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DBT: Hulk approved treatment for managing emotions!


In episode 2 of Marvel’s series She-Hulk, Bruce works with Jen to manage her emotions and thus control her inner Hulk. He tries to teach her DBT starting with meditation, but it’s clear Jen is not ready for such a structured skill-based treatment. https://www.youtube.com/watch?v=4iDa-D0WG3Q


Dialectical Behavior Therapy was developed to help clients dealing with borderline personality disorder. It has since been shown to be effective with teens struggling with self-harm and suicide ideation and is often the go-to approach in IOPs. https://behavioraltech.org/wp-content/uploads/2018/04/RCT4ModesResearchDatatoDate2016.06.28-new-logo.pdf


The D in DBT is Dialectical. This means that 2 seemingly opposite things can be true at the same time. You can do well on math tests AND hate math. If you are in an abusive relationship, you can love your partner AND need to end the relationship. In therapy, a DBT therapist knows you are doing the best you can AND that you want to do better.


The B in DBT is Behavioral. DBT is not client centered or attachment based. It is not talking about whatever is on your mind for the week. It is about changing behaviors with the idea that doing so will effect your emotions and your inner thoughts. (DBT is a cousin to CBT.)


DBT is a very structured, skill-based therapy. True DBT therapists use a prescribed outline for each session and are not as concerned with history or the why of an issue. That’s not to say they don’t care at all - one of DBT’s goals is to help clients achieve a life worth living and therapy usually helps with that. Most of your time with a DBT therapist, however, will be learning the 4 modules: mindfulness, emotion regulation, interpersonal skills, and distress tolerance. You will work in a group to learn the skills associated with each module and then one-on-one with a therapist to apply them to your specific situation. Kids and teens will also work with their family to reinforce the skills at home.


I call myself DBT-informed. One, because I’m not a certified DBT therapist. And two, because my clients are not in a skill group. But also because I do believe our past experiences are important to our current situation and like to use a psychodynamic approach as the foundation. The DBT skills, though, really come in handy with the teens and young adults I work with. Wouldn’t it be great to have some steps to follow to manage the all those peer conflicts? And what if you are really freaking out about a fight you had with your ex or the anxiety that comes with a horrible math test? In the moment, you are not processing a past experience - you just need relief! Having a few skills in your backpack helps.


For more information on how DBT works, check out this site:

https://dbt.tools/index.php

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