When first developed, Dr. Marsha Linehan based DBT on the bio-social theory of Borderline Personality Disorder (BPD). This theory states that problems associated with BPD (e.g., interpersonal chaos, intense emotional swings, impulsiveness, confusion about the self, and suicidal behavior) is a consequence of an emotionally vulnerable individual (someone whose autonomic nervous system reacts more intensely to relatively low levels of stress and takes longer than normal to return to baseline once the stress is removed) growing up within a particular set of environmental circumstances, particularly that of an invalidating environment, in which a child’s personal experiences and responses are disqualified or “invalidated” by the significant others in his or her life. It is this understanding of an individual's behavior from which the notion of "acceptance and change," the core DBT dialectic, grew (refer back to day one of the DBT Spotlight Blog Series to learn more about the core DBT dialectic "acceptance and change").
Given my background in Health Psychology (which is concerned with biological, psychological, and social aspects of psychological and behavioral processes), I take into consideration biological, psychological, and social factors of my clients’ lives when working with them. This is known as a biopsychosocial (BPS) approach.
An ample amount of research has been conducted on the BPS model and the role of biological, psychological, and social factors or vulnerabilities in mental disorders such as substance abuse and eating disorders. The combination and interaction of these vulnerabilities appear to contribute to the development of these disorders, which can be thought of as a way to cope with the culmination of these vulnerabilities. This is why DBT is incredibly helpful for individuals struggling with these kinds of disorders - DBT teaches them new, more effective coping skills. See the figure below, which elaborates on this model.
As you can see, problematic coping skills (for example, binging and purging or abusing drugs) that are related with mental disorders (in this example, bulimia and substance abuse, respectively) arise from a complex interaction of biological, psychological, and social factors. Using DBT, we accept this and thus validate that the problematic coping skills are real and make sense; however, we balance this acceptance with knowing that these coping skills are not effective and therefore must change. DBT then teaches the individual new, more effective skills to replace the problematic skills they are currently using.
If you have any questions about the BPS model, drop me a line in the comments section below and I'd be happy to answer them. Check back tomorrow to learn about the goal of DBT, creating a life worth living - day three of the DBT Spotlight Blog Series.
Behavioral Tech, LLC. (2013). Dialectical Behavior Therapy Frequently Asked Questions.
Dimeff, L. A. and Koerner, K. (2007). Dialectical Behavior Therapy in Clinical Practice: Applications across Disorders and Settings. Guilford Press.
Also, check out Behavioral Tech, LLC. (2013). What is DBT? to learn more about the background and history of DBT.