9 Aug 2022

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Dialectical Behavioral Therapy

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Donald Trump requires Dialectical Behavioral Therapy to heal his choice of words and narcissism. He has a strong ego that the feelings about others do not exist in his talks. This is supported by his stand on gender and the way he talked about how he does not care about the sick during his campaigns. He is not gentle and always treats his family, especially the wife as if she does not exist. His stance on the immigrants and how he would build a wall is just adding salt to the injury. The president is causing panic all over the spines of the immigrants thus making him be labeled as racist. 

Dialectical behavioral therapy (DBT) is a word that was coined from the teachings of Socrates. "Dialectical" is defined as “discussion and reasoning by dialogue as a method of intellectual investigation; specifically: The Socratic techniques of exposing false beliefs and eliciting truth” (Daempfle, 2012). DBT was developed in the 1980s by Dr. Marsha Linehan and has become recognized as a viable therapy. It is essential to understand the parent to explain the origin and interest of DBT properly. 

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Marsha M. Linehan was born on May 5, 1943, in Tulsa, Oklahoma. While young, she was diagnosed with schizophrenia in Connecticut at Insight of Living. After that, she was subjected to electroconvulsive therapy. She was also subjected to seclusion and Librium and Thorazine. She connected this ordeal to borderline personality disorder. However, she does not remember whether she received any psychological treatment or medication after her discharge from the Institute of Living in her late teenage. Linehan went to Loyola University where she graduated with a B. S. in psychology in 1968. In 1970, she earned her M. A. and in 1971, her Ph. D. in Social and Experimental personality psychology. Apart from being a student, she was also a lecturer for the Psychology program when at Loyola University. 

After her exit in Loyola University, Linehan was an intern at The Suicide Prevention and Crisis Service in Buffalo, New York in 1971- 72. While in Buffalo, she was an adjunct assistant professor at The State University of New York. Linehan completed her fellowship in Behavior Modification at Stony Brook University before moving back to her alma mater to be an adjunct associate professor till 1975. From 1973 to 1977, she was also an assistant Psychology professor at the Catholic University of America in Washington. 

She resumed the position of an adjunct associate professor in Psychiatry and Behavior Sciences Department at the University of Washington in 1977. Now she is a professor in the same department and the Director of the Behavioral Research and Therapy Clinics. Linehan is a fellow of American Psychological Association and the American Psychopathological Association, the former president of the Association for the Advancement of Behavior Therapy. She is also a diplomat of the American Board of Behavioral Psychology. 

In her line of duty, Linehan started working with highly suicidal people who turned out to meet the criteria for Borderline Personality Disorder. The earlier attempts to treat the patients using the old methods of therapy did not work due to some difficulties. The standard behavior therapy failed because telling a person where the problem is and what needs to be changed required for the treatment to work. This can work for some of the people with a mental health condition. However, the people Linehan was working with were so sensitive and told them where the problem is would mean they were the problem. Thus, validation was totally problematic when solving their problems. Anger was a common occurrence when handling such patients. She had an idea that the validation approach was the problem. She thought of switching to a more accepted space approach where she would validate and be accepting. That is when she tried to bring the Cognitive Behavior Therapy (CBT) in the attempt of rehabilitating the adults who were involved in suicide attempts, non-suicidal injury, and suicidal ideation. 

The mentioned are some of the chronic problems whose history can affect those in the lineage of the adults. Linehan, who was trained as a behaviorist, was determined to treating the mentioned problems and others. The use of CBT proved to be problematic to Linehan and her colleagues. She realized that the use of CBT was responding to the women who were meeting the criteria for Borderline Personality Disorder (BPD). During the adjustments of the CBT, Linehan and her colleagues realized that some other strategies were evident, and that was dialectics. So they cropped it out to form dialectical behavioral therapy. She needed a technology of change and acceptance to weave the therapy together. And in the end, it worked for her. 

The idea of radical acceptance was all she needed to make her realize that people can change their behavior. Her illness when she was young also added up to the development of the therapy. She was a misfit in a family of attractive siblings. She was a troubled patient as one of the summaries suggests. She needed the care and therapy she developed but did not get it. Being secluded made her bang her head on the walls and floor due to the urge of killing herself as she learned the effects of mental illness the hard way. She usually attacked herself with anything she could lay her hands on. Be it cigarettes or sharp objects. The problem was that she could see the events coming but could not report to anyone because she was all alone. On the other hand, Marsha was a caring person who had feelings for others and one patient quoted her “passion was as deep as her loneliness.” Linehan is unmarried but adopted a Peruvian daughter, Geraldine, who lives with her in Seattle, Washington. She is a long-serving Roman Catholic and values the meditation which the Catholic priests taught her. 

By learning about the doctor, I came to learn that the therapy can work. The Socratic and dialectic therapy occur hand in hand. As Socratic dialogue involved changing minds of people through questioning, dialectic uses dialogue which is meant to enrich one’s understanding by challenging their viewpoint. However, it is not a debate. The urge to win is not the sole reason for this conversation. It is like a conversation between friends trying to understand each other’s point of the argument. The dialectic method involves a back-and-forth way of doing a talk that turns the less sophisticated arguments into a richer understanding of the views as the conversation continues. I learned the whole meaning of DBT when I met Dr. Linahen. This was in 2013 during the Evolution of Psychotherapy Conference in which she was a speaker. The conference took place in Anaheim, California. Meeting her was not the first time I heard about DBT. 

However, it was the first time I sparked my curiosity. Though she spoke gently, she was loud enough to be heard. Her presentation details were important for how she was in stage gave the insight of DBT itself. Mostly, she “walked her walk and talked her talk.” She was creating a dialogue with those present, despite the near one-thousands of us listening. Dr. Linehan shared that she “didn’t do anything” in a session. She described the intervention as “you just talk a little and shut up a little. When it’s time to ask a question, then ask it” ( Suicide: Where we are…, 2013 ). This was puzzling. In her work, she describes DBT with much more detail and clinical application, while highlighting her research into DBT’s efficacy, “Dialectics is a complex concept that has its roots in philosophy and science….[It] involves several assumptions about the nature of reality: 1) everything is connected to everything else; 2) change is constant and inevitable; and 3) opposites can be integrated to form a closer approximating to the truth (which is always evolving)” (Psych Central, 2011). 

After hearing her speak, I felt she was a bit cavalier about her work. I saw Dr. Linehan as someone who had personal experience with borderline personality disorder as a patient and as a clinician. The way she spoke of her work, however, seemed as though she was overly modest. I was not expecting someone self-righteous or self-important. However, her presentation struck me as somewhat dismissive of her work. She spoke on the stage, then asked for a volunteer for a demonstration. She began to establish a dialogue between her and the volunteer as the dyad worked together to uncover any presenting issues. Maybe she was making light of her work or her presentation. The possibility of Dr. Linehan utilizing humor to facilitate her presentation, as well as make it entertaining for herself had also crossed my mind. I wanted to give her the benefit of the doubt since I was impressed by her model and how effective it was in treating borderline personality disorder. 

I would later come to revere her, and I even saw her story as heroic. Not until I researched her work and background did I see what inspired her to create DBT. I learned first-hand that she was hospitalized for twenty-six months, was misdiagnosed with schizophrenia; she was then dosed with powerful drugs such as Thorazine and Librium; was strapped down for sessions of electroshock treatments, the first time fourteen shocks and second time sixteen. Nothing changed and she later had to serve borderline personalities which made her secluded more. 

References  

Daempfle, P. (2012).    Science & Society . Jones & Bartlett Publishers. 

Borchard, T. (2015). Marsha Linehan: What is Dialectical Behavioral Therapy (DBT)? | World of Psychology . World of Psychology . Retrieved 3 March 2017, from https://psychcentral.com/blog/archives/2011/06/28/marsha-linehan-what-is-dialectical-behavioral-therapy-dbt/ 

Suicide: Where We Are, Where We Were and Where Are We Going   [Video file]. (2013). Milton H. Erickson Foundation. Retrieved March 3, 2017, from Alexander Street. 

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