Despite DBT being super effective with other mental health conditions than BPD, many people associate DBT with just BPD or with being severely mentally ill. These mistaken beliefs or myths can get in the way of people learning the skills they need to make their life worth living. One thing DBT is big on is busting myths, so here are some common myths people have about DBT and my challenges for them.
“DBT is only for people with BPD.”
People believing that one has to have BPD to do DBT is inaccurate and a stereotype. Like I said above, DBT has been found to be incredibly effective with tons of other mental health conditions, such as:
- ADHD
- Anxiety
- Autism
- Depression
- Eating disorders
- Mood disorders
- Non-suicidal self-injury
- PTSD
- OCD
- Other personality disorders
- Substance use disorders
These are some of the broad categories that DBT can help with. One reason that DBT helps with more than just BPD is because a client’s individual sessions are tailored to focus on the behaviors and things in their life that are causing them pain and suffering. DBT is a behavior therapy at heart, meaning that if it isn’t getting in the way of reaching your goals, then it won’t be addressed. Another reason why DBT is so effective is because of its focus on teaching new skills. DBT teaches clients mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills. The skills help people to solve the problems that are causing them pain and misery.
“DBT is just a set of coping skills.”
DBT does put a lot of emphasis on teaching clients new coping skills, but the skills aren’t all of DBT. DBT focuses on changing ineffective and potentially dangerous ways of coping and replacing those behaviors with more effective skills. In DBT, we look at what is causing and contributing to the situations where the ineffective behavior happened and how we can break the chain of events for the future. The skills are a part of DBT, but not the whole of it. If you’re doing a comprehensive DBT program, it includes individual therapy, skills training, phone coaching, and therapist consultation teams. For more info on the different components of DBT, check out this blog.
“DBT is too rigid or structured.”
DBT is structured in order to give some freedom. The skills training groups are highly structured to make sure that they’re getting through all of the information about the skills in 24 weeks. This frees up time in individual sessions to address the issues that are bringing you to therapy that would otherwise be taken up by learning skills. Like I mentioned earlier, what you’re focusing on in individual sessions is tailored to you and your goals. A way DBT does this is by creating a target hierarchy with clients. The point of the target hierarchy is to help address the specific behaviors that are getting in the way of you reaching your goals. If a higher priority behavior is present, then it is addressed before moving on to lower priority behaviors. Learn more here!
“DBT doesn’t work unless you do the full program.”
I do believe that everyone would benefit from DBT skills (I know, I’m biased), but not everyone needs the structure of comprehensive DBT or can afford a comprehensive DBT program. Most of the research on the efficacy of DBT has been done on comprehensive DBT programs, so I can see where this myth is coming from. Adapted versions of DBT, such as just doing only skills training or only individual therapy, have also been found to be beneficial. Doing what is called a DBT-informed approach and other adapted versions can be very beneficial if you don’t have access to a comprehensive program. The reason people may say that DBT doesn’t work unless it’s comprehensive is because there’s no guarantee that it will work, since you’re not getting the full benefits of DBT.
“If DBT doesn’t work immediately, it won’t work at all.”
Like most therapies, DBT takes time. Of course, it would be amazing if I could snap my fingers or wave a magic wand and solve all of my clients’ problems. Unfortunately, that isn’t how anything works. DBT does save lives, but it takes time and effort for that to happen. This is especially true for long-standing patterns in behavior. It takes time to learn new and more effective behaviors to replace the ineffective behaviors you’re wanting to change.
It’s normal to feel frustrated by a lack of progress! You’re putting in a lot of effort, and it is normal to want to see the fruit of your labor. If you start to feel frustrated with the rate of your progress, talk to your therapist about it! You might not notice the small changes that you’re making since you encounter them every day, but your therapist likely is seeing things that you aren’t since they have a more objective perspective.
“DBT invalidates emotions by focusing only on changing them.”
Your emotions are always valid because that is how you felt in that moment. However, your emotions may not always fit the facts of a situation, meaning that it would be most effective to change how you’re feeling. Changing your emotions can feel invalidating. It’s mood incongruent, meaning that it is going against what your emotions are driving you to do. For example, if you’re feeling depressed and want to isolate yourself, a mood incongruent action would be to go hang out with close friends. If something is mood incongruent, it might be harder to do, even if you really want to do it.
One of the guiding principles of DBT is balancing acceptance and change. Many of the skills are change-oriented, but before you can change anything, you have to accept it. You have to know what it is you’re trying to change if you want it to be effective. Acceptance is not against change; it is a prerequisite for it.
About the Author
Robyn Williams (she/her), M.A., LPC is a Licensed Professional Counselor who specializes in dialectical behavior therapy. Robyn works with teens and adults in a compassionate judgment-free manner to meet clients where they are in life. Robyn helps her clients develop the tools they need in order to live their life worth living, and find what means most to them. Robyn believes that while therapy can be intimidating at times, it can be a conduit for personal growth. Click here to learn more about Robyn’s experience and therapeutic approach.