How DBT Can Help Trauma Survivors: Part II

In the previous blog, we defined PTSD as a “normal reaction to an abnormal event,” and also as the “trauma after the trauma.”  We also saw that traumatized individuals (such as Sofia) often end up with deficits which cause problems in five key areas:

  • Poor awareness
  • Unhealthy coping
  • Painful emotions
  • Rocky relationships
  • Rigid / false beliefs

It is precisely these deficits which sometimes cause even more problems than the original trauma!

Sounds pretty dismal, doesn’t it?  Fortunately, DBT was specifically designed by Dr. Marshal Linehan to address each of these deficits! DBT works by teaching five specific skill sets.

  • Mindfulness to increase awareness of self and others.
  • Distress Tolerance to better cope with stress and triggers.
  • Emotion Regulation to manage painful emotions.
  • Interpersonal Effectiveness to increase people skills.
  • Dialectical Thinking to learn more flexible ways of thinking.

But as Sofia will be the first to tell you, learning these new skills is not easy and does not happen over night!

Why Learn DBT

There are many models which are used to treat trauma symptoms. DBT was selected for this blog for several reasons:

  1. DBT has been shown to be extremely effective in treating each of the five deficits which traumatized individuals tend to experience.
  2. DBT is an extremely pragmatic model in that it teaches practical skills to address practical needs that both clients and clinicians can apply immediately—in the here and now.
  3. All of the skills can be learned and practiced on your own, regardless of whether or not you are currently in therapy.
  4. Research has also found DBT to be effective with a host of other disorders which are closely associated with trauma. Some of these disorders include insomnia, anxiety, ADHD, depression, oppositional defiance, various eating disorders, and Borderline Personality Disorder.
  5. DBT is also very compatible with other models for treating trauma symptoms (such as TF-CBT).

To learn more about DBT, sign up for a 2-day seminar in your area! Any questions? Comment Below 

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How DBT Can Help Your Trauma Patients: Part 1

Meet Sofia. Sofia’s mother was a prostitute in Mexico—and her father was one of her clients from the United States.  Eventually Sofia was adopted by her father, who started to raise her as a prostitute herself—right in his own home.  Sofia’s father eventually impregnated his own daughter—and then aborted the baby himself!  Sofia was traumatized.

The Effects of Trauma

Trauma is a normal reaction to an abnormal event.  Sometimes the symptoms of trauma persist long after the traumatic situation has ceased.  This is what psychologists call Post-Traumatic Stress Disorder—in other words, the “trauma after the trauma.”  This happens when the aftermath of the trauma ends up causing more ongoing harm than the trauma itself.

Trauma can affect all aspects of our functioning, starting with awareness.  Victims of trauma often learn to dissociate from their experiences.  This means they learn to “check out” or block the traumatic event to protect themselves from the resulting physical and emotional pain.  When individuals learn to ignore or suppress their own experiences, this leads to a basic lack of self-awareness which affects other aspects of their lives.

For example, Sofia learned to dissociate when she was being molested and raped by her father by following a crack another the ceiling and mentally disengaging from her body.  In fact, Sofia eventually learned to dissociate from anything painful in life, which started to cause more problems than it solved.  That’s why Sofia had to learn the DBT skill of Mindfulness (how to become more aware).

People who have been traumatized also tend to have exaggerated responses to the brain’s three instinctive reactions to danger: fight, flight, and freeze.  This means they are easily triggered and more prone to over-reacting, avoidant behaviors, or shutting down.

Even many years after her father’s abuse, Sofia continues to experience each of these reactions in her current relationships with romantic partners.  For example, sometimes Sofia will become quickly escalated or even belligerent; sometimes she shuts down for days at a time; and sometimes she just walks out and never returns.  That’s why Sofia needs to learn the DBT skills of Distress Tolerance (how to cope in healthier ways) and Interpersonal Effectiveness (how to navigate relationships).

Traumatized people also tend to have more negative emotions (such as fear, anger, and sadness) while enjoying fewer positive emotions (such as joy or excitement).  In addition, survivors of trauma tend to have more impulsive decision-making processes, more negative beliefs, and a skewed sense of blame.

For example, Sofia continues to experience intense episodes of anger and long periods of sadness.  Besides these negative emotions, however, Sofia mostly just feels empty and numb.  In addition, Sofia continues to think she is worthless, continues to blame herself for cooperating with her father’s abuse, and continues to make impulsive decisions which “resolve” one crisis only by creating another one.  Due to her unbalanced thoughts and feelings, Sofia has had to learn the DBT skills of Emotion Regulation and Dialectical Thinking (how to manage painful emotions and change how you think).

How DBT Can Help

As a result of all of these factors, traumatized individuals (such as Sofia) often end up with deficits which cause problems in five key areas:

  • Poor awareness
  • Unhealthy coping
  • Painful emotions
  • Rocky relationships
  • Rigid / false beliefs

It is precisely these deficiencies which sometimes cause even more problems than the original trauma!

Sounds pretty dismal, doesn’t it?  Fortunately, DBT was designed precisely to address each of these deficits!  DBT works by teaching five specific skill sets.

  • Mindfulness to increase awareness of self and others.
  • Distress Tolerance to better cope with stress and triggers.
  • Emotion Regulation to manage painful emotions.
  • Interpersonal Effectiveness to increase people skills.
  • Dialectical Thinking to learn more flexible ways of thinking.

But as Sofia will be the first to tell you, learning these new skills is not easy and does not happen over night!

Why Learn DBT

There are many models which are used to treat trauma symptoms. DBT was selected for this training for several reasons:

  1. DBT has been shown to be extremely effective in treating each of the five deficits which traumatized individuals tend to experience.
  2. DBT is an extremely pragmatic model in that it teaches practical skills to address practical needs that the learner can apply immediately—in the here and now.
  3. All of the skills included in this training can be learned and practiced on your own, regardless of whether or not you are currently in therapy.
  4. Research has also found DBT to be effective with a host of other disorders which are closely associated with trauma. Some of these disorders include insomnia, anxiety, ADHD, depression, oppositional defiance, various eating disorders, and Borderline Personality Disorder.
  5. DBT is also very compatible with other models for treating trauma symptoms.

The skills you learn in this training will only enhance the insights you can learn from other sources.

 

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