Someone told me about Dialectical Behaviour Therapy as I was talking about Cognitive Behavioural Therapy and the limitations I felt CBT had. I took out this book from the library as I wanted to learn more about the framework of DBT and wanted to see if there were any practices that could help me in terms of personal growth.
I was rather uncomfortable reading this book. The authors do not say if their clients had severe childhood trauma, however, based on the stories they shared, their clients definitely sound like they had a traumatic childhood. This book is better suited for people with serious emotional problems as there were frequent references of people with cutting tendencies or those who threatened their loved ones by saying they will kill themselves if the loved one didn't meet their demand.
Some people here have commented how the authors reference the concept of spirituality. I do agree that I think the word spirituality has no place in therapy. We need to keep therapy secular. At the end of this book, the authors have an excerpt from their book, "The New Happiness: Practices for Spiritual Growth and Living with Intention." Here they define spirituality as, "living a life based on choices and actions that make you feel more connected with your deepest values." They go on to say that this book, The New Happiness, "defines spirituality as a process of doing rather than a process of believing." I think most people would be ok with this definition, however, we just don't even need to use that word. I mean, if that's what it means to you, sure but for me, living my life according to my values is just that - me living my life. I don't need to call it my spirituality or give it any other label. In Chapter 2 - Advanced Distress Tolerance Skills, they do talk about using a higher power, which is basically having faith in something bigger and more powerful than yourself. They claim that doing so can "make you feel empowered, safe, and calm." They do say a higher power doesn't have to be a god and they suggest on page 45 that you can have a higher power that is someone who can make you feel stronger and more confident, however, I do not think making a human a higher power is a good choice. I can see someone like a cult leader who takes advantage of people and manipulates them. Also I doubt that there is any science backing this claim that we need a higher power.
This book seems geared for people who have serious trouble with practicing self-restraint and emotional regulation so most of the content just didn't seem relevant for me. I did think Chapter 10 - Advanced Interpersonal Effectiveness Skills had some useful concepts. I thought the section on page 244 "Coping With Resistance and Conflict" was informative. They list 5 conflict management skills and they are:
1. Mutual validation. The authors claim that when people aren't listening to you, one of the common reasons is that they feel invalidated. Validating acknowledging their needs, feelings, and motivations. Depending on the context, some situations are not resolved even if you validate the other person. Humans are complex and many are driven by unconscious feelings that we most likely can never understand or help. All the validation in the world sometimes just doesn't work. It would be nice if the authors acknowledged the limitations of validating others.
2. Broken Record. This is basically repeating yourself and not giving someone ammunition. Examples the authors give are, "I just prefer it" or "That's just how I feel."
3. Probing. This is basically using questions to understand people. The key phrase the authors reference is, "What is it about (name the situation) that bothers you?" I can see this being usful in helping to understand the psychology of others as well since you are making an effort to understand what drives them in life. It seems like it would be useful to use in regular conversation as well as a way to deepen a friendship.
4. Clouding . This involves agreeing to some part of what they say and ignore the rest of the argument. One way is to agree or modify words of exaggeration such as "always" and "never." For example person says, "You never support me when I need something." You can respond by saying, "Yes there have been times when I couldn't completely support what you were asking."
5. Assertive Delay . Involves saying that you need time to think before you make a decision.
Chapter 1 - Basic Distress Tolerance Skills talks about using radical self-acceptance as a way to minimize self-destructive behaviours and to increase your distress tolerance skills. They have a list of pleasurable activities that people can engage in such as joining a public speaking group or take photographs. They advise using distraction, which I think is a good point since typically we think being distracted is a bad thing, however, we can use it constructively, especially in times when we are feeling volatile. For example, we can distract ourselves by leaving the situation or by doing tasks and chores. They end with talking about how to self-soothe and they reference the 5 senses as ways we can soothe ourselves such as looking at pictures we find comforting or by touching our pets. In Chapter 2 - Advanced Distress Tolerance Skills, they continue to discuss other techniques for managing stress and that includes visualizing a safe place or having a cue word. When they referenced having a cue word, I couldn't help but think of Frank Costanza's use of the phrase, "Serenity Now!" for when he was experiencing anger.
My only problem with this book is that I don't think they understand that people with these types of severe emotional problems probably have bodies that are highly stressed and in a constant state of vigilance. They just don't know how to relax on a physical level and so that impacts their daily interactions with people. They can become this way due to various traumas such as abuse in childhood, being in an accident, etc. I've done reading on trauma and read that our nervous system needs to relax and that the behaviours people engage in because they think are relaxing, are actually not relaxing for their body and continues to keep their nervous system on high alert. I found the books "The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma," and "Overcoming Depression" by Paul Gilbert to be helpful in understanding this idea. It's like the authors aren't asking themselves what is the cause that drives their clients to be so volatile and that to me is what is lacking in this book. I don't know if it's a lack in the book or a lack in the framework of DBT. They do reference a technique in chapter 2 page 59 called Feelings-Threat Balance (FTB-Cope) where you assess the level of the threat versus the strength of your feelings. They also reference using self-compassion and mindfulness, however, I just think they don't get the biology aspect.
Overall I thought this book was ok. I think it's probably best suited for those who are working with a psychiatrist on their issues and have serious emotional issues.