Hey, Psych Bytes with CCS is a weekly podcast hosted by Student Life Counseling and Consultation Service. This show is dedicated to discussing a wide range of topics pertaining to mental health commonly experienced in the college setting. It is important to note that this podcast is not a substitute for therapy. All of the topics on this show, while discussed by professionals are strictly psycho educational, and meant to inform listeners on available resources, skills and support. Topics on this show can be sensitive in nature. And should you find yourself needing additional support or resources, please visit ccs.osu.edu or call us at 614-292-5766. With that in mind, enjoy the show. What is up everybody and welcome to Psych Bytes with CCS. My name is Josh and today we are joined by Jennifer Lang, a licensed independent social worker with a supervisory designation and the Assistant Director of Clinical Services here at CCS. Welcome, Jennifer.
Jennifer Lang:Hello.
Josh Bailey:Today you and I are going to be talking about DBT, which I think a lot of people may have heard of through social media and things like that when talking about treatment for certain conditions. But you are our resident expert on all things DBT. So I was hoping that today, you could tell us a little bit about it. What it is? Who it's for? How it works? Things of that nature.
Jennifer Lang:Yeah, sure.
Josh Bailey:Awesome. So let's start off with the obvious question. What is DBT?
Jennifer Lang:Yeah, so thanks for having me, Josh. I'm really excited to talk about this today. DBT is very near and dear to my heart. In treatment, a lot of times therapists or providers are throwing around these different types of therapy— DBT, CBT, EMDR— right? Like all these letters, what do they mean? So Dialectical Behavioral Therapy is what DBT stands for. The"dialectical," that word, right? A lot of people haven't heard of that before. And essentially, what "dialectical" or"dialectics" mean is when we are holding two seemingly opposing concepts as both being truthful, at the same time, right? So it's seeing that things can be complex, it's not all or nothing, it's not black or white, right? It's helping us understand that the world is complex. So the main "dialectic" in Dialectical Behavioral Therapy is the concept of needing to be accepted, be validated, right? But also that we might need to change, right? And both of those things are real and necessary at the same time. Dialectical behavioral therapy was developed by Dr. Marsha Linehan in nine— in the 1970s, and it initially got developed to address self harm or thoughts about suicide for patients.
Josh Bailey:Wow. All right. So when you were talking kind of early before, like, it's acknowledging that two things can be equally true at the same time. Do you have any, like, examples that maybe come up more often than not?
Jennifer Lang:Yeah, so one that comes to mind when I think about, for example, students who are coming in with unhealthy coping, right? That they, for example, might really enjoy going on social media to escape, right? Escape things that are stressful, anxiety provoking, things of that nature. So validating that, yes, that's been helpful for you, and accepting at the same time that there's a limit to that. And there's also a point at which it becomes unhelpful, and that we might want to modify or change that behavior.
Josh Bailey:Gotcha. So helpful in the sense that I can go out and find connection and community and validation, but then unhelpful in the context that I become dependent on that validation. And I need that.
Jennifer Lang:Right.
Josh Bailey:I see. So with DBT, I'm assuming there are techniques or skill sets or things that are associated with it. Could you talk a little bit about that?
Jennifer Lang:Sure. So I think DBT is different than some other types of treatment in terms of how skill driven it is. Right? So if you think about what I was just speaking to, with the unhealthy coping mechanisms, DBT is really meant to target those behaviors, and to give us some new ways of managing stressful situations and our emotions. So there are four different skill sets within DBT. The main skill set is something that I think a lot of folks are already familiar with, right, which is the concept of mindfulness. And mindfulness is important in DBT, because it really speaks to the need to slowing down and being in the present, so that we can build insight and understand what we're doing.
Josh Bailey:Okay.
