Dialectical Behavior Therapy (DBT) has been shown to be highly effective in treating Borderline Personality Disorder (BPD) and is an essential component in any successful BPD treatment program.
Since many of the symptoms common to people with the disorder arise as coping mechanisms developed in response to intense and unbearable emotional pain, DBT focuses on treating emotional vulnerability and volatile emotional reactivity.
DBT emphasizes the development of four skill sets:
- Mindfulness meditation
- Interpersonal effectiveness
- Emotional regulation
- Distress tolerance
The Four Stages of DBT
Dialectical Behavior Therapy is further organized into four stages with stage-specific goals. Because of the extreme psychological complexity of BPD, therapists and clinicians individualize the order of stages and targets to conform to each person’s needs.
First Stage: The first stage of DBT focuses on providing people with BPD the tools needed to regain control of their behaviors. The target at this stage is to remove those behaviors that are self-harming or that countermand effective treatment while helping people develop positive coping mechanisms in response to emotional pain.
Second Stage: The goal of the second stage of DBT is to help people fully experience their emotions. It is common for someone with BPD to become emotionally shut down. This avoidance response is another coping mechanism that cuts off people with the disorder from the world and leaves them dangerously isolated. DBT focuses on providing people with the skills necessary to experience a full range of emotions without the fear of them losing control or being controlled by their emotions.
Third Stage: The third stage of DBT focuses on helping people with BPD create an ordinary life while dealing with problems typically associated with their family, relationships, living situation, and career. Because these areas often have many emotional triggers, there is an opportunity at this stage to practice the techniques learned in stages one and two.
Fourth Stage: After completing the third stage, people with BPD often experience a sense of emptiness or incompleteness. DBT addresses this in the fourth stage of treatment. In this last stage, people are helped to become reintegrated and connected to their worlds. They are encouraged to add meaning to their lives through such things as spiritual pursuits, changes in career ambitions, and interpersonal relationships.
DBT is completed when a person has accomplished all of the goals delineated in the four stages.
Clinical studies have demonstrated that DBT is a very effective way to treat BPD. When combined with an individualized, holistic course of treatment, DBT can improve a person’s chance of lasting recovery from the disorder.