First — great question. If you haven’t already had a chance to review the basics about DBT, I recommend reading our page about Dialectical Behavioral Therapy (DBT) as a first step.
Also, when you have 8 minutes to spare, this DBT explainer video created by folks at the University of San Francisco provides a great visual and verbal overview to help explain what is in both the previous article, and the rest of this one.
A really important thing to note is that DBT is about building the life that YOU want for yourself, not trying to shape your life based on what someone else wants for you.
DBT was designed by a woman named Marsha Linehan, who experienced some of her own highly intense mental health issues including suicidal thoughts and behaviors, what she called “extreme” emotional reactions, and difficulties connecting with people and living her every day life. In her memoir, Building a Life Worth Living, she described that through high school she was an “overachiever” and then felt like she crashed in her transition into young adulthood, when a lot of her symptoms started. When she went through her own treatment, she realized a lot of it was not helpful to her, and that nothing existed yet that really could support what she needed.
Maybe that’s how you have been feeling, too.
What might my life look like now?
Have you tried other therapies and they don’t seem to stick? Or they helped some, but you’re still feeling like you’re not living the life that you want? Does it feel like you know that some things you think or do aren’t helpful, and yet they still happen anyway? If so, that’s very human of you. As humans, our emotions tell us to do a lot of things, and sometimes those things are helpful in the long term, and sometimes they are not.
You might be someone who has some behaviors that have helped you survive in the short term — like avoiding conflict, or smoking or drinking to feel better in the moment, or acting on self-harm urges to get some relief. For some, those same behaviors also hurt them in the long term. Like if we don’t have meaningful relationships because we don’t approach tough discussions, or feeling dependent on a substance or something else to help us feel better, rather than feeling in control of our own choices.
It is a hard, and also very understandable, place to be.
Common Emotional Experiences
- Feeling out of place or like people just don’t quite get how you think or feel
- Feeling more angry about something than your friends or family,
- Noticing emotions come to you more easily and/or more often
- Having a hard time feeling your feelings
- Feeling confused about emotions, thoughts, and behaviors that keep happening
- Emotions feeling SO BIG or like they last FOREVER, or like they hit you HARD when they happen
- Riding an emotional rollercoaster and feeling like you can’t get off the ride
- Intense fears that make it hard to do the things you want to do
- Frequent feelings of shame or guilt
Common Life Experiences
- Having a hard time keeping relationships
- Feeling misunderstood, unheard, or unseen
- Trying to communicate with others and still feeling disconnected
- Suicide attempts, threats of suicide or self harm, planning, or thinking about suicide
- Missing school or work due to emotional overwhelm
- Using substances (even if it gets in the way of what you want)
- Frequent conflict with others
- Not being able to express yourself the way you want to
- Thinking about harming others
- Feeling like you can’t trust yourself
- Diagnoses such as Borderline Personality Disorder (BPD), Bipolar Disorder, Depression, Anxiety, Post Traumatic Stress Disorder
- Traumatic experiences currently or in your past
- Negative thoughts about yourself that never seem to quiet down
So why DBT?
DBT builds off the idea that even though we have not caused all of the problems in our lives, we are the ones responsible for managing how it’s impacting us now.
For instance, if no one ever showed you or taught you how to feel through and regulate intense emotions like anger, shame, guilt, grief, or any others, how could you possibly be expected to know how to do that without learning it?
Yet, if it feels like a problem for you, then the goal is to make it what you want it to be, instead.
DBT calls this building your life worth living.
As humans, we experience so many things that are out of our control. There are unexpected traumatic events, others’ decisions on how they treat us or speak to us, what we were taught or shown as children, certain societal changes or government decisions, whether or not others show up for us the way we want them to, and so many more. Building a life worth living means taking steps to control what we can, make intentional choices, respond in ways aligned with our personal values, and to make room for the life we want.
DBT is about holding people accountable for their own lives, in a nonjudgmental way
What does THAT mean?
It’s based on the belief that there are no bad emotions (though there are VERY uncomfortable emotions), that there is no right or wrong way to feel about something, and that choices and behaviors are not inherently bad, it just matters whether it is problematic for you and the life you want.
Here’s an example:
Let’s say one of my life-worth-living goals is to not have to work 40+ hours per week to scrape by, and I want to be able to work only 3 or 4 days per week. I start feeling stressed about money, because how could that be possible when it never seems to be that I have extra money to be able to be flexible like that? Now imagine one of my regular behaviors is spending more money than I want to or budget for, by shopping, impulse buying/spending, or eating out 4-6 times per week. Is that an inherently bad behavior? Absolutely not. Does it make me a bad person? NO WAY! But could it be getting in the way of one of the goals that brings more quality to my life? Definitely.
Here’s another example:
Imagine a life-worth-living goal of regularly getting together with a group of friends, say once every week. You know it would make you feel happy and connected, you genuinely feel good being around them, and it brings you meaning to have strong relationships. But when you start feeling overwhelmed, you don’t reply to text messages, and you start avoiding conversations. Or maybe you get anxious and cancel plans. Are either of those bad behaviors? No! Is it getting in the way of the life you want? Yep.
One of the best parts about DBT is that it views ALL behaviors this way — which means in DBT-ville, no one is judging you, no matter how intense you feel your behaviors or emotions might be.
Your Life Worth Living
DBT is set up in a way that getting you what you want, in a meaningful way, is the foundation of all of the sessions you participate in.
If the idea of describing your life worth living is overwhelming — DON’T PANIC. Learning about how you envision that life is a part of the pre-treatment process for DBT as a treatment. You and your DBT therapist take time to find at least one life-worth-living goal and to get a good picture of it in your mind so that you are the one picking what you are working on in therapy.
Okay, I think I’m at least interested in learning more — what next?
Schedule an intake session with a DBT therapist so you can meet your potential therapist, ask questions, and share your story. A DBT therapist will be ready and willing to answer questions at your first intake session or throughout pre-treament (and ongoing, of course).