mindfulness skills which teach clients to observe and describe their internal experiences, as well as how to turn their attention to the present moment; 2) Interpersonal Effectiveness includes specific strategies to clarify goals in interpersonal relationships, to improve relationships, as well as how to end destructive ones; 3) Distress Tolerance strategies are utilized for tolerating periods of intense distress and 4) Emotion Regulation skills are specific techniques that can reduce vulnerability to intense emotions and can increase or decrease the intensity of specific emotions. Though DBT was initially designed as a treatment for borderline personality disorder and chronic suicidal ideation, it effectively treats so much more than that, because many mental health challenges, at their core, involve a struggle with intense emotions.  DBT also helps with challenging thoughts, but I will save talking about those techniques for another post. Suffice it to say, DBT strategies can be useful for a number of areas.  DBT is effective for: major depressive disorder anxiety disorders post traumatic stress disorder bulimia binge-eating disorder attention deficit disorder  substance abuse and dependency and more  If you are feeling anxious, depressed, or are struggling to control certain impulses (e.g. drinking alcohol, using drugs, binge eating and/or purging) consider joining a local DBT skills group. The research is clear and consistent that it can help. You can learn to manage your emotions, rather than having your emotions manage you.
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