emotional regulation system stemming from
biological irregularities interacting with an
adverse, invalidating (rejecting) environment.
The consequences are difficulties in labelling
and regulating emotions and trusting one’s own
experience as valid, and self-mutilation functions
to reduce intolerable painful emotion.
Emotional dysregulation takes the form of rapid,
intense reactions, and these produce the
characteristic problems in relationships,
sense of
self, impulse control, and cognitive distortion.
Skills training and problem-solving
techniques are applied in group treatment to
improve interpersonal conflict resolution,
distress tolerance, and emotion regulation, but
these are balanced by individual supportive
techniques (reflection, empathy, acceptance)
from Eastern philosophies (Zen) and the use of
meditation. Dialectical strategies also pervade
therapy. These include teaching the patient
more balanced patterns
of thinking and behaviour
and balancing therapist strategies of change with
acceptance of the patient’s experience.
DBT has been used effectively to reduce
parasuicidal behaviours, and is currently being
extended to other self-defeating behaviours
such as substance abuse and aggression. It is
not, however, a generalised approach to
personality disorder.
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