An Overview of CBT and DBT
In addition to individual talk therapy, addicts in treatment centers are generally trained in therapeutic skills they can use on their own. CBT and DBT are two of the most common, important therapeutic treatments used in treatment centers. They are effective for treating addiction, as well as a number of mental illnesses such as depression and anxiety, from which many addicts suffer.
CBT refers to cognitive-behavioral therapy, while DBT refers to dialectical behavior therapy. As implied by their similar names, these treatments are connected. However, there are significant differences which give each treatment its own unique benefits.
The following is a brief overview of what you can expect from CBT and DBT.
Thoughts, Feelings, and Behaviors
Both CBT and DBT are built on the idea that thoughts, feelings, and behaviors all impact each other. In other words, what we think influences how we feel and behave. At the same time, how we feel influences what we think and how we behave, and behaviors influence our thoughts and feelings.
For example, if you think about the loss of a loved one, you will likely feel sad and engage in self-soothing behaviors. If you feel sad, you will think more about losses and disappointments in your life, and when you cry, your feeling of sadness may be amplified. None can be divorced from the rest.
CBT and DBT take at least two important lessons from this:
- Thoughts are often not based on logic, no matter how rational they seem
- If you can alter one of the three, the other two will follow, i.e. if you change how you think, your feelings and behaviors will change as well
Cognitive-Behavioral Therapy: Challenging Thoughts
There are multiple approaches to CBT, but they generally work according to the same principles. CBT focuses on the idea that faulty thoughts or cognition lead to abnormal feelings and behaviors. CBT therefore aims to train individuals to challenge their thinking.
Irrational thoughts include beliefs such as:
- If I fail, no one will love me
- I have no control over my own happiness
- I cannot function without certain people in my life
- I am worthless
- Much, much more
These examples are quite broad, in that they are ingrained beliefs according to which people make major life decisions. However, they express themselves on a micro, day-to-day basis. For example, the belief that one is worthless will be expressed in insecurity over one’s ability to complete certain tasks or jobs.
When one has a thought such as, “I cannot do this,” one has the opportunity to put CBT skills into practice. They will define the thought as much as possible, then challenge its basic assumptions. Using rational thinking, they bring the distortions into the light of day and see them for what they are.
The feelings associated with the thoughts, such as anxiety or despair, lose some of their power. In cases of addiction, using substances seems less urgent, as one has managed their feelings in a more effective, non-harmful way.
CBT skills are taught in therapy sessions, but homework is an essential part of the process. Therapy provides the foundation, but in order to be successful on a day-to-day basis, one needs to practice on one’s own in real life situations.
Dialectical Behavior Therapy: Introducing Mindfulness
Dialectical behavior therapy (DBT) is connected to CBT. It was originally created to treat borderline personality disorder, and is now used to treat depression, bipolar disorder, and addiction, as well.
DBT combines CBT skills and principles with Eastern mindfulness techniques. While mindfulness is at the core of DBT training, DBT recognizes that mindfulness needs to be practical in order for it to be most effective.
The main goal of DBT is to teach individuals to pause before letting feelings, thoughts, or behaviors spiral. When one begins to think distressing thoughts, one can pause and use mindfulness techniques to feel the emotions that are driving the thoughts, as well as observing the thoughts without getting caught up in them. When one is about to use substances or indulge in other harmful behaviors, one can pause and feel the emotions and observe the thoughts driving those behaviors.
Rather than focusing on meditations alone, mindfulness in DBT zeroes in on common triggers. Body checks help individuals identify what they are feeling. Individuals are also taught to “sit” with their feelings, not running away from them or holding onto them, but watching them rise and fall until they have subsided. This way, the individual does not react or get caught in a spiral.
Techniques of doing things “one-mindfully” are also part of DBT training. This teaches individuals to live in the moment. When they are eating, they know they are eating. When walking, they know they are walking. By living in the moment, one only feels what is really happening in their body, instead of what may happen in the future or what this means in regards to past hurt.
But DBT training includes many CBT techniques as well, including the basic concept of challenging irrational thoughts. Individuals trained in DBT learn to manage both their thoughts and their feelings, which helps them avoid indulging in unhealthy behaviors.
DBT also teaches techniques to use when feelings or thoughts are too strong. Patients are provided with a list of possible distractions, self-soothing, and ways to improve the moment. They create their own “distress tolerance” kit which reminds them who they can call for help, what works best when they need a distraction, and the self-soothing methods they respond to quickest.
Cognitive-behavioral therapy and dialectical behavior therapy are two very effective, practical approaches to treatment. They are used in rehab treatment centers as well as mental health institutions around the country and internationally.
You can also access CBT and DBT training privately, from individual therapists or therapy groups. CBT and DBT have already helped millions of people around the world recover from addiction, mental illnesses, and personality disorders.