November 10, 2025 • 5 mins
welcome to the mental health minis series! every other monday, we will feature a five-minute mini-episode with content from a past she persisted episode. this week’s episode is a solo where i break down where dialectical behavior therapy (dbt) came from + how it can help transform your mental health!
to listen to the full episode, click HERE!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Happy Monday and welcome to yourmental health Mini.
This week is a solo and we are talking about DBT.
If you're new here, you're like,what the heck is DBTDBT stands
for dialectical Behavioral therapy and it was a therapy
protocol that was developed by Marsha Linehan that addresses
individuals that are struggling with borderline personality
disorder and suicidal ideations.So it's individuals that are
(00:20):
struggling in a really big way. They're struggling to regulate
their emotions, they're struggling to be interpersonally
effective, and things across theboard are really tough.
And they've had challenges in the past with getting support
and therapy, seeing things get better, shifting their emotions,
their thoughts, their urges, etcetera.
So when Marshall in a hand started developing DPT, she
(00:41):
found that with these really depressed, suicidal, struggling
patients that if you told them to accept their situation, they
rejected that. They were like, you're saying
things can't change. You're saying I'm stuck like
this forever, You're not able tohelp me.
What the heck is your job? That they would get really upset
and pissed off, but then when you told them to change their
situation, they would say, this is my fault.
(01:02):
Like, what are you talking about?
Like, I didn't do this to myself.
Why do I have to deal with this?This isn't my problem.
And so with DBT, there is this perfect blend of the two.
It's a dialectic, which is why DBT is called dialectical
behavioral therapy. So you're balancing acceptance
and change and you're accepting the situation that you're in and
you're working to change it and you're doing both of those
(01:22):
things at the same time. And Marshall in a hand found
that this was a really effectiveway to validate patients and
also motivate them to work on what it was that they were
dealing with. So as I mentioned, this
population that DBT was developed for had a lot going
on. There was all of these crises
that they were dealing with on adaily basis, on a weekly basis.
(01:44):
And I can speak from my own experience going to DBT, it was
like I had this maladaptive coping mechanism come up.
I got in this giant argument with my parents.
I hate this aspect of my life. I'm so hopeless here.
I have no motivate. Like everything is basically a
burning fire, overwhelming code red.
Everything is the worst, always,all the time.
So you have all of these crises going on, and in DBT they've
(02:07):
come up with a really effective way to address these and a
hierarchy in which you deal withthese things to get effective
therapy outcomes and to make sure that you're doing the
correct order of operations. We've all heard of order of
operations. Probably for math, Like first
we're going to do parentheses and then we're going to do our
exponents, and then we're multiplying and dividing, and
then we're doing addition and subtraction.
(02:29):
Same thing exists for therapy. And in therapy, there's 4
stages. In stage one, we are addressing
severe behavioral discontrol. In stage 2, we're talking about
quiet desperation, and stage 3 we're addressing problems in
living, and stage 4 is incompleteness.
So there's actually even a DBT House of treatment, but
(02:49):
basically the bottom house is onfire.
As we talked about, we are a hotmess at this point.
So when we look at this DBT house, sometimes people will
call the first stage living in hell because that's what the
experience is for a lot of people.
It's overwhelmed, it's distressed, it's constantly
being unhappy and ineffective. And so when you see the DBT
(03:10):
house, the first floor is actually on fire.
And so this is the stage 1 of addressing severe behavioral
dysfunction. This is also called addressing
life threatening behaviors. So when we're in stage one,
we're getting in control. So we are addressing life
threatening behaviors. And so within this life
threatening behavior, it's things like self harm, suicidal
ideation, anything that increases those urges, those
(03:32):
thought patterns, etcetera. What's interesting about DBT is
that things like substance use, binge eating, not taking
prescribed medication, if you get in trouble with the law,
like none of those are considered life threatening
behaviors, are considered quality of life interfering
behaviors. So again, when we are in stage
one, we are only focusing on life threatening behaviors.
