DBT Assumptions: Your Therapist’s Thoughts About You

Each type of therapy has its way of viewing the people it’s designed to treat. DBT therapists who practice adherently are trained to make certain assumptions about all of their clients. One of the most important things to remember about assumptions is that they are not facts. Assumptions, by their definition, are beliefs someone accepts without proof.

Clients are doing the best they can

DBT therapists, at their core, make the basic assumption their clients are doing their very best to live their lives. When individuals are not making progress toward their goals, others may say they are not trying. At times, clients themselves may say they will simply try harder. Rather than settling with this socially acceptable explanation, DBT encourages therapists and clients to look deeper at what is getting in the way. Often some more important goals or skills would be helpful to learn or practice.

plant growing in hand

Clients want to improve

Individuals with mental illness face the societal stigma that their symptoms stem from motivational deficits. Taking a step back, why wouldn’t someone want to improve? Especially if they’re suffering. Assuming that clients want to improve allows DBT therapists to identify obstacles that get in the way of finding peace and balance in clients’ lives.

Clients need to do better, try harder and be more motivated to change

Wait, I thought you just said that clients are doing their best and want to improve. How could they possibly need to do better, try harder, and be more motivated? Good question! DBT views this seeming conflict as a dialectic that leads to a deeper truth: Clients are doing their best and want to improve AND YET their efforts are not enough to meet the demands of their environment. So the therapist and client must work together to determine what gets in the way and how to manage it.

Clients may not have caused all of their problems, but they still have to solve them

This assumption is a rough one because our society vastly prefers to figure out who’s to blame rather than solve the problems at hand. It also helps sidestep that tendency and highlight the client’s responsibility to manage their behaviors and learn new skills to handle their problems, regardless of if they caused them. It’s so much more fun and entertaining to vent about how parents, society, or genetics made life so difficult, AND YET changing behaviors helps change outcomes for clients.

The lives of suicidal people are unbearable as they are currently being lived

Another point of stigma people with mental illness often face is the idea that their pain is manageable, tolerable, and altogether “not that bad.” For therapists who practice adherent DBT, we fully believe suicidal clients are suffering so much that hurting or killing themselves seems like a viable option. Rather than trying to convince these clients that it’s “all in their heads,” DBT therapists seek to validate these individuals’ pain and give them new options so they can build a life worth living.

Clients must learn new behaviors in all relevant contexts

Therapists who practice adherent DBT do not encourage their clients to avoid stressful or extreme situations when they are necessary. Instead, times of stress are considered times to learn new ways of coping using skills. This assumption does not mean that the therapist watches from the bleachers while clients suffer. Instead, the therapist provides encouragement and suggestions to help the client get through an intense crisis so they can learn how to manage life, even when it’s severely painful.

Clients cannot fail therapy

here to help

When clients are not successful in DBT, therapists assume that they and/or DBT failed the client. DBT therapists undergo intense and lengthy training to learn this treatment and yet, they can fail to follow a protocol, make a therapeutic misstep, or overlook an important detail. Although DBT is a very useful treatment for many people, it is not effective for everyone at all moments.

Therapists need support

To make sure therapists are providing the best care possible, DBT ensures they have a consultation team. This weekly meeting helps therapists learn how to apply DBT adherently, troubleshoot therapy-interfering behaviors, and get emotional support. Getting support ensures the therapist can provide consistent treatment in the long term.

If you’re interested in having a therapist who makes these assumptions about you, consider scheduling an appointment with us..