Trauma and Dialectical Behaviour Therapy

Immediate Social Care is proud to announce that we now provide one to one Trauma and Dialectical Behaviour therapy:

Bessel van der Kolk, a leading researcher in the is field, defines trauma as “an inescapably stressful event that overwhelms people’s existing coping mechanisms” (van der Kolk & Fisler, 1995, p.505)

Trauma is the result of extraordinarily stressful events that shatter your sense of security, leading to you feeling helpless, powerless and vulnerable in your life.   Traumatic experiences often involve a threat to life or safety, but any situation that leaves you feeling overwhelmed and alone can be traumatic.

When the mind is overwhelmed by trauma, it finds it difficult to recognize the event or events as over. People who are traumatised, can experience the trauma event as ‘ongoing’, ‘happening right now’, in the ‘present’ moment. This is due to the brain’s inability to not being able to associate the entirety of the incident, or incidents and to assess the situation as having ended or being over.

This is why it’s important to seek treatment

What does the trauma treatment involve?

Trauma treatment and healing involves:

  • Development of trauma-related memories and feelings
  • Releasing pent-up “fight-or-flight” energy
  • Learning how to control physically powerful emotions
  • Constructing or re-constructing the ability to trust other people.

What are the stages in a trauma therapy?

There are 3 stages in trauma:

  1. First stage: The first stage of trauma will teach the patient about trauma therapy.

 In this stage, he/she will create more effective strategies to manage the effects of trauma on his/her life.

  1. Second stage: The second or middle stage of trauma therapy involves looking at past experiences of trauma. It explores how the trauma has affected the patient in the past and how it continues to affect him/her. Processing traumatic experiences can be difficult and requires special methods.

This is why we use EMDR (Eye Movement Desensitization and Reprocessing) and Somatic experiencing. This treatment encompasses fundamentals of cognitive-behavioural therapy with eye movements or other forms of rhythmic, left-right stimulation. EMDR session, concentrates on traumatic memories and related negative emotions and beliefs by “unfreezing” traumatic memories, permitting the patient to destroy them.

Somatic experiencing:  Utilises the body’s exclusive ability to heal on its own. The core of is on bodily sensations, rather than thoughts and memories about the event. The patient gradually gets in touch with trauma-related energy and tension, by concentrating on what’s happening in the body. From there, the natural survival instincts take over, safely releasing this pent-up energy through shaking, crying, and other forms of physical discharge.

  1. Third stage: The third and last stage of trauma therapy involves addressing any remaining difficulties in the patient’s life, as well as working on ways to connect fully in his/her relationships with others. The final stage is about dealing with the issues of daily life for survivors who are doing well, but who are still struggling with specific issues.

DBT on the other hand derived from CBT (link) techniques but tailored to better treat individuals with Borderline Personality Disorder. DBT’s key feature is the use of acceptance strategies alongside CBT techniques (behavioural analysis, group skills training and homework) used to address and change the problem behaviour. CBT focuses on changing behaviour, however, some individuals with BPD need acceptance and validation of their intense emotions before they are ready to change the behaviour. Acceptance strategies enable this by seeking a balance between acceptance and change. Dialectics refers to the simultaneous ‘holding’ of opposing ideas and DBT seeks this as a therapeutic step away from rigid or ‘black and white’ thinking common amongst BPD clients.

What is DBT?

It is the process of thought by which apparent contradictions are seen to be part of a higher truth.” “The process or art of reasoning through discussion of conflicting ideas.” The word “dialectical” describes the notion that two opposing ideas can be true at the same time.

What is dialectical behaviour therapy used to treat?

Dialectical behaviour therapy (DBT) is a specific type of cognitive-behavioural psychotherapy developed in the late 1980s by psychologist Marsha M. Linehan to help better treat borderline personality disorder. Since its development, it has also been used for the treatment of other kinds of mental health disorders.

What are the DBT skills?

Dialectical behaviour therapy (DBT) is a highly effective type of cognitive-behaviour therapy (CBT), originally created to treat borderline personality disorder. … DBT teaches clients four sets of behavioural skills: mindfulness; distress tolerance; interpersonal effectiveness; and emotion regulation.

What is a behavioural therapist?

Behaviour therapy is an umbrella term for types of therapy that treat mental health disorders. This form of therapy seeks to identify and help change potentially self-destructive or unhealthy behaviours. … The focus of treatment is often on current problems and how to change them.

What is mindfulness in DBT?

DBT is taught as a series of skills in four modules: mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance. The first of these modules is core mindfulness and, as the name implies, it is the foundation of DBT

What does distress tolerance mean?

Distress Tolerance skills are used to help us cope and survive during a crisis, and helps us tolerate short term or long term pain (physical or emotional). Tolerating distress includes a mindfulness of breath and mindful awareness of situations and ourselves.

What is the meaning of interpersonal effectiveness?

In DBT, Interpersonal Effectiveness refers to the skills which help us to. Attend to relationships. Balance priorities versus demands. Balance the ‘wants’ and ‘should’ build a sense of mastery and self-respect.

What is emotional regulation?

Emotional self-regulation or regulation of emotion is the ability to respond to the ongoing demands of experience with the range of emotions in a manner that is socially tolerable and sufficiently flexible to permit spontaneous reactions as well as the ability to delay spontaneous reactions as needed.

Who uses it?

Dialectical Behaviour Therapy is used by DBT-trained psychotherapists and counsellors.

Clinical Partners trained in DBT include: Alan Bore, Alison Hunt.

Why would someone use it?

DBT was developed to meet the specific needs of individuals with Borderline Personality Disorder and has been found more effective than CBT techniques for this client group. It has been found effective in treating issues such as self-harm and suicidal thoughts which are also common amongst individuals with BPD.

DBT, ACT, and MBCT are sometimes referred to as ‘third wave’ behaviour therapies which are all based on CBT, but incorporate acceptance and mindfulness in their treatment techniques. Third wave treatments focus on specific behaviour changes and achievement of specific goals.

Whilst the CBT elements offer a more directive approach than some other therapies, such as person-centred therapy, or psychodynamic psychotherapy, Dialectical Behaviour Therapy also provides a less directive space for clients to explore and eventually accept intense feelings or emotions.

DBT is used to treat Borderline Personality Disorder (BPD), self-harm behaviours, suicidal ideation and, more recently, some eating disorders.

Strengths of the approach:

DBT is a short-term treatment, and is focused on the achievement of specific goals, as defined and agreed between the therapist and client.


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