Dialectical Behavioral Therapy for IBS

Dialectical Behavioral Therapy (DBT) is a type of psychotherapy. This practice is based in mindfulness and you know as well I do that mindfulness comes up all the time when discussing different types of coping skills used for managing IBS stress and anxiety. DBT was developed initially for psychological disorders dealing with pain management and relationship problems. I have attended DBT workshops and have a therapist that specializes in this discipline. It occurred to me the other day while having a particular trying day, both with my IBS and with work situations, that the skills I have learned through DBT have been of great help managing not only the pain I experience through IBS, but also in managing the relationships I maintain with my family, friends, doctor and co-workers. These relationships sometimes become more difficult with IBS, as many of you know. Having extra skills to help with these particular issues relating to IBS can be of great importance. Please allow me to share.

DBT focuses on four very important issues that effect most people, but can become even more pertinent when suffering with IBS. I mentioned that DBT is rooted in mindfulness. The reason mindfulness is so important for this type of therapy is that being in the present moment and not worrying about what is going to come next or what has just passed, will prepare you for the rest of this ‘therapeutic lesson.’ That said, mindfulness is the first of the four part of DBT’s focus. The specific problems DBT attempts to alleviate are the following three items: distress tolerance, emotional regulation and interpersonal effectiveness. I think you can immediately see how learning to manage each of these issues might be of great help managing your life with IBS.

Distress tolerance

Distress tolerance is exactly what it sounds like. The approach that DBT takes is that of acceptance and ‘tolerating’ the distress you are experiencing rather than trying to make it go away. While we are constantly trying to make IBS ‘go away’ by changing our diet, medication and trying to live a healthful life, in most cases this does not make the IBS 'go away.' The majority still suffer with pain, discomfort, anxiety and worry, all very distressing events. Therefore, the ability to increase the ability to tolerate certain, seemingly 'unbearable' events can alleviate some of the overwhelming feelings that IBS calls.

Emotion regulation

Emotion regulation is the third goal within the DBT system. When we are stressed out we have a tendency to think of things as all ‘bad’. We tend to forget all of the good things that we have going on in our lives and all the positive work we have done to help ourselves feel better. Emotional regulation within DBT focuses on seeing both the bad that we are currently experiencing and the good that does exist in our lives, even in that moment. This is where the ‘Dialectic’ part of the DBT label is most obvious. It’s about seeing that there is more than one side to a coin and these sides, while seeming completely contradictory, may in fact be occurring at the same time.

Managing relationships

The final aspect of the DBT approach deals with our ability to develop and manage healthy relationships with those around us. The same ‘two sided’ coin approach also applies here. Sometimes when we are sick and don’t feel well, we tend to push others away, blame them for things they have not done or simply don’t share what we are feeling accurately. To have the support we need to manage our illness, we need to maintain healthy interpersonal relationships. It is very important to see things clearly and be mindful within these relationships and with our illness. I wanted to share a little about DBT because the concepts have been just one more important tool in my ‘IBS toolbox.’