Jennifer Lang:So quite literally getting an awareness of what my emotions are, what my urges are, what my thoughts are real time, so that I'm better able to manage them. So that's the first skill set. The second skill set is emotion regulation. So this is a skill set that looks at how do we target emotions that are maybe out of proportion to the situation that we're in, or maybe are lasting in a duration that isn't really warranted or helpful. So an example of this might be if somebody's feeling very angry or resentful about maybe something that happened a long time ago. And we're starting to recognize that that emotion is getting in the way of our current goals, because of how long it's been going on for. So emotion regulation really helps us to target those unhelpful emotional patterns, and kind of re calibrate our emotions in a way that is healthy. So that's emotion regulation. And then we have one of my favorite skill sets is interpersonal effectiveness. So those are big words for basically, how do I have a good relationship with myself? Sometimes we forget about that. Right? That relationships also include a relationship with self. And then also, how do I have my needs met and other relationships, while also thinking about others in those relationships? So that skill set really looks at how do I communicate boundaries with others? How do I make sure folks know what my limits are, and protecting those boundaries and communicating them? And it can also mean asking for things that I need in relationships. How do I advocate for myself and make sure that I can ask for others things that I need in a way that really reinforces the kind of reciprocity in that relationship? And one of the last skill set is distressed tolerance. And that is where we are learning to sit in distress, right, acknowledge that it might be happening, without acting in a way that is incongruent with our goals, our values, and in a way that is ultimately more healthy for us. So it is hopefully avoiding falling into those unhealthy coping mechanisms by replacing them with others.
Josh Bailey:Gotcha. Okay, so I'm glad we used the concept or the, the example of social media earlier, because as you were talking about these different skill sets, or elements, I was thinking, Oh, how does this apply to social media? How does this apply to social media? So I'm thinking about, like, emotion regulation, I am putting myself out there and putting these pictures on social media, I'm expecting people to like them, or provide me a validation. And if somebody doesn't like it, then I am deeply hurt, or I am really, really upset. And if I notice, oh, my friend who's always, you know, checking my stuff didn't like this particular photo, then all of a sudden, I'm very upset with them, and I'm lashing out towards them, or not really being able to sit with, maybe they just didn't see it? Maybe they just didn't like it. So if I find myself in those types of situations, where it seems like my reaction is very much out of proportion, this might be a good technique or a good led to address those problems to address those symptoms.
Jennifer Lang:Yeah, so I think in that situation— and that's a great one and one that comes up a lot— I think, you know, if I was sitting with you as a client, I might first stop and say, Okay, well, let's name what the emotions are that you're feeling, right? Because again, going back to the dialectic, we do want to validate because that is real, that feeling that you're having, right? But then maybe the next step would be looking at, Alright, Josh, let's scale that anger and hurt on 1 to 10 for intensity, right? Like one being, it's there, but barely, right? And 10 being like really, really extreme. And so if you were scaling it and you gave me a number, right? Then I would ask you to maybe step back, and let's say like, What do you think a lot of your friends might scale their feeling at? Right? So we're wanting to like gain some perspective around the proportion of the intensity, and if it fits the facts of the situation, right? So if we recognize that it didn't fit the facts, we would probably do an emotion regulation skill called"Opposite Action," right? Which is basically to do the opposite, right, behavior that is associated with the feeling that you're having, with the hope, right, that we see the intensity of the feeling that you're having go down.
Josh Bailey:Okay.
Jennifer Lang:I think maybe the next step, too, could be to look at an interpersonal effectiveness skill, which could be to, if you have a very close or trusted friend, is to maybe approach them and share what your reaction or feeling was. Right? Let's do something with it in a way that helps strengthen your relationship and maybe get some of your needs met.
Josh Bailey:So actually going out and addressing it versus just sitting on it, stewing on it, right? Developing a resentment.
Jennifer Lang:Right.
Josh Bailey:Okay. Alright, outside of my social media using self who can't deal, who is DBT for? Like, who do we cater this towards?
