DBT Could Help You Heal From Trauma

Dialectical behavior therapy (DBT) teaches people how to manage and regulate emotions—skills especially helpful for trauma survivors. Learn more about the benefits of DBT for trauma here.

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Dialectical behavior therapy (DBT), a type of therapy developed to treat borderline personality disorder (BPD), has proven to be an effective method for managing challenging thoughts and emotions across a range of mental health concerns—including trauma-related disorders. 

Trauma is defined as the emotional response to experiencing or witnessing distressing life events, such as an accident, physical violence, sexual assault, or natural disaster. As many as 43% of children and teens experience at least one traumatic event in their lifetime. Trauma affects each person differently, but common emotional and physical responses include anxiety, depression, feelings of anger or guilt, trouble sleeping, nausea, fatigue, difficulty concentrating, traumatic flashbacks, and more. 

Through a combination of individual therapy and skills groups, DBT can help people with trauma manage their symptoms, stop self-destructive behaviors, and nurture healthy relationships moving forward. For example, a recent study found that DBT is a more effective form of treatment for post-traumatic stress disorder (PTSD) associated with childhood abuse than cognitive processing therapy (CPT). Keep reading to learn more about how DBT helps survivors of trauma. 

How does DBT therapy help with trauma?

DBT is considered an effective treatment for trauma because it can help people manage intense emotions and impulsive behaviors. It’s a skills-based approach to care, meaning it offers people the tools to heal from trauma and get their mental wellness back on track. DBT typically focuses on teaching skills in four areas: mindfulness, interpersonal effectiveness, distress tolerance, and emotion regulation. Here’s an overview of how each of these four DBT skills can help trauma survivors.

1. Mindfulness 

Mindfulness is defined as the practice of being fully aware and engaged in the present moment without judgment. It’s considered to be a core comportent of DBT and can help people understand how to be more mindful and what to focus on. The “how” skills focus on how to change your response or reaction to your experiences, while the “what” skills encourage people to be more aware of their thoughts and emotions.

For people living with trauma, mindfulness can help them better understand their triggers and learn how to manage their reactions. It can also help to counteract dissociation — the act of disconnecting from your thoughts, feelings, or memories — by encouraging people to remain present in the moment.

2. Interpersonal effectiveness

Interpersonal effectiveness combines social skills, listening skills, and assertiveness training to help people better understand their wants and needs. DBT interpersonal effectiveness skills are designed to empower people to ask for what they need, set healthy boundaries, and work through conflict. For people with trauma, interpersonal effectiveness skills can be especially effective at helping to improve self-esteem, follow their own judgment, and feel more connected with others. 

Here are two examples of DBT interpersonal effectiveness skills that can help manage and overcome trauma include:

• DEAR MAN is a DBT skill that’s taught to help people communicate in interpersonal situations, such as at work or school. The technique involves describing (D), expressing (E), asserting (A), reinforcing (R), practicing mindfulness (M), appearing confident (A), and negotiating (N). DEAR MAN provides people with trauma with a structured approach to discussing traumatic experiences and triggers with others, promoting healing and recovery.
• FAST is another skill that’s designed to help people express their needs. It involves being fair (F), apologizing (A), sticking to values (S), and being truthful (T). For people with trauma, the FAST skill can help them express needs and maintain healthy boundaries, reducing the risk of retraumatization and promoting well-being.

3. Distress tolerance 

Distress tolerance teaches individuals how to use healthy coping techniques to navigate tough situations. Instead of defaulting to destructive behaviors such as self-isolating or substance use, distress tolerance empowers people to accept the current situation and adopt a more positive long-term outlook. This skill set can be helpful for not only managing trauma but also preventing further health concerns. For example, research suggests a strong connection between exposure to traumatic events and substance use problems, and distress tolerance skills can help people with trauma adopt healthier coping skills.

TIPP is an example of a distress tolerance skill that was designed to help people to calm down, self-regulate, and manage distress. TIPP stands for temperature (T), intense exercise (I), paced breathing (P), and progressive relaxation (P). For example, if a person with trauma is feeling triggered and has the urge to act out in a destructive way (like yelling, punching a wall, etc.), they can use TIPP and try taking a cold shower instead. 

Other simple ways to practice distress tolerance with DBT treatment include radical acceptance (accepting reality as it is) and weighing the pros and cons of different actions or situations.

4. Emotion regulation

Emotion regulation skills can help people with trauma to better understand, manage, and respond to their emotions. This component of DBT teaches people that they have the power to deal with their emotions before those emotions lead to unhealthy feelings or behaviors. Emotion regulation can also help to reduce emotional vulnerability and emotional suffering.

PLEASE is a DBT skill that trauma survivors can use when they’re feeling overwhelmed or emotionally vulnerable. It encourages people to care for their emotional well-being by addressing lifestyle factors that impact mood. PLEASE stands for physical illness (PL), balanced eating (E), avoid mood-altering substances (A), sleep (S), and exercise (E). For example, if someone with trauma feels triggered and at the verge of crying at work, they can consider if there are any physical needs they could meet to feel better, like going on a short walk and grabbing a nutritious lunch. 

How do I know if DBT is the right trauma treatment for me?

If you’re living with traumatic stress, consider speaking with a mental health professional right away. Whether you’re experiencing acute trauma from a single event or prolonged exposure to distressing events, treatment can help you manage symptoms and begin to heal. Plus, when left untreated, traumatic stress can even lead to other mental disorders and physical complications.

So, how do you know if DBT is the right form of psychotherapy to treat your trauma disorder? To start, DBT is considered to be an effective form of care for people who feel that their emotions are often overwhelming, debilitating, or interfering with work, school, or goals. 

It’s also a good fit for people who have:

• Difficulty with relationships
• Behavioral problems
• Trouble managing their thoughts
• A desire to have a more meaningful life
• Overwhelming feelings of hopelessness or emptiness
• Identity issues 
• High-risk behaviors, such as alcohol and drug abuse or unsafe sexual behaviors

DBT skills with Charlie Health

If you’re dealing with trauma and want to heal, Charlie Health is here to help. Whether you recently survived a traumatic event, have lived with complex trauma for many years, or are facing another trauma-related mental health condition, healing is possible. 

Charlie Health’s virtual Intensive Outpatient Program (IOP) offers personalized mental health treatment for teens, young adults, and families who need more than once-weekly therapy, including those facing trauma and complex trauma. Dialectical behavior therapy (DBT) skills are a cornerstone of our treatment approach, and we offer many different DBT skills groups based on clients’ unique mental health needs and goals. 

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