That is including not only the actions you're taking, the
(03:53):
behaviors you're engaging in, but also the urges that are
coming up and past experiences with those maladaptive coping
mechanisms. So that is the baseline.
That's the floor of the house. We're on fire, we're
overwhelmed, we're distressed. That is stage one.
That is what you are addressing when you're going into DPT
treatment. Now we're on the second floor of
the house. This is stage 2.
This is called quiet inspirationand this stage you are getting
(04:17):
in touch. So stage one, we are getting in
control here. We're getting in touch and we're
working on emotional experiencing and we're doing
both exposure therapy and also doing some cognitive
restructuring to work to reduce your overall suffering.
And within this encapsulates your quality of life interfering
behavior. So things like drug use, binge
eating, not taking prescribed medication, legal problems,
(04:38):
relationship issues, hierosexualbehavioral, job loss and
financial issues, those are all quality of life interfering
behaviors. They're not life threatening,
but they are impacting your quality of life.
And those are addressed in stage2.
And then stage 3 is problems in living.
So we've got in control, we've gotten in touch, now we're
getting a life. So we are identifying, working
towards our life goals, we're increasing our self respect and
(05:02):
we're both increasing happiness and decreasing unhappiness, but
it's in a more normal scale. So it's called ordinary
happiness and unhappiness. So we're not in stage 1, the
house is on fire. We're constantly overwhelmed.
It's like a normal wave of emotions.
And then the final stage, the roof of the house is
incompleteness because we know that the journey is never over.
You're not like, OK, I got to the top of the house.
(05:24):
I've gone through DBT, my life is perfect.
You're going to continue to implement those skills to the
rest of your life. So it's that radical acceptance
of like, OK, I've done the work,I've given myself the skills to
be able to navigate the challenges that life throws at
me. And this is not the ending
point. Life continues as life goes on
and I will be OK. If you enjoyed this week's
mental health mini, you can listen to the full episode.
It is #146 with yours truly. A link to the full episode is in
(05:48):
the show notes. As always, make sure to leave a
review, subscribe, share with the friend or family member, and
follow at at She Persisted podcast.
Thanks for listening.
Happy Monday and welcome to yourmental health Mini.
This week is a solo and we are talking about DBT.
If you're new here, you're like,what the heck is DBTDBT stands
for dialectical Behavioral therapy and it was a therapy
protocol that was developed by Marsha Linehan that addresses
individuals that are struggling with borderline personality
disorder and suicidal ideations.So it's individuals that are
(00:20):
struggling in a really big way. They're struggling to regulate
their emotions, they're struggling to be interpersonally
effective, and things across theboard are really tough.
And they've had challenges in the past with getting support
and therapy, seeing things get better, shifting their emotions,
their thoughts, their urges, etcetera.
So when Marshall in a hand started developing DPT, she
(00:41):
found that with these really depressed, suicidal, struggling
patients that if you told them to accept their situation, they
rejected that. They were like, you're saying
things can't change. You're saying I'm stuck like
this forever, You're not able tohelp me.
What the heck is your job? That they would get really upset
and pissed off, but then when you told them to change their
situation, they would say, this is my fault.
(01:02):
Like, what are you talking about?
Like, I didn't do this to myself.
Why do I have to deal with this?This isn't my problem.
And so with DBT, there is this perfect blend of the two.
It's a dialectic, which is why DBT is called dialectical
behavioral therapy. So you're balancing acceptance
and change and you're accepting the situation that you're in and
you're working to change it and you're doing both of those
(01:22):
things at the same time. And Marshall in a hand found
that this was a really effectiveway to validate patients and
also motivate them to work on what it was that they were
dealing with. So as I mentioned, this
population that DBT was developed for had a lot going
on. There was all of these crises
that they were dealing with on adaily basis, on a weekly basis.
(01:44):
And I can speak from my own experience going to DBT, it was
like I had this maladaptive coping mechanism come up.
I got in this giant argument with my parents.
