What is DBT? Do I have to meditate?

Dialectical Behaviour Therapy (DBT) was developed by Dr. Marsha Linehan beginning in the 1990s to help treat suicidal clients. Having struggled herself with self-harming behaviours and having been in an out of psychiatric facilities during her young adult life,(see her NYTimes interview dated June 2011) Marsha understood first-hand how desperate the client and the family is to find help. Through her research, Marsha found that chronically suicidal people have two unique experiences: An extremely sensitive emotional system combined with an invalidating environment. The invalidating environment varies for each individual but in general, in early life, the environment (family, school, peer group etc.) did not accommodate for the strong emotional experiences, anxieties and preferences of these individuals. Thus begins a lifetime pattern of emotional suffering.

Marsha’s own healing and stability began with a Zen Buddhist practice from which DBT is born. DBT teaches clients emotion regulation, distress tolerance and interpersonal effectiveness. At the foundation of each of each of these skills is mindfulness. Combining Eastern Buddhism with Western psychology has created this very useful psychological tool now referred to as mindfulness practice. To define it as simply as possible, it is paying attention to this moment, in a particular way, without judgement, without needing things to change or remain the same.

Everyone, it seems, has heard of this useful tool since it is a media buzzword and celebrity trend however the discipline required to sit in meditation practice is often daunting. It helps to start with very short daily meditation, even 1 minute(!) is enough to start. Paying attention to your breathing, noticing and letting go of thoughts and accepting the present moment is all that is required. Nothing else. As time goes on, you can add more minutes to your practice. You DO NOT need a special cushion, a Buddha statue or incense. Any chair, any location will work.

In my work with clients I find DBT skills are useful for treating clients with a variety of struggles. DBT is an evidence-based treatment that has expanded beyond treating suicidal individuals and has been proven effective to treat addictive disorders, anxiety, depression and eating disorders. DBT requires the therapist take specialized training, engage in on-going consultation and is dedicated to their own daily mindfulness practice. Like Marsha’s Lineman’s example, the best therapy is born of personal experience, trudging a similar track and finding healing.

I honestly didn’t realize at the time that I was dealing with myself. But I suppose it’s true that I developed a therapy that provides the things I needed for so many years and never got.
Marsha Linehan