Jennifer Lang:Sure. So I think as I mentioned earlier, this was initially developed for folks who were engaging in self harm, or who had had thoughts or behaviors around suicide. However, over the past— wow, I can't even believe I'm saying this now— almost 50-some years of DBT being around, there have been a lot of research studies that demonstrate its usefulness with a lot of different diagnoses and just behaviors in general. So for example, folks dealing with substance use concerns, eating disorder concerns, I think it is very widely known to be the treatment standard for Borderline Personality Disorder. But folks with trauma histories, DBT skills are sometimes the first initial layer of treatment for trauma, right? Because we want to set up some good coping habits for when we're managing some of those traumatic treatment concerns. So it has a wide range of use, which is, I think, really fantastic. I think DBT can be used in a lot of ways, though. And so you don't necessarily have to have a diagnosis of any of the things I just listed to benefit from it. So just identifying, "I want to deal with my emotions differently, or better," right? Or, "Gosh, I really don't have a lot of skills or ideas for how to have healthier relationships." This can be a type of therapy that gives you some of those skills.
Josh Bailey:What might this look like here at CCS, where we are a brief solution-focused model, versus somewhere in the community where you might have the opportunity for weekly therapy or really long term therapy? What might we see differently?
Jennifer Lang:Now that's a great question. And so DBT initially had been developed as you need to be in weekly individual therapy, and in what's called a skills group, which is really where you're learning a lot of those skills that I was listening earlier. Not everybody has time for that.
Josh Bailey:True.
Jennifer Lang:And not everyone is necessarily needing that level of commitment. However, if that sounds interesting to you, you're really wanting to commit to doing a full DBT program, there are a number of providers in the Columbus area who do provide that service. If you're interested in that, I would encourage you to check out at the psychological services center on campus, they have a DBT clinic. And we have a really awesome community provider database on our CCS website, where you can literally click"DBT" and it will search a number of providers in the Columbus area who take your insurance and also provide that service. So those are some options if you're really looking for that more traditional DBT approach. Or if you have been recommended that type of a program by a previous provider, or maybe even someone at CCS. At CCS, we have a number of providers who have some DBT training and so can infuse some of your individual brief work here with some of those skills that I mentioned. We also typically offer a DBT informed skills group every semester. So that is an opportunity. It's, you know, a short term basis. So you're looking at between 9 and 12 group sessions, which can feel like a good option for a lot of students. I think another really good place to start though, is our DBT drop-in workshop. So again, that is a low commitment to kind of dip your toe in the water, see if this works for you. So it's called Building Mastery and it's offered on one day a week, you can check out our website to see what our schedule is for fall. But basically, if you go to four workshops in a row of building mastery, you will get some skills from each of the four skill sets I mentioned, right? So you'll get a week of mindfulness, a week of emotion regulation, a week of interpersonal effectiveness, and a week of distress tolerance. So that can be a really good place to start. If this is something interesting to you, and you just want to learn more or see what's available.
Josh Bailey:That's fantastic. So it really does sound like that, at least here at CCS, we have a tiered system of trying it out right through the drop-in workshop, through, you know, brief solution, focused individual therapy, and then of course, a little more intensive during the skills group, right? With weekly therapy.
Jennifer Lang:Yeah. And if we decide in collaboration with you that it's like, well, you're finding this really useful, but like, maybe you're needing more, then we can help get you to some of those providers that I mentioned, that offer more of that kind of traditional, more kind of intensive DBT model.
Josh Bailey:Yeah. So as I'm kind of looking at the time here, I want to see if you have any kind of closing thoughts or anything that you would want to maybe expand on a little bit more just to put out there before we do conclude today?
Jennifer Lang:No, I think my reflection has been when I got trained on DBT, part of the training, right, is that you actually are kind of doing it yourself. And I just remember, almost, I was overwhelmed with excitement of just how helpful I found it to be in my day to day life. So I often joke with my clients who I'm doing DBT with that, I practice the skill all the time at home, whether it's with my husband, or with my friends, right? So when I'm talking the talk, I always tell clients, I'm also walking the walk, this is something that I think can be really helpful and beneficial for a lot of people.
Josh Bailey:Thank you very much for sharing that and kind of putting your own use with it out there. So Jennifer, thank you very much for joining us today. Hopefully we'll have you back for some more episodes in the future.
Jennifer Lang:Yes, I would love that.
Josh Bailey:All right, and everybody else. Thank you very much for joining us today. Keep your eyes peeled for our next episode. And until next time, take care of yourselves and we'll see you then.