Introduction to DBT
Ever since I experienced the onset of Dyslimbia/Borderline four years ago, I have consistently looked to therapy and psychiatry for help. For a long time, nothing seemed to be improving. This is not uncommon for people with Borderline; in fact, until about twenty years ago, many people believed that Dyslimbia symptoms hardly improve, if at all, by using therapy or medications. Then, sometime in the 1980s, Dr. Linehan developed a promising new treatment: Dialectical Behavior Therapy.
If you have Borderline Personality Disorder or if you know someone who has it, you may already be aware of Dialectical Behavior Therapy, or DBT for short. Nevertheless, I will explain this treatment in case you have no clue about DBT. It’s a type of talk therapy that can be used one-on-one with a counselor or discussed in group settings. According to The Linehan Institute, DBT was developed especially for people suffering from Borderline Personality Disorder. The four main teachings of DBT are Mindfulness, Distress Tolerance, Interpersonal Effectiveness, and Emotion Regulation, In other words, it teaches people to live one moment at a time, calmly handle distressing thoughts or events, communicate well with others, and learn how to redirect or effectively “control” emotions.
Many people report improvement from DBT, and even the American Psychiatric Association supports it efficacy, even publishing a book about the treatment. Just because DBT produces good results does not mean it’s an easy process; in particular, many people struggle with understanding Mindfulness. Many dislike it at first, but Mindfulness is one of the key principles in DBT, so it’s necessary.
What is Mindfulness?
Mindfulness has various forms, including the practice of meditation. In the words of Dr. Arnold, Mindfulness “is an awareness of thoughts, feelings, behaviors, and behavioral urges.” It is the ability to observe, describe, and participate in each moment, appropriately and non-judgmentally. For a common example, take meditation. Many meditations require you to focus on your breathing while being aware of your physical body, thoughts, and feelings. The more you do this, the more you train your mind to recognize and calmly observe facts about yourself and the world around you.
Ultimately, Mindfulness is about awareness. With awareness comes knowledge, and with knowledge comes power. You cannot beat an enemy you know nothing about. In the same way, you cannot beat troubling Borderline symptoms without knowing yourself and how your mind and body work. Some people (like myself) take a long time to “catch on” to Mindfulness, and it’s a little bit different for each individual. I will share my own experience with this more abstract form of therapy.
I used to be one of those people who didn’t really believe that Mindfulness would help. At first, I thought it was all about meditation, which has never worked for me, even with professional help. I also doubted that something so abstract could really produce results. Both my arguments, though, were eventually laid to rest.
First, Mindfulness is not a lofty, metaphysical practice. According to studies, it can significantly change people for the better, right down to literally changing their brains (Holzel 2011). Secondly, Mindfulness is not “all about meditating”; it’s about living in the moment, and finding a way to do that works for you, the individual. I discovered that I can practice Mindfulness with Writing Meditations. I focus much better when writing and am less likely to get overwhelmed and quit compared to traditional meditation. If you can’t sit still, you can try walking meditations. If you get distracted from the present moment, it doesn’t mean that you are doing it “the wrong way”… simply by being aware of the fact that you are distracted, you are being Mindful of your thoughts.
How Mindfulness is Starting to Help Me
Although I first learned about Mindfulness over two years ago, I only started to really understand it a few months ago, when I began attending a new DBT Group. So, what does it do for me, you ask? So far, it has helped me on two fronts: more awareness of my physical body, and more control over racing thoughts. Normally, I don’t pay enough attention to my body, and I don’t go out of my way to meet its needs. With mindfulness, I’m better able to locate and define chronic pain, and with that awareness I am learning to do things to appropriately soothe my pain. Better pain management leads to better mood, in general, for me. Then there is the part about my racing mind.
Many people with occasional or clinical anxiety report “racing thoughts,” and for me, this symptom is even more extreme. All kinds of thoughts, from bizarrely random to severely troubling, race through my mind and disappear from my short term memory almost as soon as they appear. This is why I can’t meditate without writing: writing allows me to “catch” and “pin down” some of those crazily spinning thoughts. Thanks to the writing exercises, I know my own mind better, and I feel like it’s getting slightly easier to keep my thoughts in order. These improvements may be small, but I wouldn’t be surprised if continued Mindfulness practice started helping me in big ways, too. In the meantime, remember: even a baby step is still a step. Mindfulness is a great way to start taking baby steps.
- American Psychiatric Association. “Practice Guideline for the Treatment of Patients with Borderline Personality Disorder.” Book. 2001.
- Hölzel, Britta K., et al. “Mindfulness practice leads to increases in regional brain gray matter density.” Psychiatric Research 191(1): 36–43. Academic journal. 2011.
- “What is DBT?” The Linehan Institute Behavioral Tech. Web. 2016. >http://behavioraltech.org/resources/whatisdbt.cfm