Dialectical behavior therapy (DBT) is a treatment that was originally created by Marsha Linehan and her team to treat individuals with borderline personality disorder (BPD). Folks with BPD have what’s called pervasive emotion dysregulation—in other words, they struggle to identify what they’re feeling, don’t have the skills to effectively manage the emotions that arise, and end up turning to problem behaviors (such as suicide attempts, self-harming behaviors, or substance use), in an attempt to cope.
To the right of me sat Natalie Portman. To the left of me sat the Crown Prince of Dubai. In front of me stood our Nobel laureate professor. And between them, I sat, holding within me the most infamous personality of all, my borderline personality disorder.
How do you effectively manage phone coaching with adolescents in DBT? By Britt H. Rathbone, MSSW, LCSW-C Therapists often identify phone coaching as a reason they are reluctant to implement dialectical behavior therapy (DBT) with adolescents. They fear that this necessary component of the treatment will be disruptive, unmanageable, and personally overwhelming. How do therapists avoid resentment, anger, and frustration with their clients while being available after hours?
Clients come to therapy because they require objective feedback that others are unable to give them (or that they are unable to accept from others). The very nature of our work is confronting maladaptive behaviors, but we need to do so in ways that are acceptable to the client, even when the feedback we must provide is painful.
In recent years, developments in neuroscience have offered significant breakthroughs in understanding the brain chemistry that contributes to the behaviors and suffering associated with borderline personality disorder. While mindfulness cannot change your genes, research is beginning to show that it can change the way your genes work (Smalley 2010).