Do you have strong emotional reactions such as anxiety, anger, or depression?
Do you have difficulty regulating your emotions?
Are you experience feelings of emptiness?
Do you have an unstable view of yourself?
Do you have a pattern of unstable and/or intense interpersonal relationships?
Individuals may experience their thoughts and emotions more intensely than others. This can lead them to experience heightened emotions. In an attempt to manage these strong emotions, people may react in a more extreme or impulsive manner. Further, they may lack awareness of these challenges, which denies them the ability to accept this pattern and work to manage them. This may provide relief in the short term. But, it often leads to increased anxiety, depression, and distress in the long term.
Thankfully, there are evidence-based practices designed to assist in the above-associated symptoms. Dialectical Behavior Therapy (DBT) is one therapeutic approach with scientific support for its implementation to manage:
- Unstable interpersonal relationships
- Identity challenges
- Impulsivity
- Reactive mood (e.g., intense emotions)
- Feelings of emptiness
- Anger management difficulties
- Fear of abandonment
- Depression
- Anxiety
- Self-injurious behavior
- Suicidal ideation
- And substance use
DBT poses that all persons may benefit from learning emotion/behavior regulation techniques.
Our therapists have extensive training in DBT and practice using the DBT skills themselves. Asking for help can be difficult due to the historical stigma placed on those with mental health concerns and those seeking help. DBT in St. Pete, FL works to reduce feelings of judgment by creating a collaborative therapeutic relationship. A DBT therapist can relate with you in skill application as they have practiced using all the skills and currently apply them to their own life.
Borderline Personality Disorder (BPD) Symptoms
Not everyone who experiences strong emotions develops borderline personality disorder (BPD). In fact, many people may learn strategies to manage their strong emotional reactions. Yet, even the most adaptive strategies across time may no longer be congruent with your current goals and environment. These behaviors often reduce distress in the immediate context. Yet, they may increase distress in the long term.
The diagnosis of BPD may appear intimidating. But, it is only a grouping of common symptoms displayed by individuals who may benefit from formalized intervention. Some individuals may display one, several, or all the associated symptoms. If you are displaying some of the listed symptoms below you may be experiencing symptoms associated with the diagnosis of BPD.
- You often act frantically in an attempt to avoid real or imagined abandonment from individuals in your life.
- You have a pattern of unstable and/or intense interpersonal relationships. This may look like you idolize someone and then devalue them.
- You have an unstable view of yourself or your self-image.
- You often act in impulsive ways. This may look like but is not limited to spending money, sex, substance abuse, reckless driving, and/or binge eating.
- You feel unstable in your emotions because you often respond in intense ways. This may include but is not limited to high experiences of anger and/or anxiety.
- You experience chronic feelings of emptiness.
- You experience strong levels of anger and have difficulty controlling anger.
- You’re often paranoid and/or feel disconnected from your body/experiences.
- You have thoughts of hurting or killing yourself.
Dialectical Behavior Therapy (DBT)
Our therapists, Dr. Huffman and Dr. Devlin, have extensive training in DBT. In addition to learning the scientific application of the skills and theory to clients, they have actively learned and applied the skills to their own life. Dr. Huffman has published peer-reviewed articles on the effectiveness of DBT. They have also presented at the International Society for the Improvement and Teaching of Dialectal Behavior Therapy conference. Further, he has been awarded second place for outstanding research in DBT for his research entitled “Substance Use on Consumer Emotion Regulation, Attendance, and Graduation from a DBT Intensive Outpatient Community Mental Health Center” by the International Society for the Improvement and Teaching of Dialectal Behavior Therapy.
What is DBT?
DBT is a scientifically supported evidence-based treatment. It is used for individuals who experience “out-of-control” cognitive, emotional, and behavioral symptoms. It was first developed by Dr. Marsha Linehan to help individuals learn to manage their thoughts, emotions, and behaviors. Since its development, it has gained national and international recognition for its effectiveness and scientific support. For example, the Society of Clinical Psychology (Division 12) of the American Psychological Association’s empirical review has noted DBT’s strong research support for the treatment of BPD. In addition to BPD, DBT has demonstrated support for its application to manage symptoms associated with:
- Substance use disorder
- Major depressive disorder (MDD)
- Generalized anxiety disorder (GAD)
- Bipolar disorder
- Anger
- Suicidal ideation
- Self-injurious behavior
- And suicidal behavior
Further, research has also demonstrated support for combining DBT with prolonged exposure for the treatment of post-traumatic stress disorder (PTSD). And, challenges associated with emotion regulation after traumatic experiences.
DBT is a comprehensive behavioral intervention that often contains 4 major domains of emphasis:
- Mindfulness skills
- Distress tolerance skills
- Emotion regulation skills
- Interpersonal effectiveness skills
The goal of DBT is to learn skills in all 4 domains and apply them consistently to your lived experience. To encourage the application of the skills to daily living, DBT is organized into 4 primary components:
- Individual therapy
- Skills training group
- Phone coaching
- Consultation team
During individual therapy, you learn how to apply the skills to your individual life and lived experiences. The skills group is a place to go with others and learn the skills in a classroom-like setting. Phone coaching is then provided to assist you in the application of the skills outside of the therapy session. Finally, a consultation is conducted with a DBT therapist to encourage their use of the skills and process their own challenges related to work and/or personal experiences.
