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Dialectical Behavior Therapy (DBT) has been shown to successfully treat a variety of disorders, including self-harm, Borderline Personality Disorder, depression, anxiety disorders, substance abuse, and eating disorders.

If your life seems more challenging because you suffer from any of these disorders, here are five reasons why DBT may be a great option for you:

1. DBT Validates Your Experience. Traditional Cognitive Behavioral Therapy (CBT) is effective, but its seemingly never-ending focus on change may be difficult for some people. If you find that your own experience is not recognized, you may withdraw from treatment, become angry, or both.

Dialectical Behavior Therapy developed in part as a response to this reaction, and makes validation in treatment a priority. A DBT therapist will recognize that a certain behavior, such as a disordered eating behavior, makes sense and is understandable within the context of your life or situation at that time while helping you to find healthier ways to cope. This mode of acceptance has increased many people’s adherence to treatment.

2. DBT Teaches Adaptive Skills. Another reason Dialectical Behavior Therapy developed is that the complexity of many clients’ disorders did not allow for a therapist to work on adaptive skills during the individual sessions or group sessions. For instance, if a therapist was trying to address suicide attempts or urges to self-harm, there simply was not enough time in the session to help the client learn and apply adaptive skills.

DBT teaches four skills – mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance – during DBT skills groups that are then reinforced through individual DBT sessions and phone coaching.

3. DBT Prioritizes Stages and Targets. Dialectical Behavior Therapy prioritizes what to address in therapy through a series of stages and targets. As the first priority, DBT addresses behaviors that could lead to a client’s death, interfere with therapy, and threaten the quality of life (Stage I).

In Stage II, the DBT therapist addresses what is called “inhibited emotional experiencing,” meaning that the client is under control and has a normal life expectancy, but is suffering in silence. Stages III and IV focus on challenges in living and having a spiritually fulfilling or connecting life.

4. DBT Models Balancing Acceptance and Change. The dialectical component of Dialectical Behavior Therapy means that therapists blend acceptance and change in a way that results in movement and flow during sessions.

This strategy is particularly helpful to those with Borderline Personality Disorder, who might have a tendency to become stuck in arguments and black-and-white thinking.

5. Your Therapist Receives Support. A final reason to seek Dialectical Behavior Therapy is that your therapist receives support themselves to make sure they are providing you the best treatment possible. In DBT, one goal is to enhance the therapist’s motivation to treat clients and enhance the therapist’s capabilities.

DBT therapists participate in weekly DBT consultation team meetings. The team helps the therapist stay balanced in his or her approach to the client while at the same time encouraging and supporting the therapist in applying various treatments.

1.Needed structure. DBT day treatment typically provides six to eight hours of therapy each day. This can give someone struggling with the many symptoms of BPD needed structure to better manage their symptoms and learn healthy ways to cope.
2.Middle of the road. With DBT day treatment, clients get more support than they would in individual therapy or outpatient DBT treatment. DBT day treatment is most appropriate for people who don’t need the level of care found in residential DBT treatment.
3.Comfort of home. Those who enter DBT day treatment can live at home while they participate in therapy. They can also live in another supportive living environment, if needed. This allows them to use the skills learned during DBT day treatment in their natural environment.
4.Intensive treatment. A DBT day treatment center provides individual and group therapy similar to that offered at a residential Dialectical Behavior Therapy program.
5.More support. Dialectical Behavior Therapy day treatment can give those suffering from the symptoms of Borderline Personality Disorder and other disorders the support needed to make a recovery from their symptoms. Throughout the day, DBT skills will be taught and reinforced by both therapists and other staff.

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What Is Radical Acceptance?

Radical acceptance is one of the techniques taught in Dialectical Behavior Therapy (DBT) that can help you to better deal with painful emotions and situations. Understanding radical acceptance and having a way to practice it can help you feel better about your emotions and your situation.

Dr. Marsha Linehan, the developer of DBT, defines radical acceptance as “complete and total” acceptance, where you “accept something from the depths of your soul.” Radical acceptance has its roots in Buddhism.

The three parts to radical acceptance are:
•Accepting reality is what it is
•Accepting that the event or situation causing pain has a cause
•Accepting that life can be worth living even if it has painful events in it

How to Practice Radical Acceptance

There are many ways you can practice the DBT technique of radical acceptance. Here are a few to get you started:

Sit with your feelings. As an exercise in understanding radical acceptance, Dr. Linehan suggests thinking back to a time when you had something you wanted (the possibility of your dream job, having just applied and interviewed for it), and then what it felt like when you learned you did not have what you wanted (you did not get the job). Just sit with how you felt, without any judgment around it.

Dr. Linehan acknowledges that when you practice radical acceptance, you have a sense of “letting go of the struggle” or you may have a feeling inside of being centered. She also acknowledges that there may be a great deal of sadness around the acceptance.

