Dialectical Behavioral Therapy

I use DBT and Psychodynamic Therapy frequently throughout my sessions.  I explore with my clients what types of negative behaviors are occurring in their lives and what they would like to change in order to achieve a more meaningful life.  Part of my work includes psychoeducation, where I help them to understand that while swapping one coping mechanism for another (such as holding a cold orange to help stay present rather than engaging in self harm) can be beneficial, there are other factors to explore.  It is important to get to the root of the issue and working with underlying feelings is what will ensure lasting healing and change.  Individuals often report success in alleviation of their symptoms through exploring past traumatic experiences and understanding difficult emotions such as fear, shame, and anger.

In DBT clients learn mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills to help them achieve a meaningful life (Linehan, 1993).  As these skills are developed improvements in coping, life skills, and feelings of overall well-being are often seen (Linehan, 1993 & Sharf, 2012).  In my DMT sessions residents sometimes use the skill of radical acceptance, which is accepting any given situation just as it is without desiring to change it (Linehan, 1993), to tolerate participating in a group they feel vulnerable in.  They use the skill of opposite to emotion action by identifying their feelings, such as fear, acknowledging their urges often associated with the feeling, such as fleeing the group, and choosing to tolerate the fear and stay in the session.  By using these skills they work through the process of creating new, more effective responses to feelings.  They use the skill of observation as they notice that by staying in group and gradually engaging and participating they learn and gain insight into how DMT and their body/mind connection relates to their treatment and recovery process.

Psychodynamic Therapy focuses on, “exploring those aspects of self that are not fully known…” (Shedler, 2010).  I utilize this orientation to help clients explore parts of their lives described by psychodynamic therapy including:  affect and expression of emotion, exploration of attempts to avoid distressing thoughts and feelings, identification of recurring themes and patterns, discussion of past experience and development, the therapeutic relationship, and fantasy life. (Shedler, 2010)  Through this process of exploration, reflection, and discovery, clients gain greater insights into the intentions and motivations of their thoughts, feelings, and behaviors and are better able to make more satisfying and lasting changes in their lives.

Psychodynamic Therapy provides a framework for understanding and making meaning of the past traumas through becoming aware of disowned parts of the self (Shedler, 2010).  When I work with a client with drug or alcohol addictions I find that when they can explore past trauma they can more fully support themselves in finding and accepting new ways of thinking and behaving.  As clients past issues are understood, re-worked, and re-framed, healing occurs on physical, emotional, mental, and spiritual levels and clients often report an improvement in their overall functioning.

References

Amighi, J. K., Loman, S., Lewis, P., & Sossin, K. M. (1999). The Meaning of Movement: Developmental and Clinical Perspectives of the Kestenberg Movement Profile. New York & London: Brunner-Routledge.
Kestenberg, J. S., Berlowe, J. & the Sands Point Movement Study Group. (1999). Training Manual for the Kestenberg Movement Profile (Rev. ed.). Keene, NH: Antioch University New England.
Levy, F. J. (1988). Dance/Movement Therapy: A Healing Art. Reston, VA: The American Alliance for Health, Physical Education, Recreation, and Dance.
Linehan, M. M. (1993). Skills Training Manual for Treating Borderline Personality Disorder. New York & London: The Guliford Press.
Sharf, R. S. (2012). Theories of Psychotherapy and Counseling: Concepts and Cases. Belmont, CA: Brooks/Cole.
Shedler, J. (2010). The Efficacy of Psychodynamic Psychotherapy. American Psychologist, Vol. 65 ( No. 2), 98-109.