Dialectics in DBT

DBT stands for Dialectical Behavioural Therapy. But what does this name really mean? Many of us will understand conceptually what ‘behavioural therapies’ are. But what on Earth is a ‘dialectic’?!

A dialectic occurs when multiple things – which are seemingly incompatible or opposite to one another – can both exist and be true simultaneously. For example, it is possible to be both happy and sad at the same time; to love someone and hate them at the same time; to be both scared but also willing and brave to push through that fear, at the same time.

The core dialectic in DBT is that of ‘Acceptance’ versus ‘Change’. Much of DBT is centred around balancing these two concepts. DBT aims to validate and accept someone’s experiences as understandable, whilst at the same time flagging them up as potentially maladaptive and requiring change.

In many situations, dialectics can be especially difficult for people with BPD to wrap their heads around. Generally, people with BPD tend to perceive life in a very all-or-nothing way. This means that we usually get stuck at the extreme ends of emotions, thoughts or behaviours and find it hard to see any other possibilities. We find it so difficult to live in the grey because often we simply do not see that there even is a grey at all… So, the fact that a synthesis of many different and often contradictory actualities can exist at the same time is a hard concept to master.

For example, if I have gotten into an argument with a close friend, I may become blinded by the situation and start to see them in an entirely negative light. I may experience intense anger and hatred towards them and believe that they are truly very awful indeed. I may convince myself that they are the worst person in the world and that our relationship is over. I may think of all the times they have hurt me in the past and find all the most fitting evidence I can in order to confirm my current negative perception of them as true.
(See this post on Teleological Thinking, for more!).

Finding the dialectic within this situation would involve being able to acknowledge the distressing emotions I am going through and validating my experiences, whilst simultaneously being able to keep in mind the strength of the relationship and possibility that things can be resolved:

  • The ‘Acceptance’ side of the dialectic could look like this:
    I acknowledge that yes, I am feeling incredibly angry towards my friend right now as a result of their actions. They have behaved in a way that has upset me profoundly, and as a result I am hurting. I am struggling to trust that things will resolve between us and have the urge to end our relationship for good. I feel let down, betrayed, misunderstood, angered and saddened by the situation.
  • The ‘Change’ side of the dialectic could look like this:
    My friend and I go back a long way and have a very strong and caring relationship. My friend is generally very supportive, attentive and loving. I have valued them in my life for a long time. Regardless of what has happened, I still care about them, and they still care about me. Perhaps there is a possibility that we will be able to get through this and that our friendship can survive like it has done many times before. 

Being able to hold these two opposing truths in mind at the same time is what we are aiming to achieve. Dialectical thinking encourages us to slow down and be more mindful, remain descriptive and less judgmental, and widen our perspective on what we deem to be true.

The use of the word “and” can be especially helpful here. For example, saying “This is a really difficult situation, AND I can get through it” is a simple but effective way to cheer-lead oneself to get through life’s challenges, whilst simultaneously validating them.

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