Dialectical Behavior Therapy (DBT)

A three-part model of mind — emotional, reasonable, wise — plus the best skills manual anyone has written for a bad night.

Description

Marsha Linehan built DBT for people who were repeatedly in danger, which shows in the design: it is concrete, drilled, and assumes you will need it at 3am when nothing subtle is available. It is also, without meaning to be, a parts model.

Emotion mind is the state where feeling drives the bus. Reasonable mind is the state where cool logic does. Read across, and emotion mind is very nearly all the firefighters at once and reasonable mind very nearly all the managers at once — the same two coalitions IFS spends its time between, collapsed into two named states instead of a cast list. Wise mind is the overlap, and it is described as quiet, certain, settled, arrived at rather than argued into. That is Self, or near enough that we have stopped being surprised by it, and it is notable that a behavioural programme with no interest in metaphysics ended up pointing at the same thing as the contemplative traditions.

Its real gift is the skills, and specifically distress tolerance: cold water on the face, paced breathing, intense exercise, the things that work on physiology when nothing works on thought. IFS asks firefighters to trust you and step back. That is the better long-term deal and it requires a relationship that doesn’t exist yet at 3am. DBT gives the system something to do in the meantime that is not the thing it usually does, and a firefighter that has been given a workable alternative is markedly easier to negotiate with later.

The coarseness is the trade. Two coalitions and a wise middle is a much lower-resolution picture than a system of parts with histories, and it will not find the exile under the behaviour. For a lot of people, in a lot of weeks, low resolution and reliable beats high resolution and unavailable.

What Dialectical Behavior Therapy (DBT) is NOT:

Not a way of overruling emotion mind — the dialectic is acceptance and change, and programmes that drop the acceptance half produce very compliant, very unhappy people. Also not only for crisis, though that is where it earns its keep. And wise mind is not a third voice arguing with the other two.

Examples:

Cold water and paced breathing before any attempt to talk to the part.
Noticing you are entirely in emotion mind, and that naming it moves you slightly.
An answer from wise mind that is quiet and doesn’t need defending.

see also:

Reactive parts - firefighters; Proactive parts - managers; Self; Window of Tolerance; Titration; Acceptance & Commitment Therapy (ACT)