Monday, February 15, 2016

I Wanna Get Better: A Different Approach to Therapy

For those of you who aren't majoring/minoring in psychology and haven't taken a class on abnormal or clinical psych, all therapy may seem to be more or less the same. A person goes in, talks about their problems, their therapist gives them some advice, and they start to get better, right? In reality, therapy is much more complicated, and there are many specific methods and approaches that clinical psychologists use that have been proven to yield the best chances of recovery for their patients; types of exposure therapy for patients with specific phobias, cognitive behavioral therapy for patients with general anxiety or depression, etc. But for a long time, psychologists were stumped when it came to patients with a disorder known as BPD.

BPD, which stands for borderline personality disorder, is characterized by emotional instability, impulsiveness, and difficulty in having stable relationships with others, and more "traditional" forms of therapy generally do not help those with BPD improve their symptoms. For a long time, therapists would either flat-out refuse to work with people with a BPD diagnosis or would spend months or years working with these patients with little to nothing to show for it. This began to change in the late 1970s, when a LUC alum and psychology researcher named Marsha M. Linehan developed a method known as dialectical behavior therapy (DBT).
Marsha M. Linehan,
developer of DBT

Linehan, who herself lived with BPD, was researching the effectiveness of treatments for chronically suicidal women when she and her research associates realized some of the pitfalls of cognitive behavioral therapy (CBT) in treating their issues. She noted that CBT tended to
  • Invalidate the emotions of the women, which caused them to act out more
  • Create unhealthy cycles in the patient-therapist relationship
  • Leave therapists unable to address the wide array of issues the women dealt with while also helping them learn the skills needed to cope in daily life
After finding these issues with CBT as a treatment, Linehan and her associates took CBT back to the drawing board so they could adapt it with these issues in mind. Several modifications and a completely new set of treatment goals later, Linehan and her team had developed DBT as a treatment specialized toward what patients with BPD and similar symptoms of BPD. In the group's first study of the effectiveness of DBT, they found that DBT had a significantly lower dropout rate for patients (36% compared with 73% for CBT), that patients who had been substance abusers were eventually able to stop using, and that patients reported improvements in their symptoms. Additional research has shown that DBT can be effective for patients with PTSD and patients with more chronic mental illnesses.

Though DBT may seem to be "leaps" away from CBT, through examining the potential processes that Linehan went through to reach it reveal similar patterns as found in Weisberg's writings on problem solving. According to Weisberg, the inclusion of new information can help trigger memories of solutions that relied upon similar information in the past, and that these memories help redirect thoughts of new solutions that seem "leaps" away from previous solutions. In this case, the realization that there are specific flaws in CBT that prevent improvement of BPD symptoms helped Linehan redirect the solution toward a more empathetic and dialectical model of therapy that was not initially thought of. Through this change in approach to problem-solving, Linehan and her associates were able to develop a truly unique and effective solution that continues to help mental health patients today and that will help for years to come.

Works Cited

Weisberg, "Creative Problem Solving: The Charlie Problem." p. 104-105


  1. Abbey, this was interesting to read! I'm glad to hear that there is now hope for people with Borderline Personality Disorder to receive the effective therapy they need. It's especially neat that Linehan was a Loyola alum!

  2. As a person who has studied and shadowed DBT therapy, it is an absolutely incredible form of therapy because it covers all grounds. In the past, BPD was overlooked or diagnosed with strong reluctance. Now, it is an actively and appropriately diagnosed and treated disorder! I think it is so important to treat the entire person, and not only get past problems, but also know how to combat them in the future with distress tolerance and mindfulness. (How appropriately Jesuit as well). Although, I do think it is important to recognize that CBT therapy is still an incredibly effective form of therapy, but not for BPD patients. CBT can be effective for those with different abnormal psychological disorders!

  3. I love everything about this! We discussed how mental health issues affecting women are often ignored or seen as less valid in my Psychology of Women class last semester, and DBT was often brought up as a potential solution. I think the ideas of "radical acceptance" plays a huge part in what makes DBT such a great tactic in dealing with such debilitating illnesses; definitely check it out if you have the time. Excellent read!


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