Are you bipolar or an addict looking for insight from a like-minded soul? Have a loved one suffering from bipolar or addiction and want some inside advice? While I’m not a doctor or medical expert, I can tell you about my experiences with this dual diagnosis and look to support others with replies. Note that your submission may be used in an upcoming blog post, although names will be changed.
This week, Stacy N. asks…
I keep hearing about CBT and DBT. I encounter these terms everywhere on message boards. What do they mean?
Cognitive behavioral therapy (CBT) combines talk therapy with a focus on thinking. A CBT therapist teaches patients to build concrete solutions to mental health issues. The treatment encourages the banishing of irrational thoughts and instead teaches coping mechanisms.
CBT emerged in the 1960s when American psychiatrist Aaron Beck realized his patients were having what he called negative “automatic thoughts,” or emotion-laden ideas that are subconscious. Beck, now 97, believes these thoughts can dominate our psyches, blocking the way forward in our lives. He developed CBT to help patients jettison these negative feelings.
According to PsychCentral, CBT is a short-term therapy that lasts five to ten months. A CBT therapist might encourage you to write down your negative thoughts to be discussed in therapy. Identifying these thoughts is an important element to this type of mental healthcare. Over time, CBT patients learn to transform these negative thoughts into positive ones.
Although CBT was initially developed to treat depression and anxiety, today’s doctors recommend it for bipolar, eating disorders, and substance abuse.
In contrast, dialectical behavioral therapy (DBT) has proven helpful for those with suicidal ideation, eating disorders, and primarily borderline personality disorder. A subset of CBT, the style of treatment was developed in the 1980s by psychiatrist Masha Linehan and is usually reserved for tough cases, such as people who find themselves with multiple diagnoses. Like Buddhism, DBT focuses on mindfulness, or living in the here and now. “Dialectical” refers to the ideas of acceptance and change, according to WebMD.
There is homework. Patients are asked to fill out daily “diary cards,” which diagram feelings such as suicidal ideation, self-harm, shame, fear, and anger on a scale of 1 to 5. Nowadays, there are even diary card apps, such as DBT Companion, Mindfulness Daily, and DBT Diary Card & Skills Coach. Search for them wherever you get your apps.
As with CBT, DBT can involve group therapy as well as phone sessions as needed, if the patient is in crisis.
