Social Worker Jeremy Schwartz had a client named Brenda whose anxiety disrupted her life in many ways. Sometimes she would miss an appointment because she had a panic attack on the train. She would break up with her boyfriend one day, then text him non-stop to next day to try to get him back. Often, she’d become isolated because she thought her friends didn’t want to hear from her.
Schwartz is a Brooklyn, New York-based therapist who suggested Dialectical Behavior Therapy, or DBT, to Brenda as a way to learn skills to help her cope with the situations in daily life that were anxiety-producing for her.
Dialectical Behavior Therapy gives people skills to live in the present moment and observe their feelings, says Schwartz. DBT skills can help a person manage the intensity of their feelings.
“People with anxiety benefit from being able to tolerate intense feelings and modify behaviors in order to create new emotional experiences,” says Schwartz. DBT teaches mindfulness skills that give people with anxiety the tools to set aside worries about the past or future, so they can address what is happening in their lives in the present moment.
Dialectical Behavior Therapy was developed by psychologist Marsha Linehan, a professor at the University of Washington, initially to work with people in dangerous situations, such as those who have suicidal thoughts or cut themselves.
Psychotherapists have found DBT effective for individuals with Borderline Personality Disorder to help them acquire skills to deal with intense episodes of anger, depression and instability in behavior and functioning. Those DBT skills are being proven to be effective for an expanded range of mental health issues.
The basis of DBT is a balance between acceptance and change, or integrating contradictory philosophies. For instance, accepting both “you are loved the way you are” and “you must strive to change.”
Alexander Chapman, a psychologist who is a professor at Simon Fraser University in Vancouver, British Columbia is one of the authors of the book, The Dialectical Behavior Therapy Skills Workbook for Anxiety: Breaking Free from Worry, Panic, PTSD and Other Anxiety Symptoms. Chapman says DBT teaches four powerful skills:
Dialectical Behavior Therapy is a collaboration between a trained therapist and a client proving to be an effective way to deal with anxiety disorders and allow people to enjoy a higher level of functioning and more peace in their daily lives.
Schwartz, Jeremy, “Dialectical Behavior Therapy: Not Just for Borderline Personality,” goodtherapy.org, March 24, 2015
Schwartz, Jeremy, “Why DBT Works When Other Therapies Fail,” Anxiety.org June 24, 2015
Luhrmann, T.M., “The Anxious Americans,” The New York Times, July 18, 2015
Chapman, Alexander, L., The Dialectical Behavior Therapy Skills Workbook for Anxiety: Breaking Free from Worry, Panic, PTSD and Other Anxiety Symptoms, New Harbinger, Oakland, CA, 2011
Gratz, Kim and Tull, Matthew T., and Wagner, Amy W., “Applying DBT Mindfulness Skills to the Treatment of Clients with Anxiety Disorder,” Acceptance and Mindfulness-Based Approaches to Anxiety, Springer Science & Business Media, New York, 2007
Borchard, Therese J., “Marsha Linehan: What is Dialectical Behavioral Therapy?” PsychCentral.com, June 2011
Australian DBT Institute, “What is Mindfulness?” Centre for Mental Health Education, Melbourne, Australia