Creating a Life Worth Living with Dialectical Behavior Therapy

By Amanda L. Smith, LMSW

As a social worker who is living and working in Waco, it’s important to me that our community has access to quality and affordable healthcare. Sadly, prioritizing mental health issues often goes ignored or is dismissed. I’m deeply honored to work with people who are ready to look for a new approach to embracing life. For most of my clients, intense emotions, intrusive thoughts, self-damaging behaviors, and suicidal thinking stand in the way of their happiness and peace of mind.

Thankfully there’s a treatment that may help.

Dialectical behavior therapy (or DBT) was created by Marsha Linehan—a psychologist at the University of Washington—to help people who have suffered with chronic thoughts of suicide, have made multiple suicide attempts, or engaged in self-harming behaviors such as cutting, burning, hair-pulling, and skin-picking.

DBT consists of several components, including weekly individual therapy, group skills training, telephone coaching in between appointments, and a therapist consultation team. While DBT is based on the ideas of cognitive-behavior therapy, the treatment also emphasizes mindfulness, validation strategies, and a balance of both acceptance and change. The goal of participating in a DBT treatment program is to help people who are experiencing roller-coaster emotions to create a “life worth living.”

For over 20 years, research has consistently demonstrated that DBT has made a lasting difference in helping many people to feel better. Most recently in the May 2015 issue of JAMA Psychiatry, the authors of a research study concluded that participation in a DBT skills training group significantly reduced the frequency and severity of suicide attempts and instances of self-injury in women diagnosed with borderline personality disorder. The good news is that there is now lots of evidence that suggests that DBT may be beneficial for people facing addictive behaviors, post-traumatic stress disorder, eating disorders such as bulimia and binge-eating disorder, and even attention deficit hyperactivity disorder.

What are Dialectics?

The word “dialectical” refers to the synthesis of opposing ideas, thoughts, and emotions. In DBT, this is referred to as Wise Mind.

One essential dialectic in DBT is the assumption that the person in treatment is doing the best that they can at any given moment and—at the same time—needs to work hard to change. Another dialectic would be that people can practice self-compassion and acceptance while they also gently push themselves towards healthier ways of living and responding to every day problems.

Dialectical thinking helps individuals to navigate through the extremes of black-and-white thinking so that they can make better decisions about important areas in all of our lives as they relate to school, work, relationships, and finances. Once this skill is learned and practiced over an extended period of time, life becomes less chaotic, less stressful, and more fulfilling.

Hope for Recovery

Recovery from suicidal thoughts and self-harm unfortunately doesn’t occur in a nice linear and predictable way. It’s usually full of encouraging starts, disappointing stops, and progress that can sometimes be challenging to spot even on the best of days.

Living a life filled with constant fear, sadness, and anger can be devastating. Making an investment in an evidence-based treatment like DBT can yield great returns. Over the years, I’ve met with countless individuals who have been empowered through DBT and have gone on to complete college, enjoy successful careers, and participate in meaningful relationships with others. Without a doubt, DBT can help change lives for the better.

Perhaps you or someone you love is ready to create their own life worth living.

For more information about DBT and how you or someone you know might enter into DBT therapy contact Amanda Smith by email at [email protected] or visit the website at or

Amanda SmithAmanda L. Smith, LMSW is a graduate of the Diana R. Garland School of Social Work at Baylor University. Her web site is and her book, The Dialectical Behavior Therapy Wellness Planner: 365 Days of Healthy Living for Your Body, Mind, and Spirit, will be available in September.

The Act Locally Waco blog publishes posts with a connection to these aspirations for Waco. If you are interested in writing for the Act Locally Waco Blog, please email [email protected] for more information.



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