Happy Monday and welcome to your mental health Mini.

This week is a solo and we are talking about DBT.

If you're new here, you're like, what the heck is DBTDBT stands for dialectical Behavioral therapy and it was a therapy protocol that was developed by Marsha Linehan that addresses individuals that are struggling with borderline personality disorder and suicidal ideations.

So it's individuals that are struggling in a really big way.

They're struggling to regulate their emotions, they're struggling to be interpersonally effective, and things across the board are really tough.

And they've had challenges in the past with getting support and therapy, seeing things get better, shifting their emotions, their thoughts, their urges, etcetera.

So when Marshall in a hand started developing DPT, she found that with these really depressed, suicidal, struggling patients that if you told them to accept their situation, they rejected that.

They were like, you're saying things can't change.

You're saying I'm stuck like this forever, You're not able to help me.

What the heck is your job?

That they would get really upset and pissed off, but then when you told them to change their situation, they would say, this is my fault.

Like, what are you talking about?

Like, I didn't do this to myself.

Why do I have to deal with this?

This isn't my problem.

And so with DBT, there is this perfect blend of the two.

It's a dialectic, which is why DBT is called dialectical behavioral therapy.

So you're balancing acceptance and change and you're accepting the situation that you're in and you're working to change it and you're doing both of those things at the same time.

And Marshall in a hand found that this was a really effective way to validate patients and also motivate them to work on what it was that they were dealing with.

So as I mentioned, this population that DBT was developed for had a lot going on.

There was all of these crises that they were dealing with on a daily basis, on a weekly basis.

And I can speak from my own experience going to DBT, it was like I had this maladaptive coping mechanism come up.

I got in this giant argument with my parents.

I hate this aspect of my life.

I'm so hopeless here.

I have no motivate.

Like everything is basically a burning fire, overwhelming code red.

Everything is the worst, always, all the time.

So you have all of these crises going on, and in DBT they've come up with a really effective way to address these and a hierarchy in which you deal with these things to get effective therapy outcomes and to make sure that you're doing the correct order of operations.

We've all heard of order of operations.

Probably for math, Like first we're going to do parentheses and then we're going to do our exponents, and then we're multiplying and dividing, and then we're doing addition and subtraction.

Same thing exists for therapy.

And in therapy, there's 4 stages.

In stage one, we are addressing severe behavioral discontrol.

In stage 2, we're talking about quiet desperation, and stage 3 we're addressing problems in living, and stage 4 is incompleteness.

So there's actually even a DBT House of treatment, but basically the bottom house is on fire.

As we talked about, we are a hot mess at this point.

So when we look at this DBT house, sometimes people will call the first stage living in hell because that's what the experience is for a lot of people.

It's overwhelmed, it's distressed, it's constantly being unhappy and ineffective.

And so when you see the DBT house, the first floor is actually on fire.

And so this is the stage 1 of addressing severe behavioral dysfunction.

This is also called addressing life threatening behaviors.

So when we're in stage one, we're getting in control.

So we are addressing life threatening behaviors.

And so within this life threatening behavior, it's things like self harm, suicidal ideation, anything that increases those urges, those thought patterns, etcetera.

What's interesting about DBT is that things like substance use, binge eating, not taking prescribed medication, if you get in trouble with the law, like none of those are considered life threatening behaviors, are considered quality of life interfering behaviors.

So again, when we are in stage one, we are only focusing on life threatening behaviors.

That is including not only the actions you're taking, the behaviors you're engaging in, but also the urges that are coming up and past experiences with those maladaptive coping mechanisms.

So that is the baseline.

That's the floor of the house.

We're on fire, we're overwhelmed, we're distressed.

That is stage one.

That is what you are addressing when you're going into DPT treatment.

Now we're on the second floor of the house.

This is stage 2.

This is called quiet inspiration and this stage you are getting in touch.

So stage one, we are getting in control here.

We're getting in touch and we're working on emotional experiencing and we're doing both exposure therapy and also doing some cognitive restructuring to work to reduce your overall suffering.

And within this encapsulates your quality of life interfering behavior.

So things like drug use, binge eating, not taking prescribed medication, legal problems, relationship issues, hierosexual behavioral, job loss and financial issues, those are all quality of life interfering behaviors.

They're not life threatening, but they are impacting your quality of life.

And those are addressed in stage 2.

And then stage 3 is problems in living.

So we've got in control, we've gotten in touch, now we're getting a life.

So we are identifying, working towards our life goals, we're increasing our self respect and we're both increasing happiness and decreasing unhappiness, but it's in a more normal scale.

So it's called ordinary happiness and unhappiness.

So we're not in stage 1, the house is on fire.

We're constantly overwhelmed.

It's like a normal wave of emotions.

And then the final stage, the roof of the house is incompleteness because we know that the journey is never over.

You're not like, OK, I got to the top of the house.

I've gone through DBT, my life is perfect.

You're going to continue to implement those skills to the rest of your life.

So it's that radical acceptance of like, OK, I've done the work, I've given myself the skills to be able to navigate the challenges that life throws at me.

And this is not the ending point.

Life continues as life goes on and I will be OK.

If you enjoyed this week's mental health mini, you can listen to the full episode.

It is #146 with yours truly.

A link to the full episode is in the show notes.

As always, make sure to leave a review, subscribe, share with the friend or family member, and follow at at She Persisted podcast.

Thanks for listening.