I hate this aspect of my life. I'm so hopeless here.
I have no motivate. Like everything is basically a
burning fire, overwhelming code red.
Everything is the worst, always,all the time.
So you have all of these crises going on, and in DBT they've
(02:07):
come up with a really effective way to address these and a
hierarchy in which you deal withthese things to get effective
therapy outcomes and to make sure that you're doing the
correct order of operations. We've all heard of order of
operations. Probably for math, Like first
we're going to do parentheses and then we're going to do our
exponents, and then we're multiplying and dividing, and
then we're doing addition and subtraction.
(02:29):
Same thing exists for therapy. And in therapy, there's 4
stages. In stage one, we are addressing
severe behavioral discontrol. In stage 2, we're talking about
quiet desperation, and stage 3 we're addressing problems in
living, and stage 4 is incompleteness.
So there's actually even a DBT House of treatment, but
(02:49):
basically the bottom house is onfire.
As we talked about, we are a hotmess at this point.
So when we look at this DBT house, sometimes people will
call the first stage living in hell because that's what the
experience is for a lot of people.
It's overwhelmed, it's distressed, it's constantly
being unhappy and ineffective. And so when you see the DBT
(03:10):
house, the first floor is actually on fire.
And so this is the stage 1 of addressing severe behavioral
dysfunction. This is also called addressing
life threatening behaviors. So when we're in stage one,
we're getting in control. So we are addressing life
threatening behaviors. And so within this life
threatening behavior, it's things like self harm, suicidal
ideation, anything that increases those urges, those
(03:32):
thought patterns, etcetera. What's interesting about DBT is
that things like substance use, binge eating, not taking
prescribed medication, if you get in trouble with the law,
like none of those are considered life threatening
behaviors, are considered quality of life interfering
behaviors. So again, when we are in stage
one, we are only focusing on life threatening behaviors.
That is including not only the actions you're taking, the
(03:53):
behaviors you're engaging in, but also the urges that are
coming up and past experiences with those maladaptive coping
mechanisms. So that is the baseline.
That's the floor of the house. We're on fire, we're
overwhelmed, we're distressed. That is stage one.
That is what you are addressing when you're going into DPT
treatment. Now we're on the second floor of
the house. This is stage 2.
This is called quiet inspirationand this stage you are getting
(04:17):
in touch. So stage one, we are getting in
control here. We're getting in touch and we're
working on emotional experiencing and we're doing
both exposure therapy and also doing some cognitive
restructuring to work to reduce your overall suffering.
And within this encapsulates your quality of life interfering
behavior. So things like drug use, binge
eating, not taking prescribed medication, legal problems,
(04:38):
relationship issues, hierosexualbehavioral, job loss and
financial issues, those are all quality of life interfering
behaviors. They're not life threatening,
but they are impacting your quality of life.
And those are addressed in stage2.
And then stage 3 is problems in living.
So we've got in control, we've gotten in touch, now we're
getting a life. So we are identifying, working
towards our life goals, we're increasing our self respect and
(05:02):
we're both increasing happiness and decreasing unhappiness, but
it's in a more normal scale. So it's called ordinary
happiness and unhappiness. So we're not in stage 1, the
house is on fire. We're constantly overwhelmed.
It's like a normal wave of emotions.
And then the final stage, the roof of the house is
incompleteness because we know that the journey is never over.
You're not like, OK, I got to the top of the house.
(05:24):
I've gone through DBT, my life is perfect.
You're going to continue to implement those skills to the
rest of your life. So it's that radical acceptance
of like, OK, I've done the work,I've given myself the skills to
be able to navigate the challenges that life throws at
me. And this is not the ending
point. Life continues as life goes on
and I will be OK. If you enjoyed this week's
mental health mini, you can listen to the full episode.
It is #146 with yours truly. A link to the full episode is in
(05:48):
the show notes. As always, make sure to leave a
review, subscribe, share with the friend or family member, and
follow at at She Persisted podcast.
Thanks for listening.
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