Dialectical Behavior Therapy

I still remember my surprise when one day in graduate school a friend told me about a new therapy for Borderline Personality Disorder that had mindfulness skills at it's core.  Even more surprising that research on this new type of therapy showed very promising results including fewer symptoms, less hospitalizations, and a reduction in the need for future services.  Borderline personality disorder is a poorly named psychiatric diagnosis that has historically been difficult to treat.  It is characterized by chronic feelings of inner emptiness and repeated attempts to self-harm.  Treating individuals with this diagnosis has been a long term focus of my career, and I want to encourage anyone reading this who struggles with these challenges to seek competent treatment and know they can recover a sense of control and dignity in their lives with the right help.

This new treatment approach is called Dialectical Behavior Therapy or DBT and it took the world of psychology by storm.  It is now a mainstay in clinics around the world, but at that time it was still relatively unknown.  During those years I worked the overnight shift at an inpatient unit in Lansing Michigan.  I remember walking in one night to find the walls covered with DBT posers and acronyms.  I was told DBT was now the official treatment protocol for the hospital.  Mindfulness had finally gone mainstream!  The most impressive thing about it was that it brought with it a new culture of respect.  Previously individuals labelled borderline typically had a difficult time in the hospital.  Because of their chronic self-injury they often became "frequent fliers" on the unit and were seen as behavioral problems who were just "acting out".  With the introduction of DBT suddenly the real inner experience of these individuals began to be validated and addressed in helpful ways.  The change on the unit was palpable.  The adversarial nature of the relationship between patient and provider began to change, and the patients got better care as a result.

I was fortunate enough to be accepted at one of the first official training programs established by the founder of DBT, Dr. Marsha Linehan.  I have since run DBT groups in California, New York, and New Hampshire.  It has been a real privilege to participate in some many healing journeys, and I remain convinced that the mindfulness skills featured so prominently in the treatment is a big reason for it's success.  More information about DBT can be found on the Meditation and Psychology page of this site.

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