A short podcast (+1) by Brian Johnson introducing Dialectical Behavior Therapy (DBT). Johnson summarizes Marsha Linehan’s origins and core ideas: DBT balances acceptance and change (the dialectic) and uniquely integrates mindfulness as a therapeutic skill. He notes DBT’s evolution from treating suicidal/self-harm behaviors to broader applications, cites endorsements and historical recognition, and offers recommended readings and a brief reflective exercise.
Chapters
Hi, this is Brian. Welcome back to another heroic one. In the last several plus ones we've been chatting about Marsha Linehan's incredibly heroic story as told in her memoir Building a Life Worth Living. I mentioned the fact that I got the book after Peter Attia recommended Marsha's therapeutic model. It's called Dialectical Behavior Therapy, or DBT for short. Now, Attia found her approach life changingly helpful to optimize his emotional health, which I repeat is he considers an absolutely essential component to optimizing our longevity such that we can live longer and enjoy that longer life. So today I want to chat more about Dialectical Behavior Therapy. Let's get to work. First thing to know is that although DBT was originally created to help people with suicidal ideation and self harm behaviors build a life worth living, it has evolved to help people deal with a range of issues from addiction recovery to simply creating a great life. Marsha has trained over 10,000 therapists worldwide in DBT, and in 2011 the editors of Time magazine named DBT one of the 100 most important new science ideas of our time. So let's define dbt. Marsha tells us, and I quote, two things make DBT unique. The first is the dynamic balance between acceptance of oneself and one's situation in life on the one hand, and embracing change toward a better life on the other. That is what dialectics means, the balance of opposites and coming to a synthesis traditional psychotherapy focuses on, primarily on helping people change their behaviors, replacing negative behaviors with positive behaviors. She continues by saying, the solution I arrived at was to find a way to balance both acceptance and change, a dynamic dance between the two, back and forth, back and forth, back and forth. This balance between pursuing change strategies and pursuing acceptance strategies is a basis of DBT and unique to dbt. This emphasis on acceptance as a counterbalance to change flows directly from the integration of Eastern Zen practice as I experienced it, and Western psychological practice. And she says, the second aspect of DBT that makes it unique is the inclusion of mindfulness practice as a therapeutic skill, a first in psychotherapy. This, too, she says, came from my experience with Zen practice. At the time, the mid-1980s, mindfulness was something of an arcane subject, often dismissed as too New Agey to be taken seriously, particularly in academic circles. Now, as I'm sure you know, mindfulness is everywhere, not only in psychotherapy, but also in healthcare, business, education, sports, even the military. Now, once again, DBT is short for dialectical behavior therapy. Marsha tells us that the word dialect can be defined as a method of examining and discussing opposing ideas in order to find the truth. She says, I like to think of it as the tension or synthesis between opposites. And she says dialectical behavior therapy seemed an appropriate name, reflecting as it does, the tension between seeking change in a person and encouraging them to embrace acceptance. So I repeat, the dialectic of DBT is between seeking change and acceptance. Marshall also says dialectics allows opposites to coexist. You can be weak and you can be strong. You can be happy and you can be sad. In the dialectical worldview, everything is in a constant state of change. There is no absolute truth and no relative truth either. No absolute right or wrong. Truth evolves over time. Values that were held in the past might not be held in the present. Dialectics is the process of seeking the truth in the moment. Drawing on a synthesis of opposites, Marcia walks us through how important mindfulness is to dbt. She was inspired by the Buddhist monk Thich Nhat Hanh and his great book the Miracle of Mindfulness. Check out those notes. But wasn't ready to make mindfulness a central part of her work until she saw how another heroic psychologist, Ellen Langer, described it in her book Mindfulness. Check out those notes too. Now, for the record, Marsha defines mindfulness as the act of consciously focusing the mind in the present moment without judgment and without attachment to the moment. She says mindfulness practice is the repeated effort of bringing the mind back to the awareness of the present moment. It includes the repeated effort of letting go of judgments and letting go of attachment to current thoughts, emotions, sensations, activities, events, or life situations. And that's today's plus one. If you feel so inspired, let's do a quick little dialectical work. Take a moment to accept the reality of your current life. Now take a moment to commit to changing what you know needs changing in your life. Got it? Awesome. Now let's get more specific. What's one specific thing you know you need to accept? Then what's one specific thing you know you need to change? Got it. Awesome. Now, how can you put that wisdom into practice today? P.S. for more wisdom on Zen, check out our notes on Thich Nhat Hanh's Silence, fear, no mud, no lotus, and peace is every step. Plus John Cabot Zinn's Wherever you go, there you are and Joko Beck's Everyday Zen and David Reynolds Constructive living, all of which are linked in this +1 in the app.
