By Martha McLaughlin

Originally developed to treat borderline personality disorder, Dialectical Behavior Therapy (DBT) is a psychotherapy approach that’s used for a variety of conditions now. It involves both individual therapy and skills training, generally conducted in a group setting.

DBT focuses on balancing acceptance and change and teaching life-enhancement skills, with mindfulness as a core skill to be mastered. In DBT, every skill training session begins with a period of mindfulness meditation.

The Basic Components of Mindfulness in DBT

Meditating woman on office deskMindful magazine defines mindfulness as “the basic human ability to be fully present, aware of where we are and what we’re doing, and not overly reactive or overwhelmed by what’s going on around us.”1 At its core, mindfulness is a matter of focus. Our thoughts generally want to take us to the past or the future, but mindfulness helps us focus on the present moment.

In DBT, participants are taught to do the following when learning mindfulness:

  • Observe – Students are taught to monitor and collect data. Sometimes people focus on information coming in through their senses, such as sounds in the room or the physical features of an everyday object. The practice helps people learn to observe their thoughts and feelings in the same objective way.
  • Describe – Participants learn to put words to their observations. They learn to label their physical sensations and emotional states. This helps both with observing patterns and communicating with others.
  • Participate – In DBT, participation means acceptance with awareness. Students are taught to neither push away nor be consumed by the emotions and thoughts they observe. The goal is to be fully present.

DBT participants are taught to do these things non-judgmentally, one-mindfully and effectively. Let’s take a closer look at what each of these entails:

  • Being non-judgmental means observing thoughts and feelings objectively and impartially without deciding they’re right or wrong. Sometimes it’s described like watching clouds drift by in the sky or observing waves in the ocean.
  • When you’re one-mindful, you focus on the present moment and pay attention to one thing at a time, rather than multitasking or following thoughts and feelings wherever they lead. Mindfulness exercises often involve concentrating on things like breathing or the feel of feet on the floor in order to help the mind focus and prevent it from taking a journey.
  • Effectiveness simply means doing what works, balancing ideals with pragmatism. When it’s time to move from contemplation to action, decisions are based on goals and not unduly affected by judgments. It involves making choices in a given situation based on likely consequences and not always on the strength of feelings.

Want to hear more about how mindfulness and DBT can work together to strengthen mental health? Check out this interview with Dr. Eboni Webb, a renowned DBT educator, which originally appeared on the Recovery Unscripted podcast.

Benefits of Mindfulness

One of the benefits of mindfulness is that we learn to understand ourselves more fully. We begin to see emotional patterns and identify the thoughts that trigger them. This awareness can help us make decisions that move us toward our objectives. DBT calls this using our “wise mind,” which is the ideal intersection of our logical and emotional perspectives.

Learning mindfulness is helpful, in part, because even though the ability to focus on the present moment and observe our thoughts and feelings objectively is something we’re all capable of doing, it isn’t our default mode of operation. This is true of all of us but may be especially true for people who’ve had certain types of experiences. Someone with a history of not having her needs and emotional states validated, for example, may learn to downplay and not pay attention to them herself. When we fail to acknowledge our internal world, we can’t learn from the messages that our brain and heart are trying to send.

DBT has proven effective for a wide variety of mental health disorders, even when modified and adapted to different population groups.

  • A 2008 study examined people with treatment-resistant depression. Those who participated in DBT skills training, which included a focus on mindfulness, showed significantly more improvement than those who didn’t learn the skills.2
  • A 2012 study attempted to determine the effectiveness of the mindfulness module on its own for people with borderline personality disorder. The researchers found a correlation between the amount of time spent in mindfulness practice and improvement in psychiatric symptoms.3

If we can learn to spend less of our time on autopilot and more time being fully aware of the life we’re living, joy can be felt more fully and our other emotions can be observed and used as data to help us make emotionally healthy choices. We can acknowledge and accept our thoughts and feelings without being overcome or controlled by them. By understanding ourselves more deeply, we can learn to accept and love ourselves more fully.


Sources:

1What Is Mindfulness?Mindful, October 8, 2014.

2 Harley, Rebecca, et al. “Adaptation of Dialectical Behavior Therapy Skills Training Group for Treatment-Resistant Depression.” The Journal of Nervous and Mental Disease, February 2008.

3 Soler, Joaquim, et al. “Effects of the dialectical behavioral therapy-mindfulness module on attention in patients with borderline personality disorder.” Behaviour Research and Therapy, February 2012.