DBT Therapy Orlando: Working with Anxiety and Eating Disorders
Orlando Therapist Discusses DBT Therapy: Working with Anxiety and Eating Disorders
Do you often find yourself distracted by the past or the future? Does your life move past you in a blur? Do your thoughts and behaviors feel out of your control?
As therapists in Orlando, we see clients who feel that they have lost control of themselves. They no longer have the ability to slow down and live for the here and now. They feel anxious, overwhelmed, and helpless.
Dialectical Behavior Therapy (DBT) is an option for those who want to gain control back from their emotions and/or behaviors that are causing them anxiety, overwhelm, and helplessness.
What is DBT?
Dialectical behavior therapy (DBT) is a type of cognitive-behavioral therapy. Its main goals are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others. [1]
The “D” in DBT means “dialectical.” A dialectic is a synthesis or integration of opposites. In DBT, dialectical strategies help you get unstuck from extreme positions.
The “B” in DBT stands for “behavioral.” DBT requires a behavioral approach. This means that you and a therapist assess the situations and target behaviors that are relevant to your goals in order to figure out how to help solve the problem(s) you are experiencing.
The “T” in DBT stands for “therapy.” DBT is an evidence based psychotherapy treatment. Commonly used for people with borderline personality disorder, suicidal behavior, self-harm, substance use, post traumatic stress disorder, depression, and eating disorders.
How does DBT work?
DBT is based on 6 characteristics. Those characteristics are:
Acceptance and change. You’ll learn strategies to accept and tolerate your life circumstances, emotions, and yourself. You will also develop skills that can help you make positive changes in your behaviors and interactions with others. [1]
Behavioral. You'll learn to analyze problems or destructive behavior patterns and replace them with more healthy and effective ones. [1]
Cognitive. You'll focus on changing thoughts, beliefs, behaviors, and actions that are not effective or helpful. [1]
Collaboration. You'll learn to communicate effectively and work together as a team (therapist, group therapist, psychiatrist). [1]
Skill sets. You’ll learn new skills to enhance your capabilities. [1]
Support. You'll be encouraged to recognize your positive strengths and attributes and develop and use them. [1]
At Mindful Living Counseling Orlando, we use DBT with our clients who are struggling with anxiety, eating disorders, and unhealthy relationship patterns.
Why DBT?
We use DBT with our clients because it allows them to be who they are, appreciate their emotions for what they are (distressful or not), and because it teaches them how to live an authentic and fulfilling life WITH all of their emotions.
We find this is important in healing work because we have always found it helpful when the distressful emotions are normalized and clients are able to appreciate the emotions, like anxiety or sadness, for what they are and how they help them or how they can provide them guidance. For example, a client can learn that when they are sad they know they had something they cared about. It could also be a reminder that they want to make a change so, when they are anxious, they allow it to remind them to take a step back and to plan accordingly. Then, when they do move forward through the distressing feeling, there is a possibility to feel a sense of pride and achievement when they did something that they felt was difficult.
DBT encourages us to be in the moment, to smell the roses, so to speak. Instead of constantly running from the feelings of possible disappointment, guilt, or anxiety, it encourages you to slow down and take them all in, good or bad.
How does DBT help with anxiety?
Often, with anxiety, our minds are focusing on the past or the future. The “should haves...” or the “what ifs…”
With DBT, we can teach our mind to stay in the present, in the here and the now, and take things one step at a time so that life doesn’t feel so overwhelming. It teaches us to validate our emotional mind and to strengthen our logical mind so that we can combine the two, what is called the Wise Mind in the DBT terms, to make choices not solely based on our emotions. Reacting to our emotions can lead us to create more “should have” worries which then increases our anxiety around our ability to handle the future “what ifs.”
Chain Analysis, a technique to understand our behavior, helps us to validate our anxious responses, especially when we become more aware of our vulnerabilities in the moment that made us less able to cope with the situation and the emotions that came up with it.
How can DBT be helpful with eating disorders?
Clients who suffer with an eating disorder often feel disconnected from their physical and emotional responses. DBT can help become more mindful and present in their life connecting them back to their physical and emotional responses.
Often times when someone is struggling with an eating disorder, the brain isn’t receiving the nourishment that it needs to be able to regulate their emotions. DBT provides clients the skills that can support them to be more in tune with what is happening in their body, allowing them to take a step back and ground themselves, then being able to address the situation more effectively.
Some of those skills taught in DBT that are helpful for people struggling with an eating disorder are:
STOP (stop, take a step back, observe, proceed mindfully)
TIPP (temperature, intense exercise, paced breathing, paired muscle relaxation)
ACCEPTS (activities, contributing, comparisons, emotions, pushing away, thoughts, sensations)
How can DBT be helpful for someone that has unhealthy relationship patterns?
DBT can help someone with unhealthy relationship patterns because it teaches skills that are important to have when forming healthy relationships with others.
DBT helps to teach assertiveness skills, helps to reduce defensiveness between loved ones and helps a person to be able to speak their needs.
DEAR MAN is a communication format that is used in DBT that can help a person express their needs and desires. DEAR MAN stands for: describe, express, assert, reinforce, mindful, appear, negotiate.
GIVE and FAST are also DBT skills that are implemented to support the skill of maintaining healthy relationships while continuing to honor your own boundaries and needs. GIVE stands for: gentle, interested, validate, and easy manor. FAST stands for: be fair, no apologies, stick to values, and be truthful.
Are there any specific techniques from DBT that can help someone feel more calm?
Using the TIPP skill set can help a person feel more calm in times of distress.
The “T” in TIPP stands for Temperature. Using temperature could look like putting cool water on your face or holding ice to shock you out of the emotional response which brings your frontal lobe back online.
The “I” in TIPP stands for Intense Exercise (in the case of clients who are struggling with an eating disorder, we switch intense exercise to intense energy exertion). The purpose of this is to let out the built-up anxious energy that comes with the adrenalin or defense responses of feeling unsafe or distressed.
The “P” in TIPP stands for Progressive Muscle Relaxation and then Paced Breathing. The purpose of these skills is to calm the parasympathetic nervous system when a person is in a flight, fight, or freeze response.
Anxiety Therapists in Orlando
Sometimes you need a little more than self-help blogs. We get that. If you’re looking for some additional support, we are here to help. We’re offering in-person and virtual appointments. Click here to find out more about counseling at Mindful Living Counseling Orlando.
[1] The Linehan Institute Behavioral Tech. What Is Dialectical Behavior Therapy (DBT)? 2017.
Mindful Living Counseling Orlando is a trauma healing center. Our Orlando Therapy Services include anxiety therapy, trauma counseling, eating disorder recovery, teen counseling, and healing from toxic relationships. At Mindful Living Counseling Orlando, we use a down-to-earth approach infused with cutting-edge therapies that go beyond traditional talk therapy so clients can heal at the root level and experience lasting change. Feel free to access one of our Guided Meditations to help you feel settled and calm now.