Dialectical Behavior Therapy – Creating a life worth living

linehanCreating a life worth living – that is the essence of Dialectical Behavior Therapy or DBT for short. I’ve been wanting to write about DBT for a while now. It’s one of those new third-wave therapies that I wrote about recently in Incorporating mindfulness into your life. This is along the same lines as Acceptance and Commitment Therapy but is usually targeted towards different types of people.

DBT was developed by Dr. Marsha Linehan to be used with people diagnosed with Borderline Personality Disorder, a pervasive disorder that affects individuals emotional regulation and interpersonal relationships. However, its effects span way beyond those with Borderline Personality Disorder. We actually had the director of a county hospital in Los Angeles come and speak to us last year about how they use DBT with the people they see. The whole idea of it is behind the word “dialectical,” which comes from the word “dialectic,” which references the idea that there is truth in more than one perspective. Isn’t that a good line?! “There is truth from more than one perspective.” Can you find truth in someone else’s perspective?

One of the best things I learned from the seminar I heard on DBT was that everyone, including those with Borderline Personality Disorder, are all doing the best that they can. No one is ever wrong because things make sense in their head. There are contingencies… There are reasons for why they are doing what they are doing. There is a reason behind why anyone does that which they do.  This is the essence of dialectics – it doesn’t have to be about being right OR wrong – it can be about being right AND wrong.

Why is dialectics important? Well, think about something that you’re really trying to change. Perhaps you are having issues with a friend or child and you want to change the way that you interact with them. Or perhaps you’re trying to lose weight, change careers, whatever it is for you. Do you have something? The idea behind DBT is that it asks you to hold the idea of acceptance and change in your mind at one time. Can you tell the radical truth and be totally genuine with yourself to say that this is the situation as it is – without judgment and without blame – and just accept it for what it is. There is no changing the past. However, you can change the future and you have to be able to hold that hope for change and acceptance of the past in your mind at the same time.

One of the ideas that often comes up in DBT is being able to control your emotions and not getting too deep into them unnecessarily. To do this, we have to reorient our attention away from these emotions. A good analogy for this that is often used in DBT is the idea of the rider and the horse. As the rider, you have to take control of the horse, and if you don’t take control of the horse, the horse will go wherever it wants. Think of your true self as the rider and your thoughts as the horse. This is exactly how your mind operates. If you create this separation between you and your thoughts, you can be the rider so the mind does not wander.

These ideas are the beginnings of creating a life worth living – accepting that things don’t have to be either / or, but AND. You don’t have to be a mercy to your thoughts – you can be the one in control. Take your life back into your authentic self and create a life worth living.

Have you ever thought about these ideas? Can you accept what is AND think about changing the future? What kind of life do you want to create?

Are you the horse or the rider? Do you take control of your thoughts and reorient them when they go too far?

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Rubin Khoddam, PhD Clinical Psychology student at University of Southern California, founder of Psych Connection.

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Categories: Blogs by Rubin, Therapy

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10 replies


  1. Lessons in the Art of Living | Psych Connection
  2. Remove your inner thorn on the road to acceptance | Psych Connection
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  6. Don’t judge someone else’s experience based off of your own experience! | Psych Connection
  7. Dealing with reality: Release what could have been and accept what is! « Psych Connection
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