Having an angry reaction to something is not wrong, but choosing to behave aggressively as a result of that anger is where problem behaviors arise. This is one of the lessons learned through Dialectical Behavior Therapy (DBT), a primary treatment for Borderline Personality Disorder (BPD).
Dialectical Behavior Therapy seeks to teach people with aggressive tendencies to employ mindfulness techniques in order to prevent aggressive behavior. Through DBT, they learn to tolerate uncomfortable emotions by sitting with them before acting on them.
DBT encourages patients to call their therapists when emotional dysregulation occurs. A dialogue between patient and therapist may help illuminate what triggered the emotional response, factors that contributed to their reaction (including being tired or hungry), and how effectively the patient coped with that particular incident. The dialogue may also prevent the patient from acting aggressively and have a more measured reaction to the trigger.
For many people, acting out aggressively is the only way they know how to relieve the intensity of their emotions. DBT therapists may have to work to keep in mind that their patients are always doing the best that they can.
Judgment and accusations are never effective in DBT treatment. Therapists have to craft their words carefully, being sure to validate the emotions a patient is having without validating the aggressive behavior that follows the emotion. Minimizing the emotional validation part of that equation is detrimental to treatment, according to Michele Galietta, PhD, a senior advisor at Treatment Implementation Collaborative.
The more a person with Borderline Personality Disorder is validated emotionally, the more they grasp that the emotion itself is not the problem. Dialectical Behavior Therapy seeks to teach patients the skills they need to increase the space between feelings and actions so that as that space increases, the need for action diminishes.
Root Causes of Aggression
Knowing the root causes of a person’s problem behaviors and the triggers that result in them acting aggressively helps therapists to better tailor a course of DBT treatment for their clients. In DBT therapy, the more patients and their therapists understand about when and why aggressive tendencies occur, the more effectively they can break down the process and help to increase space between feelings and actions.
Galietta explained that Dialectical Behavior Therapy treatment for each individual client is “well conceptualized” before treatment begins. A DBT team will examine the gamut of a patient’s behaviors and attempt to understand where they stem from and what will best help to decrease them.