How DBT Helps Minimize Symptoms of PTSD

What Is PTSD?

Post-Traumatic Stress Disorder is triggered by the experience of enduring or witnessing a terrifying event (abuse, natural disaster, terrorism, war, violence, assault, etc) that kicks our fight or flight instincts into overdrive. In the case of Complex PTSD (CPTSD), a number of ongoing traumatic events can cause trauma over time. Some symptoms of PTSD include avoidance, anxiety, changes in physical and emotional reactions, intrusive memories, and dramatic shifts in mood and cognitive processing. For some people, symptoms of PTSD will start right away, but with others, they may appear many years later. While PTSD is treatable, the symptoms can be debilitating and significantly decrease the sufferer’s quality of life. 

Who Gets PTSD? 

PTSD is common and can affect individuals of all ages and walks of life. Symptoms can last anywhere from months to years, and the severity varies by individual. 

Why DBT Works For PTSD

The reason Dialectical Behavior Therapy (DBT) can work so well in minimizing the symptoms of PTSD is that some of the modules and skills (such as Mindfulness) focus on staying grounded and present in the moment. Since much of PTSD is rooted in reliving past traumatic experiences, the ability to stay present is a key part of mitigating symptoms. In addition, the Emotion Regulation and Distress Tolerance modules of DBT can help those with PTSD to avoid susceptibility to intrusive thoughts and memories, and minimize emotional volatility. This is because when individuals with PTSD are in distress, their brain turns toward survival mode. Traumatic memories are reopened in the moment in reaction to activated distress, which can trigger automated biological responses such as panic attacks, shut downs, and other destructive, negative emotional experiences. Learning to tolerate, regulate and survive these triggers is part of DBT skills training. 

Some DBT methods have actually been adapted specifically to treat PTSD, such as Informed dbt, which integrates other cognitive behavioral interventions into DBT to create a multifaceted treatment plan for those with PTSD. 


DBT Concepts Used For PTSD

The core philosophy of DBT is skills-based training, which involves the introduction of new tools and coping mechanisms for those seeking to manage their symptoms. DBT focuses on both acceptance and positive change. 

All four DBT modules are in fact relevant to PTSD. These are: 

  1. Mindfulness: Learning to stay present and grounded helps you to stay focused on the situation at hand and to avoid ruminating and obsessive thoughts about past experiences or future uncertainties. Mindfulness skills help ground you in your own body and increase your mental stability through staying present in the moment. 
  1. Emotion Regulation: Learning to accept, manage and change different emotions helps, as emotional dysregulation is a common outcome of PTSD symptoms. When distress arises, emotional upheaval can cause extreme mood swings and intense emotional suffering. Emotion Regulation teaches skills to head off negative emotions before they arise, regulate or change them after they start, and accept the unavoidable negative emotions when they do arise as a natural part of life. 
  1. Distress Tolerance: Learning to tolerate painful emotions and situations is important, as intrusive, obsessive thoughts increase our distress experiences and can rapidly worsen without intervention. Distress Tolerance teaches specific, applicable skills to replace ineffective behaviors and reactions to distress (such as self-soothing techniques). 
  1. Interpersonal Effectiveness: Learning to communicate with others with respect while maintaining healthy boundaries is critical, as a common practical impact of PTSD is difficulty with trusting or interacting with others. DBT helps to bridge the gap between past trauma and present relationships, working to bring self-respect and respect for others to every human connection. Interpersonal Effectiveness also helps us to avoid and resolve conflict, which in turn reduces the frequency of distressing interactions. 

DBT Techniques That Minimize PTSD Symptoms 

An ongoing challenge of PTSD is that stress and conflict are natural parts of life, and truly unavoidable. These two things often trigger a fight, freeze, fawn, or flight response in those with PTSD, so the main goal of DBT for PTSD is to manage reactions to stress and conflict, rather than total avoidance. 

Beyond the general module training described above, here two other common techniques leveraged in DBT therapy for those with PTSD: 

  • Self-acceptance: It’s important to stress that self-acceptance does NOT mean justifying or approving of hurt, abuse, and trauma; rather, self-acceptance means understanding that pain does not always mean we need to suffer long-term, and that we are fully capable of overcoming our experiences and taking back control of our emotions. Self-acceptance encourages us to both feel our emotions, accept them, and then move on toward healing. 
  • Validation: Many individuals with PTSD question their own experiences and reality because the resulting stress and pain from their trauma can feel like too much to bear. Validation encourages us to avoid self-doubt, to validate our experiences and what happened to us or what we witnessed, and then to move on toward healing. Fighting the reality of our experiences and trauma does nothing but delay our healing process.

DBT For PTSD In Relationships

Relationships are arguably the most frequent way those with PTSD may encounter triggers. This is because for those with PTSD, interpersonal tension can produce a heightened biological reaction and intense emotional upheaval. Feeling safe is the most important part of a relationship for those with PTSD. When their trauma is untreated, they may feel unsafe even in safe relationships, which means most of their romantic relationships will suffer long-term. 

For those with a history of abuse in particular (sexual, emotional, psychological) or abandonment, it takes a significant amount of work over time to decrease their automated response to conflict or perceived threats (where none may actually exist). Hypervigilance and a fear of the unknown are common symptoms of those with PTSD in romantic relationships, which can increase pressure on their partner and decrease their overall quality of life. 

DBT can help a lot in relationships by keeping the PTSD survivor from drawing conclusions based on emotional trauma vs. reality through grounding in Mindfulness, Acceptance of reality (present situation vs past experience), Distress Tolerance and Emotional Regulation when conflict does arise, and better Interpersonal Effectiveness through healthy boundary setting and mutual respect. 

If you’re looking to get started on your healing journey with DBT for PTSD treatment, START TODAY.

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