DBT for PTSD & Trauma

Dialectical behavioral therapy (DBT) is a type of cognitive behavioral therapy (CBT) that helps you manage your emotions in a healthy, productive way. One of the famous tenets is radical acceptance and it was originally developed for people with mental health conditions that cause intense emotional and behavioral challenges — like those living with borderline personality disorder (BPD). We now know that BPD and post–traumatic stress disorder (PTSD) often overlap. Studies show that comorbidity of BPD and PTSD is not uncommon. 

PTSD can occur after experiencing or witnessing extreme trauma. It can cause nightmares, flashbacks, depression, and anxiety, among other debilitating long-term effects. Learning to process and deal with your past traumatic event can be life-changing. DBT is regarded as an effective, promising type of treatment for those living with the challenging symptoms of PTSD. 

Learn more here as we discuss how DBT for PTSD works, what the research says about efficacy, and how it can help with complex trauma. We’ll also explore what techniques are used, how to find a therapist who’s trained in DBT skills for PTSD treatment and more. 

Does DBT Treatment Work for PTSD?

DBT for PTSD has been found to be a very effective form of treatment. Research suggests it can also be effective as a precursor to other PTSD treatment techniques. In fact, it’s been so successful and offered so much hope that the therapy technique has even been adapted to specifically treat PTSD. This adaptation is known as dialectical behavior therapy for post-traumatic stress disorder (DBT-PTSD).

What research says about DBT effectiveness

An abundance of research has been done on the efficacy of DBT for PTSD. Research supports its effectiveness, and some studies find it to be superior to CBT in reducing symptoms of complex PTSD. Randomized clinical trial results show that DBT-PTSD results in a reduction of PTSD symptoms in 58% of women survivors of childhood abuse, versus just 41% in those who were treated solely with CBT. The findings are significant and should encourage more studies and research. 

Another study looked at how effective DBT-PTSD is in treating adult survivors of childhood sexual abuse (CSA). The results from that study again seem to confirm that DBT-PTSD can be effective at reducing or eliminating symptoms of CSA-related PTSD. 

While exposure therapy and cognitive processing therapy (CPT) — both forms of CBT — are other common therapy techniques used to treat PTSD, there are many reasons why these shouldn’t be considered as sole options. Suicidality, high rates of attrition, a tendency for impulsiveness, and dissociation can all make PTSD treatment difficult. Some research suggests that DBT can be integrated with other types of treatment (specifically with exposure therapy) as an improved, more effective way to treat PTSD. 

To summarize research findings that support the efficacy of DBT in treating PTSD, the following studies can be reviewed:

• A study looks at how implementing DBT with prolonged exposure therapy can offer improved results. 
• Research comparing CBT and DBT-PTSD as forms of treatment for complex PTSD suggests DBT-PTSD is more effective at reducing symptoms. 
• Another study shows that DBT techniques can be successful in reducing destructive behaviors that stop some people from seeking treatment after a PTSD diagnosis. 

Is DBT Good for Complex Trauma?

Complex trauma (also known as complex PTSD, or C-PTSD). It’s the term used to describe when traumatic events are experienced repeatedly or over a long range of time. Profound neglect, sexual or physical abuse, human trafficking, being tortured or held captive, or abusive relationships can all result in complex trauma. 

Complex trauma is closely related to PTSD, as the symptoms can overlap and be very similar. Like in treating PTSD, DBT is also an effective way to treat those living with complex trauma. Studies support that DBT for trauma can be a successful form of treatment. 

How Does DBT Therapy Help with Trauma?

DBT for trauma focuses on helping you manage your emotions in a healthy way. You’ll also learn how to nurture and navigate relationships that might be suffering from the aftermath of the trauma you experienced. 

DBT trauma treatment can help if you have self-destructive behaviors that interfere with your ability to function. There are specific, effective techniques DBT uses that directly target the symptoms of PTSD and extreme trauma.

Mindfulness

One of the most effective and positive DBT outcomes is the technique that teaches mindfulness. Practicing mindfulness means learning to be present and focused on your here and now. It’s a useful tool that can be implemented across all areas of life. In times of stress, anxiety, or any other symptoms of PTSD, focusing on your breathing and learning how to remain grounded in present reality can be both powerful and effective.

A hugely beneficial aspect of mindfulness is the fact that as you become better at it, you’ll find you’re able to start applying it before you begin to spin out of control. You’ll start to recognize behaviors and thought processes that are inducing stress and preventing you from healing from the trauma you experienced. Essentially, you’ll become better at stopping these patterns in their tracks.

Emotion regulation

Emotion regulation is exactly what it sounds like. It’s the ability to manage, accept, or change — thus, regulate — unhealthy or destructive emotions, so they don’t control you. When your emotions are out of control, it can be difficult to keep your mind stable. 

DBT teaches you how to regulate unwanted emotions so you can stop them before they take hold. You’ll also learn how to regulate, or change when needed, emotions that have already started, so you can prevent them from becoming overwhelming.

Distress tolerance

Distress tolerance is the ability to handle emotions and thoughts that once seemed too painful or daunting to face. It can also help you learn to identify and avoid certain behaviors you engage in that can exacerbate situations.

People who live with PTSD often have intrusive thoughts they find difficult to control. The practice of distress tolerance can help you develop skills so you can better–manage those stressful thought patterns. These tools can be anything from self-soothing meditation, to breathing techniques that activate the parasympathetic nervous system to calm you down, to several other strategies.

Interpersonal effectiveness

Your ability to communicate with the people in your life in a healthy way, that sets boundaries, allows you to establish self-respect. This, in turn, can help you feel effective and connected in your relationships. Interpersonal effectiveness, which is focused on during DBT sessions, can be useful here.

PTSD makes trust hard. It can make interactions and relationships difficult to navigate. If you find this to be true, DBT can help you learn how to build and maintain healthy relationships you might be struggling with. You’ll practice asking for what you need, setting boundaries, maintaining a sense of self-respect, and working on conflict resolution tactics so you can keep things from boiling over or getting out of control.

Finding Therapy for PTSD or Trauma

PTSD can be a difficult condition to manage on your own. The good news is: you don’t have to. Effective forms of therapy, like dialectical behavioral therapy, can help you heal from your past trauma so you can live the healthiest, most productive, most rewarding life possible, without past trauma haunting you.

DBT skills for PTSD can teach you how to overcome what you might think is impossible. Finding a therapist who’s skilled and trained in DBT techniques is your first step. Aside from PTSD, you can also find a therapist for DBT for borderline personality disorder. Talkspace offers online therapy in an affordable and convenient way that makes getting the help you need more accessible. 

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