Visualize the path to reality. One way to begin understanding and practicing radical acceptance is by learning to turn your mind to the reality you are trying to accept. To help do this, you might visualize a fork in the road, with one path to reality (which you are working to accept). You must constantly put yourself on the “reality” part of the road.

Meditation and breathing. You might also consider gaining skill in radical acceptance as part of a meditation practice. There are several online resources that can guide you through this, or you can create your own activity. This one comes from the website DBT Self-Help:

Start by taking three deep breaths, filling your belly with air. Exhale slowly and inhale slowly. Notice the exhale as it leaves your lungs. Introduce a few simple phrases to validate your experience and help practice radical acceptance.

You can remind yourself that your emotions are not wrong and that you are justified in having them. You can tell yourself that, even if you are hurt and you feel wronged, it’s time to let go. You can accept that you will benefit by setting aside your emotions just for now.

It’s not good to think about your situation at this moment. Instead, take care of yourself. Touch your elbow. Is the skin rough or smooth? Touch the other elbow. What does it feel like? Sit back and breathe. Then touch the other part of each elbow. How does that skin feel? You are present and connected with yourself. Take a few more deep breaths. Trust yourself that, at that moment, you are okay.

Radical acceptance helps you accept your emotions without judgment. This may not always be easy to do, but it can help you better regulate your emotions, tolerate distress, be mindful, and improve interpersonal relationships – all key tenets of Dialectical Behavior Therapy.

Avoid smoking triggers

Recognize places and situations that make you want to smoke and avoid them. Instead, visit places where smoking isn’t allowed, such as a museum or movie theater. Hang out with people who don’t smoke or who also want to quit smoking. At work, use the main door instead of the smoking entrance. Keep especially busy during times when boredom may tempt you to smoke. Make it inconvenient to smoke by stashing your cigarettes and lighters in the car when you’re at home or work. Also, replace old behaviors with new routines that aren’t associated with smoking. Chew gum while you drive, or take a new route to work to keep your interest in your environment and away from smoking. Get up from the table immediately after eating. Drink water or tea instead of coffee or alcohol. Practice saying, “No thanks, I don’t smoke.”

Try a stop-smoking product

Don’t use withdrawal symptoms or cravings as an excuse to not quit smoking. Plenty of stop-smoking products and medications with Food and Drug Administration approval are available to help you manage. Some types of nicotine replacement therapy — including patches, gum and lozenges — are available over-the-counter. Nicotine nasal spray and the nicotine inhaler are available by prescription. Other prescription medications may also be options. Bupropion (Zyban) can help control nicotine cravings. Varenicline (Chantix) can reduce both the pleasurable effects of smoking and any nicotine withdrawal symptoms. You may be able to use a combination of stop-smoking products at the same time. Using a stop-smoking product along with counseling to achieve changes in your behavior and beliefs is the most effective way to quit smoking. Talk to your health care provider about what stop-smoking products may be best for you.

Manage your stress

Stress and anxiety can increase your urge to smoke and derail your effort to quit smoking. To keep stress and anxiety under control, prioritize your tasks. Consider what tasks you can eliminate or delegate to someone else. Take a break when you need it. Practice relaxation exercises, such as physical activity, deep breathing or meditation. Stretch or simply listen to your favorite music.

Take it one day at a time

Don’t worry about next week or next month. Focus on what you can do today to quit smoking. Every hour without a cigarette can bring you one step closer to quitting for good — and freedom from an unhealthy, expensive habit.

Celebrate your successes

Made it through the day without a cigarette? Treat yourself to something special. Made it through the week? Count how much you’ve saved by not buying cigarettes. Use the savings for a special treat or invest the money for the future. Reward yourself for not smoking by doing something you enjoy every day, such as spending extra time with your children or grandchildren, going to a ball game, taking a walk, soaking in the tub or watching a movie. All of your small successes can help you reach your goal to quit smoking for good.

Being prepared can help you quit smoking and other tobacco use. Use these proven strategies to help end your dependence on tobacco.
By Mayo Clinic Staff

You know that when you quit smoking, it’s one of the best things you can do for your health. So now you want to get serious and quit smoking. But you also know that quitting smoking can be challenging and that it takes most smokers several tries before they succeed. So how do you quit smoking, hopefully for good? These tried-and-true strategies can help you reach your goal to quit smoking. Try one or two, or try them all until you find what works to help you quit smoking.

Action guide to dealing with triggers (PDF file requiring Adobe Reader)

Put it on paper

Consider what you don’t like about smoking and why you want to quit smoking. Are you worried about health consequences, such as lung cancer and heart disease? Do you want to feel better? Set a good example for your kids? Rid yourself of that lingering smoke smell on your hair, skin and clothes? Write it all down and carry the list with you. Each time you pick up a cigarette or have the urge to, read your list and remind yourself why you want to quit smoking.

