Sometimes life feels very difficult, almost unbearable and we are left desolate and helpless. Dealing with the intensity of one’s emotions can be challenging and this might lead one to take extreme measures by over consuming alcohol and drugs, having a lot of sex, self harming, having suicidal ideation and loosing our boundaries with other people, to the point of one’s own self destruction. In such instances, we cannot handle the sensations and feeling that are coursing though the bodymind and we don’t want to feel them. Our nervous system is fraught with arousal and we do not have the necessary psychological skills to self soothe and self regulate. We attempt to drown out or change the feelings we experience be it anger, jealousy, sadness or frustration, often with very unproductive and temporary methods. Yet, while tragically these coping strategies bring us limited relief, the underlying problem continues to be with us, haunting us and goading us to continue in our self destruction.
Often cases of trauma constrain an individual’s ability to tolerate distress and the DSM V psychological disorders known as Borderline personality disorder, Bipolar disorder and other Mood disorders that show a constraint in managing grief or rage effectively have traumatic experiences underlying them. In such instances, it is extremely important to get the right psychotherapeutic support where the therapeutic work does not remain at the level of talk only. It is important to be able to tolerate emotions by feeling them in the body and being mindful of our experience where we can balance our emotions with our thoughts, our mind with our body, our internal world with the external world and ourselves in relation to others. Dialectical Behaviour Therapy (DBT) is a therapeutic modality to work with intense emotions and low levels of affect tolerance to enhance mood management, prevent self harm and promote well being. DBT was founded by Marsha Linehan and is, at its a core, a set of self soothing and self regulating skills that help individuals gain their equilibrium in the most trying of circumstances. It is noninvasive and medication free, premised on refining an individual’s self awareness, reframing thought processes and birthing new wholesome behaviours.
DBT is a progression from Cognitive Behaviour Therapy where the contemplative side of the individual is engaged through integrating a mindfulness practice along with cognitive and behavioural therapeutic practices. In its essence, DBT consists of 4 dominant skills- distress tolerance, mindfulness, emotional regulation and interpersonal effectiveness. It teaches one to live in the present moment while moving through very disturbing and difficult emotional states. DBT primes individuals to draw on their higher minds and radically accept circumstances they cannot change while not feeling victimised by them. My clients who have persevered with DBT show remarkable progress in managing the stresses and contingencies of their life, it is not that they do not feel sad or angry or hurt anymore but they have the ability to make space for these emotions and utilise their energies in ways that are productive and beneficial as opposed to ways that are self destructive and malefic for themselves.