Dialectical Behavior Therapy: The Four Modules

Originally designed by Marsha Linehan, Ph.D. in the 1980s, Dialectical Behavior Therapy (DBT) was developed to help those struggling with borderline personality disorder. DBT merges eastern approaches and western therapies, including Cognitive Behavioral Therapy (CBT), which emphasizes a person’s ability to change their behaviors and thoughts. DBT is based on the assumption that self-destructive behaviors are caused by an inability to manage intense emotion.

Though originally created to treat borderline personality disorder, DBT has also been found effective for an array of mental illnesses, such as bipolar disorder and bulimia nervosa. As such, it can be – and has been – used as eating disorder treatment in Westport and elsewhere.

The Four Modules of Dialectical Behavior Therapy

In order to teach its patients how to manage their symptoms and engage in more effective coping behaviors, DBT offers the following four skill modules:

Mindfulness

Mindfulness is mastering how to be in control of your mind, instead of the other way around. This does not mean controlling your thoughts; rather, it is practicing the ability to focus your attention on the present moment without judgment.

Often, people with eating disorders find it difficult to stay in the moment and may have intrusive thoughts that direct their behavior. Mindfulness can disperse these thoughts and redirect the patient’s attention to the present moment so that they can take note of and accept whatever they are feeling at that time.

Emotion Regulation

Emotion regulation teaches how to describe and observe emotions without self-hatred, fear, or judgment. More often than not, people with eating disorders have difficulty not only with communicating their emotions, but also with identifying and experiencing them. Instead of suppressing or rejecting emotions, emotion regulation emphasizes the adaptive nature of feelings and teaches how to generate more positive ones.

Distress Tolerance

This skill is about learning how to get through a crisis without spiraling into despair and actions that may make matters worse. Often, people who lack distress tolerance skills will turn to their eating disorder as a way to cope with overwhelming emotions and difficult situations. Since the symptoms of the disorder are usually perceived as providing immediate relief in the face of distress, mastering the ability to tolerate and accept emotional pain is essential to recovery.

Distress tolerance aims to lessen harmful, impulsive behaviors, such as bingeing, purging, and self-harm, by giving alternative ways to cope with negative thoughts and emotions.

Interpersonal Effectiveness

Those with eating disorders often report difficulties with putting their desires before those of others and saying “no.” They also deal with self-esteem issues. All these factors can interfere with the development of healthy relationships and cause one to feel invalidated. When people feel invalidated, they are more likely to feel negative emotions and the urge for self-destructive behavior. After all, the ability to maintain fulfilling relationships and the ability to negotiate your needs with others are central to wellbeing. Interpersonal effectiveness provides concrete strategies on how to effectively communicate with other people and how to improve assertiveness and self-esteem.

DBT, with its four modules, is just one way to treat eating disorders. At The Center for Cognitive and Behavioral Health, we offer an array of treatments, including DBT and CBT, for a variety of conditions, such as anxiety, eating disorders, trauma, and substance abuse. Contact us today to learn more about our services.