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Dialectical Behaviour Therapy (DBT) and the Buddhist Philosophy

DBT deals with intense and labile emotions. There is a connection between mindfulness and emotion regulation. Mindfulness facilitates adaptive emotion regulation.

Dialectical Behaviour Therapy (DBT) and the Buddhist Philosophy

Posted on March 20th, 2017
Ruwan M Jayatunge M.D.

Dialectical behavior therapy (DBT) is a modified form of cognitive behavioral therapy (CBT) that was developed in late 1970s by Marsha M. Linehan a psychology researcher at the University of Washington (Linehan, 1993). DBT is an empirically supported treatment for suicidal individuals (Linehan et al., 2015). It can be adapted to treat borderline personality disorder patients with comorbid substance-abuse disorder (Koerner & Linehan, 2000) and depressed elderly clients with personality disorders (Lynch et al., 2003). DBT addresses deficits in emotion regulation, distress tolerance and interpersonal relationship.

The patients with borderline personality disorder have faulty schemas and splitting in the patient’s relations to others. They have frantic efforts to avoid real or imagined abandonment. Often they have pattern of unstable and intense interpersonal relationships, impulsivity, emotional instability and recurrent suicidal behavior. In addition they are impacted by chronic feelings of emptiness. Borderline personality disorder is treated with psychotherapy and medication. Dialectical Behavior Therapy and Buddhist Psychotherapy are effective in treating borderline personality disorder.

The basis for DBT is stemming from the mindfulness practice of the Buddhist teachings and the philosophy of dialectics. Mindfulness according to the Buddhism is bare attention a sort of non-judgmental, non-discursive attending to the moment-to-moment flow of consciousness (Sharf, 2015). Mindfulness meditation has three overarching purposes: knowing the mind; training the mind; and freeing the mind (Fronsdal, 2006). As described by Palmer (2002) developing the capacity for being mindful and living in the moment allows a greater potential for feeling appropriately in charge of the self.

DBT combines mindful awareness largely derived from Buddhist meditative practice. Kirmayer (2015) concluded that Mindfulness meditation and other techniques drawn from Buddhism have increasingly been integrated into forms of psycho-therapeutic intervention. Since the 1990s, mindfulness meditation has been applied to multiple mental and physical health conditions, and has received much attention in psychological research (Tang & Posner, 2013). Mindfulness has been described as a practice of learning to focus attention on moment-by moment experience with an attitude of curiosity, openness, and acceptance (Marchand, 2012) Schmidt (2004) states that mindfulness is strongly related to compassion, and it is compassion that serves as a source for all healing intentionality. Both mindfulness and self-compassion involve promoting an attitude of curiosity and non-judgment towards one’s experiences (Raab, 2014). The core mindfulness skills (focus, compassion, curiosity, inner calm, balance, and awareness) lead to serenity.

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