Posted by raisinb on March 30, 2008, at 11:01:12
In reply to CBT versus DBT, posted by Kath on March 29, 2008, at 19:26:44
CBT targets what CBT therapists would call "irrational" or "absolute" thinking. You are supposed to analyze these thoughts and substitute more rational or less extreme alternatives.
DBT is also cognitive-behavioral, but it is based on Dialectics, which is a philosophical position that regards change as the synthesis of opposites. So, if you say, "I can't deal with other people," and yet, "I hate to be alone" (just an example of an inner conflict) your therapist might help you to come to a higher synthesis of these two poles--like, "I am okay by myself; therefore, it's easier for me to deal with the uncertainty and disappointment that come with relationships."
Linehan noticed the black and white, all-good or all-bad thinking that seems to be a common symptom of BPD and thought that dialectics would be a good way to get patients out of it.
In my view, the difference between the two is that CBT often regards one thing as "true" or "rational," while DBT takes the stand that there is no absolute truth. Something can be "true" and "not true" at the same time. One party in a relationship can be both "right" and "wrong." A patient has to be accepted exactly as she is, but she has to be pushed to change, too.
As I understand it, the T in DBT can be very confrontational/playful in taking the opposite position to whatever the patient is saying, in order to jolt the patient out of rigid thinking.
As Dinah mentioned, there are also a lot of mindfulness skills involved. Linehan borrowed a lot from Zen Buddhism in putting together the therapy.
I have never been in DBT myself, but I love Linehan's book on the subject. The dialectical philosophy helped me get a lot more perspective on mental patterns I get trapped in. It's a great read if you have some time.
poster:raisinb
thread:820570
URL: http://www.dr-bob.org/babble/psycho/20080321/msgs/820662.html