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Emotion dysregulation and Emotion Regulation are two terms that DBT clients hear a lot. What exactly does your DBT therapist mean by these terms? Emotion Dysregulation Emotion dysregulation refers to any difficulties in effectively managing and controlling one’s emotions. It is characterized by unstable and intense emotional experiences, difficulty in modulating the intensity and duration of emotions, and challenges in responding adaptively to emotional triggers. Emotion dysregulation can manifest in various ways, including: Intense and unstable emotions: Individuals may experience intense and rapidly fluctuating emotions that are difficult to manage or regulate. They may find it challenging to control the intensity of their emotional responses or have difficulty returning to a baseline emotional state after an emotional event. Impulsivity: Emotion dysregulation is often associated with impulsive behaviors, where individuals may act without thinking, engage in self-destructive actions, or engage in risky behaviors as a way to cope with or escape

The Benefits of DBT for Individuals with Borderline Personality Disorder Dialectical Behavior Therapy (DBT) is a form of therapy that was specifically developed to treat borderline personality disorder (BPD), which is a mental health condition characterized by intense and unstable emotions, impulsive behavior, and difficulty with relationships. DBT was created in the late 1980s by Dr. Marsha Linehan, a psychologist who was working at the University of Washington. Frustrated with the available options, Dr. Linehan developed DBT as a treatment for individuals with borderline personality disorder (BPD). Dr. Linehan drew on a range of therapeutic approaches, including cognitive-behavioral therapy (CBT), mindfulness practices, and dialectical philosophy, to develop DBT. The therapy incorporates both individual and group therapy sessions. Over the years, DBT has been adapted for use in treating a variety of other mental health conditions, including eating disorders, substance abuse, and post-traumatic stress disorder (PTSD). DBT has become a widely

In Dialectical Behavior Therapy (DBT), mindfulness refers to the practice of paying attention to the present moment with a non-judgmental and accepting attitude. It is one of the four core modules of DBT, along with emotion regulation, distress tolerance, and interpersonal effectiveness. In DBT, mindfulness is taught as a foundational skill that helps individuals become more aware of their thoughts, feelings, and physical sensations, and develop the ability to observe them without getting caught up in them or reacting impulsively. This practice of observing and accepting one’s experience is essential for developing emotional regulation and distress tolerance skills. Mindfulness in DBT is often taught through various exercises, such as guided meditations, breathing exercises, and body scans. These exercises help individuals to develop a greater awareness of their internal experiences, and to cultivate an attitude of curiosity and non-judgment toward those experiences. The goal of mindfulness in DBT is to help

In dialectical behavior therapy (DBT), the distress tolerance skills are those used during periods of intense emotions, difficult experiences or crisis situations, when your primary goal is to “make it through” without making the situation worse. These DBT crisis survival skills are effective when you are experiencing an intense emotion that feels like it will last forever, when you feel too overwhelmed by an emotion to complete a current task, or when you are worried you might resort to some really ineffective or risky coping behavior. The first crisis survival skill you learn in DBT will probably be the TIPP skill. Some DBT skills focus on changing thoughts, others on changing behavior. The TIPP skill is a physiological intervention. This means it is a skill that works through the body. The purpose of the TIPP skill is to change your body chemistry to quickly reduce the intensity of an extreme

The 4-miss rule in DBT is quite simple: clients who miss four weeks of individual sessions OR four skills classes in a row must leave the program. This rule is stated upfront, to set up a clear expectation: if you miss four appointments, that is considered a premature dropout. Until you miss four, you’re still in. This information is provided to DBT clients during the early part of treatment, before a commitment to the program is made. By clearly laying out this expectation, clients know the difference between simply missing appointments and dropping out. In many types of therapy, clients are allowed to “drift in and out” of treatment. When some people get relief, or their situation improves, they think they don’t need therapy anymore and they stop coming. Then, when symptoms return or they encounter some obstacle, they return to therapy. This makes lasting progress impossible. The DBT 4-miss

