Lady Gaga credits DBT with helping her get her life back on track. Is there anything Lady Gaga can’t do? She’s a renaissance woman and a true hyphenate: musician-actress-entrepreneur. Now we can add mental health advocates to her resume. Recently Lady Gaga has gone public in a big way, revealing her struggles and triumphs with issues of mental and physical health.
In a recent interview with Oprah Winfrey, Gaga spoke openly about her experience with dialectical behavioral therapy (DBT), which she described as, “a wonderful, wonderful way to deal with mental health issues.” She also spoke to Elle magazine about how she identified with the character she played in the smash hit movie, A Star is Born, saying, “I was raped when I was 19-year-old, repeatedly,” and touched upon other personal topics, including her struggle with fibromyalgia. Gaga also noted, “I have PTSD. I have chronic pain. Neuropathic pain trauma response is a weekly part of my life. I’m on medication; I have several doctors.” Gaga shared that she once believed that she’d never recover from her traumatic life experiences, and had gone through a psychotic break.
“It was one of the worst things that has ever happened to me,” she stated. “I didn’t understand what was going on, because my whole body went numb; I fully dissociated.” She went on to say that she was prescribed olanzapine, a mood stabilizer, which helped her immensely.
What is DBT, which Gaga describes as a successful treatment component in her own life? DBT is a therapeutic treatment that was initially used to help suicidal individuals and those with Borderline Personality Disorder. Since that time the method has been used to treat a range of diagnosed conditions, including posttraumatic stress disorder, eating disorders, depression, and substance use disorder.
While no one therapy or treatment offers a one-size-fits-all form of assistance, Gaga explained that for her, “It’s a really strong way of learning how to live, and it’s a guide to understanding your emotions.” According to Adam Carmel, professor of psychology at the University of Washington, DBT can be a beneficial tool for teaching individuals useful ways to manage stress and regulate emotion. The method, “incorporates a lot of mindfulness and skills for being able to control your thoughts, rather than your thoughts controlling you,” he said.
In Gaga’s case, medication was needed to treat the chemical aspect of her mental health issues, while the psychotherapeutic DBT treatment addressed the psychological and emotional root causes of her distress. Regardless of the particular treatments that helped Gaga to regain a functional lifestyle, her general message is relevant to the general population. The takeaway from her candor is that it’s normal and necessary to seek help when we need it.
What Is DBT
With that in mind, let’s take a look at the history of DBT and examine the principles involved in its process. The following information is meant to illuminate the origin and tenets of DBT and is not a recommendation for treatment. What exactly is DBT and how can it help with mental health? Marsha Linehan is the person behind the development of dialectical behavior therapy. After being diagnosed with schizophrenia as a teenager, the American psychologist was treated with electroconvulsive therapy (ECT) and psychotropic medication. She later embarked on a teaching career and was made a fellow of the American Psychological Association.
According to Linehan, DBT is the result of her efforts to develop appropriate, successful treatment for suicidal women with co-occurring psychological disorders such as borderline personality disorder. Linehan has said that it was important to her that DBT emphasizes the clinician’s acceptance of the patient as well as self-acceptance.
While DBT is considered to be a cognitive-behavioral treatment, like any other psychotherapeutic approach, DBT has aspects that are unique to it. This includes its conception of five key functions of treatment. The first function involves enhancing a client’s capabilities including crucial life skills such as emotional regulation, awareness of the current moment, appropriate interpersonal skills and distress tolerance skills ability. Function two centers on the incorporation of the coping methods learned in treatment. For example, clinicians agree that one must be able to apply the skills learned in therapy to their daily lives. To this end, patients are provided opportunities to practice learned skills and given feedback during the process. The third function focuses on increasing motivation and decreasing unproductive behavior. For example, a practitioner might review the client’s past dysfunctional behavior then help to identify the sequence of events that precipitated the behavior as well as examine its consequences. The next function, number four, centers on the practitioner’s ongoing skill in performing at a high level. This involves enhancing and sustaining motivation as well as ability when working with patients who are addressing multiple, serious issues which can include suicidal crises and behavior counterproductive to therapy. The last function serves to structure the client’s environment so that maximum progress can be achieved. Specifically, this involves ensuring that effective and productive behavior is strengthened while problematic behavior is not reinforced. One example would be helping those addressing substance abuse issues to avoid situations and events that promote drug use.
Within these five functions, DBT recognizes the primary importance of emotional regulation in treatment, something that Lady Gaga found valuable while confronting her own life struggles. DBT exists in a landscape of multiple psychotherapeutic approaches and numerous and varied treatments. It may or may not be the right approach for you or a loved one–at the end of the day, the most important thing is not which therapy you ultimately chose, but that you seek help when you need it.
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