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DBT - Dialectical Thinking

DBT is short for Dialectical Behavioural Therapy. It was developed by Marhsa Linehan, a psychologist who was detained in a psychiatric hospital in Oklahoma for over two years as a teenager in the 1960s. In her memoir, Building a Life Worth Living, she describes some of the cruel treatment she received in the hospital, including electroconvulsive therapy, solitary confinement and being strongly medicated against her will. She recalls one day making a pact with herself - that she was going to get herself out of hell and then devote her life to helping other people do the same. After being released from hospital, she spent years at night school and finished with a PhD in psychology. 


DBT was originally designed for people who feel emotions very intensely and can tend to have an all or nothing approach to situations. Dialectical thinking (sometimes also called paradoxical thinking) encourages people to move away from always defaulting to a one sided view of situations. Taking a dialectical approach enables us to recognise that multiple truths can exist simultaneously. Rather than either/or thinking, DBT encourages a both/and approach. 


Allowing ourselves and other people to hold contradictory thoughts and desires is extremely useful. If we think that there can only be one truth, we will attempt to find a linearity and coherence in the world and in ourselves that makes it impossible to see situations in their full complexity and nuance. 


For example, we might feel frustrated with a long-term relationship if we think that it’s lost the passion it once had. Taking a dialectical approach might allow us to recognise our own contradictory desires for security and stability on the one hand and newness and the excitement of uncertainty on the other. Rather than blaming the relationship, it might feel possible to recognise these contradictory desires and to think creatively about how they could be fulfilled, whilst also accepting that it would be difficult to have both sets of needs met at all times. 


Thinking dialectically can also cultivate a cognitive flexibility that can be very useful in conflicts. The belief that we can validate the truth in someone else's position without having to completely abandon our own can create movement towards resolution. Acknowledging a truth that contradicts our own can be difficult for lots of people.


For example, perhaps someone has spent a lot of time in an invalidating environment where their experience of the world was never seen as legitimate. It may feel hard for this person to believe that if they validate a contradictory viewpoint, their own opinions will still be valuable and worthy of respect. In this context, rigid attachment to your beliefs makes sense. If this resonates with you, what might help you to know that you won't be obliterated if you spend some time thinking about a conflict from someone else's point of view?


Conversely, if someone has had very little experience of being required to yield and make concessions to other people, they may experience challenge as affronting. They may have little understanding that what seems like a neutral status quo often involves them dominating other people. If this resonates with you, what might help you to notice when people around you are making concessions to accommodate you?


If you are having difficulty moving beyond a conflict at the moment, you might want to try some of these practices:

  • Write a description of all your thoughts and feelings about a situation, including why the outcome is important to you. What does the conflict mean to you and how does it connect with any significant themes and values in your life?

  • Now imagine what it might be like to validate the other person's views (but don't actually try to do this yet!). What thoughts and feelings come up for you when you imagine this? What does it feel like you would need to give up or lose? What would this mean to you? Why does it feel important to you?

  • What practices will make your truth feel real and your views important? Try creating something that you can return to as a reminder of this - maybe writing or drawing. Or perhaps you want to be witnessed in movement or ritual.

  • If you've started to feel more comfortable in the validity of your position, try spending some time thinking about the conflict from the other person's point of view. Start with small amounts of time so you don't end up feeling overwhelmed and defensive - perhaps set an alarm for ten minutes to start with then go and do something else.

  • How much do you understand about the other person's position? Do you know why this issue feels important to them? Do you know why your point of view feels so challenging for them to accept? If not, would you like to ask them about these things?

  • To try to work out the sticking points between you - are they differences in facts or interpretations? If there are differences in facts, is there a way you can check these out with the other person?

  • Gradually increase the amount of time you spend engaging with this situation from the other person's stance. If you start feeling defensive pause and notice what's coming up for you. Remind yourself that both positions can be true. Return to the documents you created about your beliefs if these start to feel threatened.

  • If you can engage non-defensively with the other person's position, try writing out the most compelling version of their point of view. Articulate why it feels important to them. Trust that you can afford to validate their position without undermining your own.

  • Share your reflections with the other person if it feels safe to do so.


These are a couple of examples about how dialectical thinking might be useful in practice. But does that mean that it's always the right approach in every situation? To answer yes would be (paradoxically) not very dialectical. A more realistic answer is perhaps that it’s a useful tool in many but not all situations.


For example, in their book Life isn’t Binary, Meg-John Barker writes that both/ and thinking can be damaging, such as when it is used to legitimise debates over whether trans people really exist. People arguing in favour of gender essentialism (the idea that our genitals determine our gender identities, roles and experiences) often assert that they are entitled to express their opinion because it’s one side of a legitimate debate and that efforts by trans people to close them down are dogmatic (and therefore not dialectical). However, gender essentialism is a theory which does not allow for the existence of trans people and therefore the promise that these ideas can be viewed as legitimate and that trans people co-exist safely alongside them is illusory. 


This example highlights a broader limitation with DBT and other psychological ideas which focus on finding universal theories that can be applied to all humans irrespective of their particular social contexts. They can offer us powerful tools to change individual behaviour and emotion, but are often silent on issues of power. The impact of any idea or language will always be determined by who is deploying it and how - nothing has meaning without context.


DBT and other mainstream psychological ideas don't offer much that can help us analyse power and context. Without that kind of analysis, these tools are unlikely to do more than inure people to their own oppression. For example, dialectical thinking in the conflict scenario above, privileges ideas of equanimity and even handedness. These approaches can be very useful in intimate relationships. But they could also be used in ways that are reactionary and oppressive - for example they might give rise to a performance of rationality and the absence of emotional intensity, qualities which are often used to shore up white male power. Dialectical thinking alone won't necessarily tell us much about who in a conflict should hinge and to what degree. There's an implication that meeting in the middle is the way through any conflict, but this approach may well be at odds with values of social justice and collective liberation.


If we are to accept the complexity and nuance of the world, we need to hone our skills of discernment to assess which theories and skills will serve us and other people best in which contexts. 

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