Psychotherapy is one of the best treatment methods available for addiction, mental illness and self-destructive disorders. Cognitive behavioural therapy and dialectical behavioral therapy are two forms of psychotherapy that encourage patients to talk about their struggles and learn how to cope and recover. With both, you gain a deeper understanding of personal challenges and develop skills to help you manage them on your own.
As with many other forms of talk therapy, CBT and DBT require time, effort and willing participation for patients to benefit fully. Once you master the skills necessary to face your personal demons, you can use these new tools and strategies for the rest of your life.
What Is CBT?
Cognitive behavioural therapy is a well-tested, specialized form of verbal treatment that can help patients control and change their thinking patterns, feelings and behavioural responses. It’s based on the belief that thoughts and actions influence feelings and emotions, so changing the way you think and react to situations will improve your mental well-being.
Sessions are aimed at pinpointing when a person makes a negative interpretation, and which behavioural patterns reinforce these thoughts. In this way, patients can develop alternative ways of thinking and behaving, thereby relieving their mental illness and improving their outlook.
CBT was first developed in the 1960s, when researchers were struggling to better understand depression. Psychologists discovered that the underlying issue behind this mental illness was automatic thoughts. These thoughts may include beliefs that people have about themselves, the world and the future.
In those with depression, these automatic thoughts are distorted, which puts a negative spin on certain situations. CBT therapists work to identify these distorted cognitions through a process of evaluation, and clients learn to distinguish between reality and the inaccuracy of their thoughts.
Once the patient is taught to recognize and monitor their thoughts, they can begin to challenge these false beliefs. Maybe they write their negative thoughts down in a journal or speak them out loud as they arise, in order to better identify them. Then, they can begin to prove these thoughts wrong by looking to their past.
Hence, the therapist can begin to help the patient reframe their thoughts in a more positive light. This helps the client create a more rational belief system and worldview, while also developing healthy coping strategies for counteracting negative thoughts when they arise in the future.
CBT is intended to work over the span of five to 20 sessions, but the length of time can vary from a few days to a few years.
What is DBT?
Dialectical behavior therapy is actually a form of CBT, with a greater emphasis on the emotional and social elements of mental illness. DBT aims to build upon the foundations of CBT, and helps people cope with more extreme emotions and self-deprecating or harmful behavior.
Originally, DBT was developed to treat borderline personality disorder (BPD), but it can also help people manage other mental illnesses.
DBT was developed a little more than a decade after CBT, with the aim of fostering more acceptance and validation of patients’ feelings. Those who experience extreme emotions often think their beliefs are minimized or undervalued in CBT therapy, and as a result, they lack a strong relationship with their therapist.
When a patient receives validation that their emotions are real, this helps build trust, which is essential if they’re to be honest with themselves and their therapist and make changes to their life.
This form of therapy also focuses on mindfulness, tolerating distress and effectively managing interpersonal relationships. Centring skills used in Buddhism and Zen practices are incorporated into meetings and phone calls to help patients learn to live with pain and hurt.
Through mindfulness, they can learn to accept their present situation, instead of suffering by trying to change it. This explains why DBT is so effective in treating those with self-harm tendencies, because they’re able to learn coping skills that replace their destructive habits.
What are the differences?
There are two key differences between DBT and CBT, and these involve the roles of validation and acceptance. DBT requires a patient to accept their emotions as real and valid, thus making the necessary behavioural changes a bit more bearable.
CBT, however, puts more of a focus on reconstructing your thoughts and actions to improve your state of mind. Thus, CBT therapists aren’t as concerned with validating a patient’s emotions, and often, the CBT patient doesn’t require this validation.
Aside from these two key differences, there are a few other distinctions to be made. For one, the main focus of CBT is to reconstruct distorted or automatic thoughts in order to fix feelings and behaviours. Thus, this type of therapy is used to treat post-traumatic stress disorder, eating disorders and negative thought patterns.
DBT, on the other hand, aims to teach patients skills that can help them create a life that’s worth living. It was developed to help people cope with extreme emotions that may result in outlandish behaviors. This therapy is geared more towards treating those with addictions, anxiety, suicidal tendencies and borderline personality disorder.
Another difference between the two psychotherapies is that CBT therapy sessions consist of one-on-one talks between the client and therapist. DBT, on the other hand, includes talk sessions, phone calls and group therapy.
These group sessions, such as Alcoholics Anonymous meetings, provide a level of treatment that goes beyond a private conversation. Being able to work with and connect with others who are learning the same coping skills fosters a sense of belonging and security, and further validates a client’s emotions and thoughts.
Although different, sometimes CBT and DBT intersect or partner with one another to form a more cohesive therapy strategy. Many CBT psychiatrists incorporate certain elements of DBT into their treatment model.
Sometimes, once DBT clients have learned how to use coping skills to regulate their emotions, connect with others and practice mindfulness, they transition into a more traditional CBT setting. This helps address any specifically troubling negative behaviours or recurring distorted thoughts, and improves the outcome of their therapy.
How do you decide?
The best way to figure out which treatment is best for you is to talk to a mental health professional. They’ll consider your present situation and symptoms, your medical history and the goals you’d like to achieve through therapy.
They may also help you talk through your thoughts and feelings to determine whether you’re struggling with anxiety, depression, trauma or another mental illness. That way, they’ll be able to recommend the type of psychotherapy that will be the most effective when it comes to meeting your particular needs.
[su_pullquote align=”right”]Just as physical illnesses require a diagnosis and subsequent prescription medications, mental illnesses also require a diagnosis before treatment occurs.[/su_pullquote]
Receiving and understanding a specific diagnosis is essential to deciding on the correct method of therapy. Just as physical illnesses require a diagnosis and subsequent prescription medications, mental illnesses also require a diagnosis before treatment occurs. Different conditions respond differently to treatment techniques, so it’s important to pinpoint the correct one.
If you have yet to receive a professional diagnosis, consider arranging an appointment with a psychiatrist or psychologist for testing. This will give you both an official diagnosis and a good idea of your mental strengths and weaknesses to move forward with. Subsequently, it will help you identify whether CBT or DBT is right for you.
Once you receive a diagnosis, consider which treatments generally work better for those who struggle with the same illness as you. For instance, DBT has been found to be considerably more effective than CBT in treating people with borderline personality disorder, while those with depression and anxiety often find success with CBT therapy.
If you have more than one diagnosis, you may benefit from elements of both psychotherapies. Don’t be afraid to dip your toes into both types of treatments, before deciding on one or the other.
Another thing to keep in mind, when deciding between CBT and DBT, is your personal goal that has caused you to seek therapy. What exactly is it that you’re seeking to improve, fix or accomplish?
Do you want to strengthen your relationship with your family, beat an addiction or fight depression? Are you looking to find a more positive mindset and global perspective, or are you looking to stop self-harming? Pinpointing a specific goal will help you determine which route you must take to achieve it.
A light at the end of the tunnel
With so many treatment options out there, it can be difficult to choose one that is right for you. You want success and a better life, but figuring out how to get there can be confusing. CBT and DBT are some of the most common therapeutic practices for treating mental illness, so they’re a good place to start if you’re struggling with negative thoughts or emotions.
Most importantly, once you decide on a treatment plan, stick with it. Give it a few weeks before calling it quits. Remember that your therapist is there to talk you through your struggles, but they won’t do the work for you. Manifesting change requires commitment and determination, and that must come from you.
Recovery won’t happen overnight, but through gradual change and your use of the correct therapeutic strategies, you will see a light at the end of that long tunnel—one that signifies a less painful, more fulfilling life.
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