Dialectical Therapy (Form of Cognitive Therapy)
 

Dialectical Behavior Therapy (DBT) is the application of a broad array of cognitive and behavior therapy strategies to the problems of Borderline Personality Disorder (BPD), including suicidal behaviors. DBT also has a number of distinctive defining characteristics. As its name suggests, its overriding characteristic is an emphasis on "dialectics" - that is, the reconciliation of opposites in a continual process of synthesis. The most fundamental dialectic is the necessity of accepting patients just as they are within a context of trying to teach them to change. This emphasis on acceptance as a balance to change flows directly from the integration of a perspective drawn from Eastern (Zen) practice with Western psychological practice.

Stylistically, DBT blends a matter-of-fact, somewhat irreverent, and at times outrageous attitude about current and previous Para suicidal and other dysfunctional behaviors with the therapist warmth, flexibility, responsiveness to the patient, and strategic self-disclosure. Emotion regulation, interpersonal effectiveness, distress tolerance, core mindfulness, and self-management skills are actively taught. In all modes of treatment, the application of these skills is encouraged and coached. The tendency of borderline patients to actively avoid threatening situations is a continuing focus of DBT.

The focus on validating requires that the DBT therapist search for the grain of wisdom or truth inherent in each of the patient's responses and communicate that wisdom to the patient. Validation also involves frequent, sympathetic acknowledgement of the patient's sense of emotional desperation. Throughout treatment, the emphasis is on building and maintaining a positive, interpersonal, collaborative relationship between patient and therapist. A major characteristic of the therapeutic relationship is that the primary role of the therapist is as consultant to the patient, not as consultant to other individuals.

from Dr. Marsha M. Linehan's book, Cognitive-Behavioral Treatment of Borderline Personality Disorder (1993).