Girl, Interrupted is perhaps the most popular work in popular culture about Borderline Personality Disorder. When many persons think of BPD, they think about the 1999 film adaptation starring Winona Ryder and Angelina Jolie (perhaps confusing Ryder’s character, the one diagnosed with BPD, with Jolie’s character, the erratic but charismatic sociopath). The film is based on a memoir of the same name written by Susanna Kaysen. The author was not a fan of the film, which added melodramatic embellishments. The book is fairly simple, detailing 18 months Kaysen spent in an inpatient psychiatric hospital in Massachusetts in the 1960’s when she was 18 years old (Kaysen, 1994). Is BPD portrayed accurately in those works? Or does it give the public a distorted image of what it means to have BPD? The truth is the book and film don’t show much at all about BPD, or what it means to live

Persons with BPD constitute an oversized percentage of persons found in inpatient hospitals. They often end up there after contact with police or through the emergency room, and a suicide attempt or suicidal thoughts. Once there, however, the care they receive is generally not well tailored to their symptoms. Borderline Personality Disorder (BPD) affects between .7-2% of the population. Research indicates anywhere from 3-10% of persons with BPD will eventually commit suicide. Despite the seriousness of this disorder, most persons with BPD who are receiving mental health treatment are not receiving BPD specific treatment. The result is often poor management of symptoms, high utilization of emergency rooms, and a disproportionate rate of admittance or commitment to inpatient psychiatric hospitals. Persons with BPD are disproportionately found amongst “high-utilizers” of this system. The American Psychiatric Association’s “Guidelines for the Treatment of Borderline Personality Disorder” suggest a liberal use of hospitalization (Paris, 2004).

Loving someone with Borderline Personality Disorder (BPD) presents certain challenges. Sometimes, your relationship can feel like a“rollercoaster.” If you’re struggling with this, these tips may be helpful. Those with BPD sometimes struggle through this common pattern: periods of idealization (“you are so wonderful and I love you so much”) and devaluation (“I hate you and you are the absolute worst”). People with BPD may feel both of these things in the same day, or even during the same conversation. This is because people with BPD struggle with emotions: they feel these very strongly, have difficulty controlling their emotions, and are susceptible to becoming overwhelmed. The results? Their emotions sometimes are in the driver’s seat, and they might lash out at their loved ones in a desperate attempt to feel better. Fortunately, there are things that you can do to help “weather the storms” in your relationship. Here are five ways to

Self-harm is when someone hurts themselves on purpose. Also called self injury, it includes behavior such as cutting, burning, and even things like punching walls. Everyone agrees self-harm is a serious symptom requiring treatment. But why do people commit self-harm? Many young persons commit self-harm. It is often thought to be a way children and teens manage strong, negative emotions. Rather than using more healthy, adaptive ways of coping with difficult problems and feelings, people often use dangerous and unhealthy methods. This includes risky sexual behavior, aggressive behavior, and self-harm. These methods may be effective at temporally blocking out negative feelings, but they cause problems of their own. They also tend to perpetuate the underlying issues, and prevent someone from developing coping methods that are actually effective at addressing the source of their feelings. But, what causes young people to self harm? When considering young persons, one place to always

Mindfulness means being in the present moment. How is mindfulness used in DBT? Mindfulness as a concept has grown in importance in the field of psychotherapy over the last several decades. Jon Kabat-Zinn is credited for bringing mindfulness to the United States back in the 80’s. He describes mindfulness as “a means of paying attention in a particular way; on purpose, in the present moment, and nonjudgmentally.” While not always clearly stated, Kabat-Zinn’s work on mindfulness is rooted in buddhist meditation practices. Around that same time, Marsha Linehan, the developer of dialectical behavior therapy (DBT), was curious as to whether or not mindfulness could be helpful for those who were suicidal and experienced severe emotion dysregulation. Marsha translated what she had learned of Zen principles into accessible skills that we teach in DBT skills group today. More specifically, her translation led to the three “What” skills, three “How” skills, and