During a recent hospital visit to address a low white blood cell count, a side effect from the kidney transplant she received last year to manage lupus, singer Selena Gomez reportedly experienced a panic attack, and realized she needed to seek additional help.
News reports claim the “13 Reasons Why” producer, who’s been vocal about her struggles with depression and anxiety through the years, endured an emotional breakdown on the second of two stays at her local medical center. Reporting on the events, People mentioned that Gomez had been undergoing Dialectical Behavioral Therapy, a treatment Gomez told Vogue last year “has completely changed my life.”
Gomez stands to radically improve her life with treatment, multiple studies indicate. But what exactly is it?
DBT, was developed in the 80s by psychology and psychiatry professor Marsha Linehan at the University of Washington to decrease suicide, suicidal ideation, self-harm, purging, and even more fundamentally, “to help people build a life worth living.”
Rachel L. Hutt, Ph.D., a licensed clinical psychologist and DBT-Linehan board-certified clinician who practices at MindWell NYC, says the therapy works by helping people realize “that they actually have reasons to live,” as opposed to just warding off self-destructive impulses and practices. Eventually, she explains, it proved to be an effective practice for people with many sorts of problems tethered to an inability to manage their emotions, including those stemming from depression, anxiety, eating disorders, drug addiction and, more recently, PTSD.
“Overall,” she says, “it’s a treatment to help people manage emotions, decrease destructive behaviors, and to build a life that makes them want to live,” she says, emphasizing that it offers a set of skills and strategies, “very concrete tools,” to use to better cope with difficult feelings.
DBT treatment has four components: Individual therapy; group therapy focused on acquiring life skills — mindfulness techniques, emotion regulation, and interpersonal effectiveness — to help you healthily manage your emotions, behaviors and relationships; phone coaching, where you can access your therapist for “a quick boost in skills use” in real time and your therapist must be on a team with other DBT practitioners to get help managing your case.
Some may conflate DBT with Cognitive Behavioral Therapy (CBT), which is not surprising given that DBT includes CBT methodologies with the added benefit of “new wave treatments,” which center on acceptance and mindfulness, Hutt says. Adam Carmel, Ph.D., a clinical assistant professor who works in the lab of DBT pioneer Marsha Linehan at the University of Washington, adds: “What makes DBT differ from traditional CBT approaches is that in addition to changing problematic thoughts and behaviors, which is the core approach of CBT, DBT places emphasis on acceptance,” he says. “DBT therapists use acceptance-based approaches just as much as change-based approaches while working with clients to accept their difficulties in life as they learn new ways to cope.”
For people who don’t have access to insurance or the hefty out of pocket fees, which can run anywhere from $150 to $500 per individuals sessions and $100 to $200 per group sessions, Hutt recommends purchasing — and putting into practice — Marsha Linehan’s DBT Skills Training Handouts and Worksheets, Second Edition. Hutt stresses that the book can’t replace working with a trained practitioner, but the handouts are very user friendly and cover DBT’s main tenets.
Hutt also points out that it’s important to find a certified DBT specialist: “There’s a lot of misinformation out there about what DBT is, as well as practitioners who say they do DBT, but don’t actually do full DBT,” she says. Aside from what Hutt outlines here, she encourages readers to check out clinical psychologist Esme Shaller’s video on the topic, “What Is Dialectical Behavior Therapy,” describing it as “a great resource.”
To help manage your distress, Hutt and Carmel recommend culling from the DBT module ACCEPTS, which stands for Activities, Contributing, Comparisons, Emotions, Push away, Thoughts, and Sensation. Give the first three a go for starters:
Act: To calm heightening tension, maybe a negative thought that won’t relent, interrupt it by doing something healthy like reading a book, calling a good friend, going for a walk or watching a movie. Move on to another pleasurable activity once the first one is complete until you can steady your emotions or watch them dissipate altogether.
Contribute: Help someone in need, whether it’s a close friend or a cause that you believe in. It’ll shine some light on your darkness by making you feel good about yourself for being of service to someone you love or a cause greater than yourself.
Compare: Get some perspective on your situation by thinking of the larger scheme of your own life and the lives within and beyond your immediate world who may have harder lots. It’ll help de-magnify your own problem and remind yourself that others have overcome greater challenges and maybe even thrived.