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Selena Gomez said something in a Vogue interview that just doesn't get said often enough: Therapy is awesome. "I wish more people would talk about therapy," Gomez says. "We girls, we’re taught to be almost too resilient, to be strong and sexy and cool and laid-back, the girl who’s down. We also need to feel allowed to fall apart."
Gomez was referring to the specific technique of therapy she engages in, Dialectical Behavior Therapy (DBT). Gomez said "DBT completely changed my life," and according to the story, she's a "passionate advocate" of the technique and sees her shrink five days a week. Like any celebrity wellness philosophy, you're probably curious what it is and how you can do it too.
DBT is a treatment developed back in the '80s by Marsha M. Linehan, a psychologist who worked with women who engaged in suicidal behaviors, were diagnosed with borderline personality disorder, or had difficulty regulating emotions. "She started out with behavioral therapy and found that it wasn't effective, because people didn't feel understood," says Randy Wolbert, LMSW, a consultant with the Linehan Institute who trains clinicians to use DBT. So Linehan took pieces of cognitive behavioral therapy, and a little bit of Zen philosophy about acceptance and mindfulness, and turned it into DBT.
DBT usually consists of individual therapy at least once a week, plus skills training: That's usually done in a group setting, and participants learn practical ways to make their emotions and life overall feel more manageable and rewarding, Wolbert says. "These are things individuals haven't learned yet, like how to be interpersonal, regulate your emotions, and live in the moment," he says. DBT participants are also encouraged to touch base with their therapists over the phone between sessions to get skills coaching, or to get help in a crisis, he says.
The whole goal of DBT is to "build a life worth living," as opposed to focusing on treating symptoms or problems, explains Aleta Angelosante, PhD, clinical assistant professor in the Department of Child and Adolescent Psychiatry at NYU Langone’s Child Study Center, which has the first fully-adherent DBT program for adolescents in Manhattan. Every DBT group opens with a mindfulness exercise, and the concept of being mindful is woven into treatment, Dr. Angelosante says. "We talk about the dance of DBT, because you're toggling between acceptance and change," she says. In DBT therapists try to make people feel like they're validated, so people are comfortable communicating what they think and feel, Wolbert says. Then, they work on a plan for how they will act differently in the future. Dr. Angelosante says everyone can have a different flow within the DBT framework, and that it's not a one-size-fits-all method — but no therapy really is.
DBT was at first really successful with a population of people who had a hard time finding success in therapy, or felt like it just "didn't work." After clinicians heard it worked so well for the difficult-to-treat population, everyone wanted in on the action. "Now it treats lots of different kinds of problems and degrees of difficulty," she says. DBT can be particularly helpful in treating substance abuse and PTSD, Dr. Angelosante says. "What's nice about it is there's not a narrow focus," she says.
Wolbert thinks DBT works well because there's an emphasis on changing strategies while still accepting yourself. "People are invested in treatment and they get better," he says. If you're interested in seeing a DBT clinician, the Linehan Institute has a helpful directory of licensed professionals to choose from. Wolbert says more and more therapists are getting certified now, so there's a good chance you can find someone near you — and who knows, it may just change your life for the better.
Update: An earlier version of this story neglected to mention that DBT was first designed to treat patients with borderline personality disorder. We apologize and have corrected the story.