Finding the Dialectic in Dialectical Behavior Therapy (DBT)

Dialectics, in Dialectical Behavior Therapy, refers to the process of investigating and synthesizing apparently opposing or contradictory ideas. In DBT, there might be your truth and my truth, but there is no search for absolute truth. Instead, there is a dialog about our contradictory positions in which both can find a new meaning. It is not a search for resolution by establishing right and wrong, but a development of understanding, over time, that may never result in a final truth or indisputable fact.

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Extreme Emotion, Problem Behaviors and BPD: Dialectical Behavior Therapy’s Bio-Social Theory

What makes some people able to manage life’s daily stresses and burdens with equanimity, while others experience an emotional rollercoaster when they hit even the slightest bump in the road? Are they simply built differently? Is it a result of a better childhood? Traumatic experiences? Our DNA?

People diagnosed with Borderline Personality Disorder (BPD) often experience some of the greatest struggles with everyday obstacles. They frequently describe themselves as having problems controlling emotions, being moody, getting angry quickly and feeling like relationships are out of control. Superficial cutting, over or under eating, drinking excessively, substance abuse, using physical violence and interpersonal struggles with friends and family members are common high risk behaviors. Negative emotions and problem behaviors seem ever present, whether they want them or not.

In her book Cognitive Behavioral Treatment of Borderline Personality Disorder, Marsha Linehan, Ph.D., explains her bio-social theory for understanding where these problematic emotions and behaviors originate. Linehan’s theory suggests that BPD is primarily a dysfunction in how our bodies regulate emotions. In other words, some people are hard-wired to be more sensitive to emotional stimuli than others. Those who are diagnosed with BPD tend to be highly sensitive and reactive to emotional events.

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