Dialectical Behavioral Therapy

Initially, dialectical behavioral therapy (DBT) was meant for purposes of treating chronically suicidal persons suffering from a condition known as borderline personality disorder (BPD).  It has since been adapted for treatment of individuals suffering from various mental illnesses, though majority of those treated are primarily diagnosed with BPD. The role of a therapist is to help the client in developing new skills such as mindfulness practices and coping methods, in order for him or her (the client) to improve on behaviors and thoughts considered unhealthy.

Notably, mindfulness practice can be traced back to meditation practices of the East, an ideal example being yoga. It equips one with a capacity to become increasingly aware of their feelings and thoughts by way of observing bodily sensations.  However, DBT has its basic tenet being that therapists are not supposed to expect their clients to exercise activities and behaviors that the therapists themselves are not willing to do. In this essay, I will be reflecting on a self DBT therapy that I engaged in sometimes back, and during which I practiced mindfulness. I committed myself to change the behavior of nail-biting; something that I always did whenever I was unsure of how to approach a situation.

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When I began the commitment to change the nail-biting habit, I experienced major difficulties adjusting to my new self. I had engaged in the habit for years and it had almost become an integral component of my personality. In fact, I often resorted to yet another habit as I struggled to keep off my nails from my mouth. Whenever I was faced with a difficult situation, I would start scratching my hair as if looking for an answer from there. Even though developing an alternative way of controlling feelings that are confusing and overwhelming is encouraged in DBT patients, I feared that I would stop biting my nail, but be unable to control myself from scratching my head. This frustrated me a lot as I felt like I was trying something that was unachievable. It is at this point that I assigned myself a homework in which I had to ensure that I reduced the number of times I either scratched my hair or bit my nails in a day. If I ever achieved to cut on the previous day’s frequency, I would reward myself such as going for an evening out. I did this in consistence with the DBT individual therapy component of DBT that is usually focused on improving the motivation of the clients and assisting them in applying skills relevant to their lives’ events and challenges. At this age, I aimed at enhancing my self-control in realization of the fact that being successful in reducing the frequency of the habit would earn me a reward. Having to control myself emerged to be a hard task, but one that was worth trying. In fact, I significantly credit my success in the DBT to this stage. On realizing that I was managing to cut down on the frequency even if by a single time, I would feel motivated to try harder the following day.

I took the mindfulness exercises very seriously, as they are the ones that enabled me to identify what I would think and feel before biting my nails or engaging in another alternative habit. Chapman defines mindfulness as maintaining self-consciousness alive to the current situation. The practice mostly emphasizes on paying attention to, as well as being awake and aware of the present moment’s experience. Knowing this, I knew that mindfulness practice would come in handy in stopping myself from biting my nails subconsciously. I thus made every effort to ensure that when I was faced by situations that prompted me to bite my nails; I focused on the present situation and kept my mind from wandering to other things. The practice was instrumental in my experience and success in the DBT.

The challenges I experienced in the self-therapy came as a surprise to me because I had convinced myself that it was easy and would not take me long. This is especially so because I used to think that the reason I continued showing the habit was because I had not paid any serious attention to stopping it. As such, the attitude that it was a simple thing made it challenging to cope with the intensive efforts I was making and in fact, I had to stop at some point and re-start knowing the seriousness of what was awaiting me.

One thing that I did observe as I practiced and tracked my behavior and urges was that I would engage in the habit without giving serious thought to the issue at hand. Simply putting it, I had found a way out of solving a difficulty by just biting my nails. Secondly, I noted that I could not face another person as I did it, implying that I was not comfortable doing it after all. In fact, there are some situations in which I would excuse myself to think over an issue and end up only biting my nails and solving the issue of concern. McKay, Wood, & Brantley also made a similar observation amongst people with unhealthy behaviors, and argued that the behaviors they engage in as they solve a problem only worsen their problems.  Fortunately, with time, I realized that mindfulness practice would help me realize on time that I was about to create a situation in which I could bite my nails. I would then immediately look for an alternative but productive way of tackling the situation. For instance, if I could get an answer to a question by making some calculations, that is what I would do instead of just biting my nails and thinking hard on what the answer could be.

The other thing that I noted was that certain feelings or emotions would cause me to more actively engage in nail-biting than others. For instance, a situation that angered me would cause me to intensively bite my nails as I thought of how I would approach the culprit. This reaction can be explained by what Dimeff & Koemer termed as pervasive emotional dysregulation, in which one experiences difficulties out of being unable to regulate his or her emotions. I also tried not to engage in mindfulness practice, by assuming that the situation was too boring to focus on, and I realized that in agreement with Rathus & Miller, these are the instances I engaged in the target behavior most.

Over a period of a few months, I managed to reduce the frequency of engaging in the target behavior and I eventually overcome it completely. This was expected as my behavior could not be regarded as serious. Behaviors such as those that follow traumatic events can take years to treat.  Interestingly, I have noted that I am now better at problem-solving than during the days I would exercise nail-biting. In addition, I am now relating better with other people and my self-confidence has improved tremendously. This is especially because I used to feel that I was engaging in a habit that is often expected in children. Nonetheless, I have realized that I have to constantly practice mindfulness practice for me to keep from going back to the old habit. I will now be in a position to apply what I have learnt when dealing with a client. Penderson, L. & Pederson, C. assert that DBT therapists should follow the evidence they obtain from their own settings with their clients. I am now convinced that having experienced DBT myself, I am in a better position to help my clients.