DBT has a planned approach to treatment. It guides the single-session therapy and the process of therapy. The reason for this is to learn to manage the most acute symptoms before moving on to other areas of concern. So, your DBT therapist will work with you on applying the acquired skills in sequential order. They will address the most acute to least acute symptoms.
While all difficulties can be discussed in each session, the focus of therapy will work sequentially through these areas of emphasis:
- Life-threatening behaviors
- Treatment interfering behaviors
- Quality of life interfering behaviors
DBT is often thought of as a skills-based intervention. But, it also contains a critical dialectical philosophy at the core of its conceptualization. Dialectics is the method used to identify how our brains often conceptualize our experience and the world in opposites or contradictions. For example, you might think I am either a “good person” or a “bad person.” You may also think you should work to “accept” your current position or “change” it entirely. This way of being is common and often contributes to the development and maintenance of maladaptive behaviors. Yet, life is rarely experienced in the extremes.
The goal of DBT is to allow the synthesis of opposites so that our diverse experiences can be “true” at the same time.
For example, a central dialectic in DBT is that of acceptance and change. DBT proposes we must allow both acceptance and change to exist, such that work in therapy will encourage radical acceptance of your current position. All while working with you to enact change at the same time. DBT assumes that your behavior can not be understood separately from your environment. DBT also recognizes that change can be difficult. Thus, therapy focuses on the interaction between you and your environment. And, the application of skills to better assist you in managing your emotions and in structuring the environment to assist in this management.
How do we monitor skills application and treatment in DBT?
DBT skills application and your weekly experiences are monitored through a “diary card.” The diary card is a weekly behavioral and emotional tracker. This allows you to record your daily experiences. Items traditionally recorded on the diary card are your:
- Emotions (e.g., anger, sadness, shame, fear, envy, jealousy, joy, love)
- Behaviors (self-harm, suicidal behaviors, drug use)
- Thoughts
- Urges
- And experiences of physical misery
These are recorded with a number system so that comparisons across weeks in functioning can occur. This allows for a common language between the DBT therapist and the client. The diary card also requires you to record your DBT skill use and its effectiveness. This encourages you to apply the information you are learning outside of therapy and bridges the time between sessions. In addition, the diary card allows your DBT therapist to better understand you and facilitates the selection and adaptation of skills based on your experience of their effectiveness across applications in various settings.
What does DBT look like at Wellness Psychological Services?
At this time, Wellness Psychological Services is offering individual DBT therapy and consultation. In general, you can expect to engage in one-hour weekly therapy sessions with an individual therapist. Group skills training and phone coaching are not provided at this time. But, we are hopeful we can provide these services in the future. Still, research has noted the effectiveness of individual DBT, without formal group skills training.
Research has noted its potential benefits in reducing costs for consumers by only having to pay for one individual session a week. Therefore, in your individual sessions, you will learn the information normally taught during the skills training groups. You will practice them in session, and learn how to apply them in your life. Engaging with DBT in this way has its benefits and consequences (it’s a dialectic). Yet, some potential benefits are that you may apply the learned skills to your own experiences faster and feel more comfortable learning in the one-on-one individual therapy sessions.
Our therapists conduct a consulting team. This adheres them to using the DBT framework in their professional work. But, it also encourages them to apply the DBT skills to their own lived experiences. This ensures that you are receiving the highest quality DBT services as the DBT therapists provide each other with feedback on skill selection, application, and modification for themselves and the clients they serve.
Where can I find more information?
The Society of Clinical Psychology (Division 12) of the American Psychological Association (APA) provides scientifically-supported information on the effectiveness of DBT. On their webpage, you can find handouts, worksheets, self-help books, web-based applications, and information on the clinical trials of DBT. You can also find recorded example sessions of DBT so that you may briefly see how a traditional DBT therapy session is conducted. The information on Division 12 of the APA is updated on a regular basis. They publish the most up-to-date peer-reviewed information on treatments and disorders. To learn more, please visit this link.
Begin DBT in St. Pete, FL, Tampa, FL, and Tampa Bay
Our team of caring therapists would be happy to offer support in helping you manage your emotions. We are happy to offer support from our Tampa, FL-based practice, and across Florida. You can contact Wellness Psychological Services to start your therapy journey today!
Other Services Offered with Wellness Psychological Services
We’re happy to offer multiple services in support of your mental health. We are happy to offer online therapy, counseling for depression and bipolar disorder, anxiety, stress management, relationship problems, testing and evaluation, OCD, and EMDR therapy. We also provide support for people dealing with relationship issues. Our couples therapists focus on marriage counseling, divorce discernment, and collaborative divorce. We also offer therapy for professionals, eating disorder treatment, life coaching, and more. Contact Wellness Psychological Services in Tampa Bay, FL today to learn more.