What’s the difference between CBT and DBT?  I have to admit that I didn’t know the differences until I looked it up to write this blog post. I was curious as to what kind of therapy I’m receiving, as I really don’t know. I usually can’t remember what my therapy sessions are like anyway, due to my dissociation and memory problems. However,  I want to know what method my doctor is in fact using.  I need to know what course she’s charting for me, even if my ship keeps trying to sink.

CBT is cognitive behavioral therapy. Cognitive meaning of or pertaining to the mental processes of perception, memory, judgment, and reasoning (as contrasted with emotional processes).  Behavioral refers to the sum total of responses to internal and external stimuli.  Therapy…well, you know what therapy is. The premise of cognitive behavioral therapy is that changing faulty thinking leads to change in emotions and in behavior.  Therapists use CBT techniques to help individuals challenge their patterns and beliefs and replace errors in thinking such as overgeneralizing and catastrophizing with more realistic and effective thoughts, thus decreasing emotional distress and self-defeating behavior.  Catastrophizing is to view or talk about an event or situation as worse than it actually is. (I have a problem with this)  CBT also focuses on changing or reversing the habits of magnifying negatives and minimizing positivesIt helps individuals replace maladaptive coping skills, emotions and behaviors with more adaptive ones, by challenging an individual’s way of thinking and the way that they react to certain habits or behaviors. In other words, it’s showing a person another side, an alternative, something different, that happens to be more positive rather than negative. Replacing “bad” thoughts with new, improved thoughts. It’s like gaining a fresh, new perspective.

DBT is dialectical behavioral therapy.  Dialectical refers to linguistics, or language, and behavioral refers to actions. DBT combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely derived from Buddhist meditative practice.  It uses a combination of one-on-one therapy and also group therapy. DBT may be the first therapy that has been experimentally demonstrated to be effective in treating Borderline Personality Disorder (generally speaking).  It also has been shown to help with mood disorders, including self-injury.  Recent studies suggests its effectiveness with sexual abuse survivors and chemical dependency. (I’m a chemically dependent self-injurer who’s been diagnosed with Borderline Personality Disorder in the past and who my psychiatrist (and some of the K’s) believes is a survivor of sexual abuse, who also has an unspecified mood disorder.)  DBT strives to have the patient view the therapist as an ally rather than an adversary in the treatment of psychological issues.  Accordingly, the therapist aims to accept and validate the client’s feelings at any given time, while, nonetheless, informing the client that some feelings and behaviors are inadequate or faulty, and showing them better alternatives.  Mindfulness practice is increasingly being employed in Western psychology to alleviate a variety of mental and physical conditions, including obsessive compulsive disorder and anxiety (both of which I have).

The more I read about DBT, the more I’d like to try it. The idea of using Eastern meditative traditions in my therapy sessions really appeals to me. It’s too bad that DBT also involves group therapy, and I don’t do group since I generally don’t like people, and am even afraid of them. It appears that my therapist is using CBT (I think) and since we seem to be making progress, and even more importantly, since I’ve finally found a doctor whom I both respect and like as a person, I shall continue with my current course of treatment. After all, it’s taken me years to find a therapist I feel comfortable with, and I think that’s the most important thing of all when it comes to therapy.