Intro to Dialectical Behavior Therapy for Ending Self-Harm

This is the Introduction to a forthcoming series about learning and using dialectical behavior therapy (DBT) skills for self-harm. 

If you have been struggling with self-harm and are considering professional help as an option, you may have already come across a type of treatment called dialectical behavior therapy (DBT) for ending self-harm. Though many find success with other common therapies such as cognitive behavioral therapy (CBT), DBT has proved uniquely suited to patients who engage in self-harming behavior.

What Is Dialectical Behavioral Therapy (DBT)?

Dialectical behavior therapy is a specific type of psychotherapy designed to help patients learn how to regulate their emotions and use healthy coping skills. It was first developed by Marsha Linehan to treat patients with borderline personality disorder (BPD) and patients with chronic suicidal and/or self-harming tendencies.  

Currently, DBT is used to treat people with high emotional sensitivity and multiple, chronic, and/or severe mental health issues. In addition to BPD and self-harm, this can include conditions such as eating disorders, addiction, and posttraumatic stress disorder (PTSD).

What Is the Idea Behind DBT for Self-Harm and Other Problems?

The major theoretical premise behind DBT is that some people, as a combined result of biology and environment (nature and nurture), are predisposed toward emotional dysregulation. 

Emotion dysregulation can be defined simply as the experience of feeling overwhelming emotions due to heightened emotional vulnerability and an inability to modulate those emotions. 

This theory proposes that in those afflicted by emotional dysregulation, maladaptive behaviors (such as self-harm) are an attempt to regulate those emotions and/or a natural consequence of the emotional dysregulation, creating and reinforcing destructive patterns. Dialectical behavior therapy, then, aims to help people develop healthier coping skills and learn different ways of approaching and responding to emotional distress. 

How Effective Is DBT for Self-Harm?

A significant number of studies suggest that DBT is effective in treating several mental health issues, the most promising results showing improvements in those receiving treatment for BPD, PTSD, self-harm, and/or suicidal thinking. 

Regarding self-harm, for example, multiple controlled trials and independent studies conducted over the course of a year found that DBT definitely decreased self-harming behaviors at a greater rate than other treatments. According to the SAMHSA National Registry of Evidence-based Programs and Practices, one study even reported that compared to 9.33 incidents of self-harm in one month among participants receiving non-DBT treatment, participants receiving DBT were reported to have only 0.55 incidents of self-harm.

Though DBT, like anything else, has its limitations, it is one of the most studied and used treatments in the mental health field due to its proven efficacy. 

But What If I Can’t Afford or Access DBT Treatment? 

While effective, DBT is a very comprehensive and intensive type of treatment, and one not always available to every person who may need it. Ideally, of course, you would be able to receive treatment from a professional certified in DBT and have a full team of mental health professionals helping you along the way. There is no replacement for the kind of support and expertise you can receive from a professional team, and if you are able to access that kind of treatment, it is strongly recommended. 

However, if you cannot currently access DBT for whatever reason but are still interested in learning how to use DBT methods for self-harm either alone or to supplement to some other treatment, this series of articles will teach you specific skills you can use to understand and combat the impulses behind your self-harm.

Sources

1. Webb, Kristin, “DBT: An Overview.” UNC School of Social Work Clinical Lecture Institute. February 6, 2015. 
2. Good Therapy Staff, “Dialectical Behavior Therapy (DBT).” Goodtherapy.org. June 13, 2018.
3. New Harbinger Staff, “DBT for Adolescent Self-Harm and Suicidality.” Newharbinger.com. April 23, 2014.