Enlist support

Get others on your side. Tell your family, friends and co-workers that you want to quit smoking. You may even ask them to remind you why it’s important to quit smoking if they see you pick up a cigarette. Also, ask your friends or anyone in your household who smokes to quit smoking, too. And consider joining a support group — either in person or online — for people who’ve quit smoking or want to.

See a specialist

Contact a tobacco treatment specialist through your doctor, a local treatment program or a telephone-based program. Toll-free tobacco quit lines are available in every state in the United States and many countries throughout the world. One big benefit of telephone quit lines is that you can participate from your own home — you don’t need transportation. The more counseling you receive when you want to quit smoking, the more likely you’ll remain tobacco-free. Ask your doctor or hospital for information, or check your local phone book.

Take it slow

Most people have the best success with quitting smoking by setting a quit smoking date and then abruptly stopping on that date. If you’ve tried that method a few times and it hasn’t worked for you, you might want to start the quit smoking process by gradually cutting back on your smoking. Ways that you can cut back gradually include delaying your first cigarette of the day, smoking only half of each cigarette, buying only one pack of cigarettes at a time, and trading one smoking break a day for physical activity. Build on each success until you’ve quit smoking entirely.

Hypnosis can be effective in helping people cope with pain, stress and anxiety. It may also be effective as part of a comprehensive program for quitting smoking or losing weight.

Hypnosis isn’t right for everyone, though. For example, you may not be able to enter a state of hypnosis fully enough to make it effective. Some therapists believe that the more likely you are to be hypnotized, the more likely it is that you’ll benefit from hypnosis.

The therapist will explain the process of hypnosis and review what you hope to accomplish. Then the therapist will typically talk in a gentle, soothing tone and describe images that create a sense of relaxation, security and well-being.

When you’re in a receptive state, the therapist will suggest ways for you to achieve your goals, such as reducing pain or eliminating cravings to smoke. The therapist also may help you visualize vivid, meaningful mental images of yourself accomplishing your goals.

When the session is over, either you are able to bring yourself out of hypnosis or your therapist helps you end your trance-like state.

Contrary to how hypnosis is sometimes portrayed in movies or on television, you don’t lose control over your behavior while under hypnosis. Also, you generally remain aware of and remember what happens under hypnosis.

You may eventually be able to practice self-hypnosis, in which you induce a state of hypnosis in yourself. You can use this skill as needed — for instance, after a chemotherapy session.

Hypnotherapy can be an effective method for coping with stress and anxiety. In particular, hypnosis can reduce stress and anxiety before a medical procedure, such as a breast biopsy.

Hypnosis has been studied for other conditions, including:
•Pain control. Hypnosis may be beneficial for pain associated with cancer, irritable bowel syndrome, fibromyalgia, temporomandibular joint problems, dental procedures and headaches.
•Hot flashes. Hypnosis may relieve symptoms of hot flashes associated with menopause.
•Behavior change. Hypnosis has been used with some success in the treatment of insomnia, bed-wetting, smoking, obesity and phobias.

HOW YOU PREPARE:

You don’t need any special preparation to undergo hypnosis. But it’s a good idea to wear comfortable clothing to help you relax. Also, make sure that you’re well rested so that you’re not inclined to fall asleep during the session.

Be sure you carefully choose a therapist or health care professional to perform hypnosis. Get a recommendation from someone you trust. Learn as much as you can about any therapist you’re considering. Start by asking questions, such as:
•Do you have training in a field such as psychology, medicine, social work or dentistry?
•Are you licensed in your specialty in this state?
•Where did you go to school, and where did you do your post-graduate training?
•How much training have you had in hypnotherapy and from what schools?
•What professional organizations do you belong to?
•How long have you been in practice?
•What are your fees?
•Will insurance cover your services?

DEFINITION:
Hypnosis, also referred to as hypnotherapy or hypnotic suggestion, is a trance-like state in which you have heightened focus and concentration. Hypnosis is usually done with the help of a therapist using verbal repetition and mental images. When you’re under hypnosis, you usually feel calm and relaxed, and are more open to suggestions.

Hypnosis can be used to help you gain control over undesired behaviors or to help you cope better with anxiety or pain. It’s important to know that although you’re more open to suggestion during hypnosis, you don’t lose control over your behavior.

RISKS

Hypnosis that’s conducted by a trained therapist or health care professional is considered a safe, complementary and alternative medicine treatment. However, hypnosis may not be appropriate in people with severe mental illness.

Adverse reactions to hypnosis are rare, but may include:
•Headache
•Drowsiness or dizziness
•Anxiety or distress
•Creation of false memories

Use special caution before using hypnosis for age regression to help you relive earlier events in your life. This practice remains controversial and has limited scientific evidence to support its use. It may cause strong emotions and can alter your memories or lead to creation of false memories.