Therapy Tuesday: DBT – Part 3: The Venn Diagram of Treatment

dbt venn

This diagram shows what DBT actually does for patients. The idea is that those of us suffering from BPD, Bipolar Disorder, PTSD, Anxiety disorders, and Depressive disorders, are most likely to be using the emotional mind more than the rational mind. To be absolutely clear, this isn’t about intelligence, it’s about maladaptive coping skills.

Especially in the case of abuse victims, logic doesn’t work the way it does for those who haven’t had ongoing trauma. Why? Because abusers aren’t logical and their victims basically have to bail on logic in order to survive. The key term is there in the diagram, “reactive.” Victims very often become reactive instead of proactive.

The skills taught in DBT therapy work on teaching/restoring that logical process. It builds (for those who never learned) or rebuilds (for those who were torn down) things as simple and as difficult as not hearing someone say, “I’m angry,” and instantly assuming it’s their fault or that they’re about to be harmed.

Reacting to the past is a protective adaptation abuse victims share, almost universally. Everyone has that adaptation, to be fair. If you put your hand on a hot stove and burn it, you will avoid doing it in the future. That’s just a basic survival instinct. The extreme reactions happen when abuse victims are trying to avoid abuse.

I once witnessed someone knock a small space heater off of a table. When asked, “Oh what fell?” the person lied. The question was asked in surprise because of the noise, but not in anger. The person who knocked the heater over went white as a ghost as soon as the question was asked. Then they said, very calmly, “Nothing, I just tripped.” I said nothing because I still remember the days when I was still in that place where the idea that someone might get angry and hurt me over an accident was enough to make me seek any shelter possible, including lying.

With DBT skills, it is taught that we have to work toward restoring logic, without removing emotion, so we can arrive at the “wise mind.” That is the place where decisions are made that protect an individual, are respectful of others, and not based on those coping skills that came out of dealing with trauma or the past that has been survived.

Next week, I’ll write more about the logical mind. The following week will be the emotional mind, and I’ll wrap up this series with the wise mind.





All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.

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