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Dialectical Behavior

Dialectical Behavior Therapy (DBT) based on the paradoxical and biopsychosocial theories of psychological functioning. These theoretical orientations analyze the individual aspects (a behavior) of a system or are largely related to other parts of that system (context, environment, and other behaviors) (culture).

More specifically, DBT aims to change the behavioral, emotional, intellectual, and personal patterns that hinder individuals from the life they want. It consists of 4 modules: attention, personal effectiveness, emotion control, and distress tolerance.

It is a modified form of cognitive behavioural therapy, with its main goals directed towards teaching people how to live in the present. They are also taught to manage stress, improve relationships with others, and control their emotions.

Who needs dialectical behaviour therapy?


Though originally meant for treating individuals with borderline personality disorder (BPD), this therapy has been modified to treat a host of other conditions concerning mental well-being. It is immensely helpful to people who sport self-destructive behaviours leading to eating disorders, substance abuse, and other conditions like PTSD.

DBT aims to change behavioural, personal, emotional, and intellectual patterns that may hinder their daily lives or those which they want to lead. The 4 general modules are followed up in DBT for any individual related to attention, emotion control, personal effectiveness, and tolerance of distress.

DBT may be an effective treatment for bipolar disorder (BPD), ADHD, and eating disorders such as binge eating, bulimia nervosa, anorexia nervosa, GAD, non-suicidal self-injury, substance abuse, etc., among others.

Techniques used in DBT


DBT has now become an evidence-based therapy approach that is used to treat many mental well-being conditions of individuals.

• Patients are taught behavioural skills in a group setting

• Used in individual therapy when the behavioural skills learned by the patient are adapted in a one-on-one setting
• Used in phone coaching when patients call in between the sessions for help to handle difficult situations they are facing then

In the core mindfulness technique, patients are taught to focus always on the ‘now’. This turns the attention to what is happening inside you and also helps to tune your senses to what is happening around you. This helps you slow down during times of emotional pain. It also helps you to avoid indulging in impulsive behaviour and automatic negative thinking behaviour.

Distress tolerance allows you to accept yourself and come to terms with the current situation. It teaches you techniques such as distraction, improving the present moment, self-soothing and realising the pros and cons of not being able to tolerate distress. These help you to handle intense emotions as they come to you and develop a long-term positive outlook.

Interpersonal skill is developing a quality of becoming more assertive in a relationship while managing to keep it positive and healthy. You learn to listen to others, communicate properly, respect others and yourself and deal with challenging situations.

Emotion regulation allows you to sail through your feelings in a very effective manner. It will help you to identify and change your emotions if required. Recognizing and coping with intensive negative emotions reduces emotional vulnerability.

What happens in DBT treatment


DBT treatment happens in 4 stages.

During Stage 1, the most self-destructive (suicidal, self-harm/injury) behaviours are identified and addressed. Stage 2 involves addressing those issues that affect the patient’s quality of life (ability to tolerate distress, interpersonal effectiveness, emotional regulation skills). In stage 3, all issues related to interpersonal relationships and self-esteem are handled and, in Stage 4, people are taught to experience the most happiness and pursue life goals.

Benefits of DBT


• You will learn strategies acceptance and positive change.
• You will learn to identify destructive behaviour patterns and replace them with positive ones.
• You will focus on beliefs and changing thoughts that are not helpful or effective.
• You will learn to communicate and collaborate effectively and work together as a team along with the therapist/group therapist/psychiatrist.
• You will learn new skills which will serve to enhance your capabilities.
• You will be taught to recognize your positive strengths/attributes and also develop and use them.