DBT, Mindfulness, & Neuroscience?
Have you ever been in therapy, and your therapist is asking you to do something, but you are unsure about why? Sure, we all know that counseling is effective, but it is helpful to understand the process of therapy, and why your therapist does what they do during your treatment.
A common counseling modality that is used in treatment is called Dialectical Behavioral Therapy (DBT). DBT is an evidence-based approach that can be used in individual settings, group therapy settings, and at various levels of care such as inpatient and outpatient treatment. The main goals for DBT are to learn coping skills/distress tolerance, emotional regulation, increase mindfulness, and improve relationships. This type of therapy can be used for anyone, but it has commonly used in treatment for borderline personality disorder, post-traumatic stress disorder, substance use, eating disorders, and recurring suicidal ideation. Since DBT is a commonly used treatment, it is likely that your therapist may ask you to utilize some of the techniques and interventions found in this modality. In this case, before asking you to put these concepts into action, your therapist will give you psychoeducation about the therapy. This means that you will learn about what DBT is, and the reasons why your therapist is implementing these concepts into your treatment.
Counseling is a vital part to healing. People may go to therapy for a variety reasons, which are all valid, but the process of therapy can be different for everyone. Now that we understand what psychoeducation is, it is natural to wonder what the actual science behind counseling is – that is where neuroscience comes in. Neuroscience focuses on the brain, its functions, and its impact on behavior. Think of counseling and neuroscience as going hand-in-hand; neuroscience provides research and support for the techniques that therapists implement in counseling. For example, neuroscience provides therapists with a basis for why using DBT is effective for certain populations. So, what are some of the concepts that explain the connection between neuroscience and counseling?
First, we have neuroplasticity. This means that basically, we are always making room in our brain for learning. The brain changes as we acquire information, respond to our surroundings, and try new things. In therapy, as we talk about our experiences and gain insight into our behavior, our brain is quite literally forming new connections. In DBT, your therapist may ask you to start practicing deep breathing exercises to help regulate your body during stressful times. As you start practicing this, your brain will begin to form the connections that deep breathing helps you to relax, and you will practice this technique every time you experience stress.
Neurogenesis is another concept that can be applied to counseling. Neurogenesis tells us that new neurons can be formed in the process of learning. Throughout life, our brains develop neural networks as we go through new experiences. The best part is, we can form new neurons in our brains forever!
There are a few ways that neuroscience is connected to DBT practices. Regarding mindfulness meditation, research has shown that practicing this can reduce stress and improve emotional regulation. When we do mindfulness practices, the frontal-limbic networks involved in these processes show patterns of engagement in the brain (Tang, Holzel, & Posner, 2015). In other words, our brains respond in favorable ways. The limbic system is the part of the brain that is responsible for governing emotions and memory; the limbic system consists of the amygdala and the hippocampus. The limbic system could be considered the place of origin for certain emotional responses, like anger or fear. The amygdala helps to regulate our perceptions and reactions and is also connected to different parts of the brain such as the sympathetic nervous system, facial expressions, the processing of smells, and release of neurotransmitters that are related to things like stress and aggression; these are all systems that are related to emotional regulation (Best, 2009). The pre-frontal cortex is another region of the brain that is related to emotion processing. The pre-frontal cortex is the guiding center for many of our networks such as emotions, memory, and planning. The amygdala and pre-frontal cortex work together by communicating with each other about our emotional experiences; the amygdala will detect an important event or experience, and transport that information to the pre-frontal cortex so that our body can act. Understanding how emotions work and the neuroscience behind these processes allows therapists to adapt treatment strategies (such as DBT) to help clients understand their own emotions better.
As we understand the science behind treatment, we can begin to better understand how we can make connections and gain insight into ourselves during the therapeutic process. Understanding the process of therapy and treatment can also help to de-stigmatize mental illness.
4. Tang, YY., Hölzel, B. & Posner, M, (2015). The neuroscience of mindfulness meditation. Nat Rev Neurosci 16, 213 225. https://doi.org/10.1038/nrn3916 https://www.nature.com/articles/nrn3916
5. Best, B. (2009). The amygdala and the emotions. In Anatomy of the mind (chap. 9). Retrieved from Welcome to the World of Ben Best website: http://www.benbest.com/science/anatmind/anatmd9.html