DBT: When Does Talk Become Therapy? (Shop Talk #9)
Can a conversation save your life?
I recently met a therapist who practices dialectical behavior therapy (DBT). She and her team work with clients who may struggle with a number of issues including borderline personality disorders and thoughts of suicide, among other things. As we talked it seemed to me that her practice was very much focused on, well, talking. Her practice of therapeutic talk has a pretty good track record of helping people find ways through each scary personal wilderness.
In Doing Dialectical Behavior Therapy: A Practical Guide (NY: The Guilford Press, 2012), Kelly Koerner describes some pieces of how this therapy works:
Emotion dysregulation is the inability, despite one’s best efforts, to change or regulate emotional cues, experiences, actions, verbal responses, and/or nonverbal expression under normative conditions.
Gaining control is a matter of recognizing biologically-based contributing characteristics, focused regular therapeutic conversations, skills training, self-monitoring and a host of other strategies and tactics.
As a non-therapist outsider, I am simply curious as to how far conversation can go to help people become well again. And I am very curious as to what a therapeutic conversation looks like. While we may or may not suffer the particular illnesses that Koerner notes, I am reasonably certain anyone reading this can testify to the clarifying power of a conversation with a good friend and the long-term impact conversations have on keeping us…sane.
In ListenTalk: Is conversation an Act of God? I try to show what happens in our simple and ordinary conversations. I found a few philosophers to talk with some ancient texts (pre-order ListenTalk here), and what they ended up saying together continues to surprise me. It’s a book that will be interesting to people of faith, but the big idea is that since people matter, our talk together matters. And more than that, we actually come alive in tiny ways when in conversation.
I’ve begun tracing the different paths where conversation is truly an engine for some particular outcome. I’ve noted the product place of conversation in many business settings. I’ve wondered about the role of conversation in connecting any/all of us to God. And now here is another example of using the ordinary tool of talk to uncover and possibly address deep-seated need.
Talk. It’s a marvel.
Other Shop Talks you may find interesting:
- Writing with Sheet Metal (Shop Talk #2)
- Is Your Job Fulfilling? (Shop Talk #3)
- Power Distance Vs. Skunkworks (Shop Talk #8)
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Image credit: Kirk Livingston
conversation is an engine 
Kirk, my daughter had DBT when she was being treated for depression. I’d say it’s more than conversation – it’s changing thought patterns. Of course, those patterns are only discernible to others via conversation, so that’s key to the work! The conversations we had with her involved a lot of gentle reminders about the falsity of the “voices” in her mind telling her she was a failure and tried to help her see the patterns she was falling into unwittingly. She is, thankfully, doing fantastically well now. So I’d say that yes, on some level, conversation can be life-saving.
Mary Thompson
May 22, 2015 at 11:00 am
Mary, Thanks for chiming in.I like how you connect thought patterns as discernible through conversation–that seems right. I also like how you surrounded her with gentle conversational reminders of what is real and what is not. It seems to me friends and family do this for each other constantly, if it is not exactly therapeutic, it seems nearly “pre-therapeutic.” I’m so glad your daughter is doing better. The therapy itself seems rather amazing to me.
kirkistan
May 22, 2015 at 11:11 am