In 2003 my husband was diagnosed with bipolar disorder, I looked for an effective therapy. If I could find something that we could use together, my husband and I would have a better chance of keeping our marriage. We both had dabbled in meditation. My husband’s mind however, was racing. We understood how mindfulness and meditation were beneficial, we just didn’t know how to get there. When we found DBT, we knew it was the answer.
DBT has been developed and successfully implemented in the treatment of bipolar disorder, binge eating, chronic substance abuse, self-mutilation, depression and anxiety. DBT takes the best of cognitive and behavioral therapies to formulate an intensive treatment. Without appropriate skills, people with mood and personality disorders tend to swing from logical mind to emotional mind. With DBT skills, the same people learn to move gently into wise mind, finding understanding. There are four components: Mindfulness, Emotional Regulation, Distress Tolerance, and Interpersonal Relationships. The skills trainer “pushes” the skills and therapist “pulls” those skills out clients, helping them apply their skills to real life. Mindfulness is broken into “what” and “how” skills. There are five “what” skills. One skill is learning the difference between observing and describing our thoughts and feelings. Another skill is full participation in life. Another skill is alertness to every thought and feeling. Yet another skill is recognition of self-sabotaging thoughts. The last “what” skill is awareness how thought plus emotion equals behavior. “How” skills include being non-judgmental and doing things mindfully. Another “how” skill is choosing to do what works.
“Emotional regulation” means learning to normalize the intensity of behavior. Increasing mindfulness without judging or controlling emotion is the key here. One must learn to go through an emotion, not around it.
“Distress tolerance” is radical acceptance. Radical acceptance accepts an unpleasant situation while at the same time, believing that the situation could be changed. One must also work on changing the situation. Radical acceptance promotes change.
In the DBT program, clients contract to a minimum of 26 weeks of DBT Therapy and 26 hours of DBT Skills Training. There are nine assumptions that keep families and clients on track. They are:
1. People are doing the best they can.
2. People want to improve
3. People need to do better, try harder, and be more motivated to change.
4. People may not have caused their problems, but they must solve them.
5. The lives of clients and family members are painful as they are being lived.
6. Clients must apply new behaviors to important situations in their lives.
7. There is no absolute truth.
8. It is more effective to take things in a well-meaning way than to assume the worst.
9. Neither clients nor their families can fail in DBT.
In 2004, my husband and I started the Meehl Foundation. I became a pastoral counselor and a DBT Skills Trainer. In the spring of 2008, we will open Meehl House, a residential group home for people with bipolar disorder and borderline personality disorder. For more information on the Meehl Foundation’s outpatient DBT family, adolescent, and adult client programs, or information on transitional group homes, please contact us at
www.meehlfoundation.org or 979.798.5182.