Exploring Dialectical Behavior Therapy (DBT) with a Yale Professor of Psychiatry - Dr. Ashley Pierson

​Our first episode of Scoot, released in October 2021, was an interview with Dr. Ashley Pierson, the Assistant Professor of Psychiatry and Acting Director of DBT Services at Yale University. In her conversation with host, Kasey Taylor, she discussed the history and treatment methods of DBT, a relatively new form of psychotherapy and the only form created by a woman. 

What does “dialectic” mean?

“Dialectic” means that two opposing ideas can be true at the same time, In DBT, this is often practiced by replacing “but” with “and.” For instance, “I love you but I am mad at you” vs. “I love you and I am mad at you.” By replacing these words, the speaker validates both ideas without rebutting one. 

How did DBT start?

DBT was founded in the 1980s by Dr. Marsha Linehan. She found that DBT was originally effective for people diagnosed with Borderline Personality Disorder (BPD), but it has expanded and been used to help people experiencing severe suicidal thoughts and managing difficult emotions. In her memoir, Building a Life Worth Living, Dr. Linehan shares her personal struggles with mental health and how saving herself from the depths of depression and suicidality empowered her to build DBT. The goal of DBT is to transform negative thinking patterns and destructive behaviors into positive outcomes. 

How does it work?

DBT teaches skills through the following four modules: mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. These modules are usually taught in weekly group sessions, and then clients also meet 1:1 with a therapist to apply these skills to their life, create individualized behavior plans, and build “live-worth-living” goals.The purpose of each module is explained below: 

• Mindfulness: focuses on improving an individual's ability to accept and be present in the current moment. 
  
• Interpersonal Effectiveness: consists of techniques that allow a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships. 
  
• Emotion Regulation: covers strategies to manage and change intense emotions that are causing problems in a person’s life.
  
• Distress Tolerance: geared toward increasing a person’s tolerance of negative emotion, rather than trying to escape from it.
  

Interested in finding a DBT therapist?

Look for a mental health professional who is specialized and trained in DBT. The Linehan Board of Certification, a non-profit organization, developed certification standards for therapists. Additionally, it is important you find a therapist who you feel comfortable working with. You can start your search here. 

For more insight on DBT, you can listen to Dr. Pierson’s interview on Scoot, available wherever you listen to podcasts. Here is the Spotify link. 

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You can follow Dr. Ashley Pierson on Twitter: https://twitter.com/dr_ashpierson 

Additional Sources:

• https://linehaninstitute.org/
  
• https://www.sheppardpratt.org/news-views/story/dbt-101-what-does-dialectical-even-mean/ 
  
• https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy