DBT stands for Dialectical Behavior Therapy. What the heck does dialectical mean anyway?

Dialectic is a word that describes how both the thesis and the antithesis of a perspective can both be true. Put another way, for every statement or interpretation, there exists an opposite. A dialectical stance holds that both of these opposites can be simultaneously true. In fact, in DBT we often describe dialectics as two opposing truths.

For example, you might really want to change parts of your life (thesis) and think that change is impossible (antithesis). In DBT, we try to find the synthesis between these opposing truths. We aren’t looking for some sort of compromise, or “winning” thought, but the integration of the two. So, a dialectical frame of wanting to change would be, “You want to change your life, and you’re not sure how.” You might even find yourself struggling with the dialectical thought, “I want my life to change, and I don’t want to do things different.” In fact, DBT therapists assume that people engage in ineffective coping strategies (like drinking or self-injury) because those strategies work in some way. For many people we work with, those behaviors are the only thing they’ve found that helps them survive emotional misery. 

This truth is reflected in the foundational dialectic in DBT: acceptance and change.

DBT therapists believe that everyone is doing the best they can, that they want their lives to improve, and that they need to work harder. In fact, DBT was developed because therapies that focused on acceptance OR that pushed hard for change were ineffective with many emotionally sensitive clients. In the short term, people tend to like heavily acceptance based therapies. They might feel comforted and understood by another person. At the same time, their lives are unlikely to change. Let’s say you desperately want a romantic relationship. Acceptance based therapies might lead to validation of your pain. Your therapist might make statements about how hard dating is, or why dating is particularly difficult for you. 5 months later, you’re still likely to be single. We often refer to these validation heavy therapies as “traditional talk therapy.” Contrast that approach with a change oriented therapy…You might be told exactly what to do in order to get into a romantic relationship and the tasks might feel completely impossible! You know you couldn’t message someone back on a dating app or create a profile on match.com! The solutions of therapists from a change oriented only perspective feel impractical, impossible, or overly simplistic. 

DBT therapists try to bring together these approaches by using validation and insight (acceptance based techniques) to make changing behavior possible. DBT creator Marsha Linehan describes this as sweet coating that allows you to swallow the bitter pill. As DBT therapists, we know that change is incredibly painful and difficult. The metaphor often used is “You are in hell. The path out of hell is an aluminum ladder sitting in the coals.” This emphasizes the foundational truth that change is often painful and that it’s the only way out of emotional hell. This paradoxical statement is a great example of dialectical thinking common to DBT. 

One of the primary goals in DBT is to increase our ability to think (and act) dialectically. The first step towards dialectical thinking is to try to see things from another perspective. This is also called cognitive flexibility. Looking for the “kernel of truth” in another perspective can be self-validating. It might allow you to see why you struggle to make changes in your life even when you’re very motivated to change! In you are in a disagreement with someone else, trying to see the truth in their perspective, to put yourself in their shoes, might lead to understanding of their viewpoint and decrease frustration. 

My favorite dialectical strategy, though one that often requires some willingness, is to make lemonade out of lemons. Said another way, we look for the silver lining, or the benefit that comes from even very painful experiences. For example, even when your day is straight out of Alexander and the Terrible, Horrible, No Good, Very Bad Day category, you’re given an excellent opportunity to practice skills. Often, if we think back over painful experiences we’ve had, we’re able to see some benefit (even if its small). 

These strategies, of looking for what is being left out, of finding the kernel of truth, or of making lemonade, are all ways to encourage dialectical thinking. Thinking with increased flexibility, and letting go of rigid black and white perspectives, is a key task of DBT, and can help you climb the ladder out of suffering and towards a life worth living.

At Front Range Treatment Center, we specialize in DBT. Contact us today to schedule an appointment, or speak to a DBT therapist to learn how DBT can help you reach your goals.