How does a DBT therapist approach posttraumatic stress disorder (PTSD)?

In Dialectical Behavior Therapy (DBT), the approach taken by therapists when addressing posttraumatic stress disorder (PTSD) emphasizes the importance of helping clients manage their traumatic stress symptoms effectively. This approach recognizes that individuals with PTSD may have difficulty regulating their emotions and behaviors because of their trauma history. Therefore, it is crucial for therapists to stabilize these symptoms before delving deeply into the trauma itself.

The focus remains on providing clients with skills to manage intense emotions, reduce impulsivity, and cope with distress in the present moment. This foundational work is essential as it helps create a safer therapeutic environment where clients can gradually address the more challenging aspects of their trauma without becoming overwhelmed. Essentially, controlling current behaviors and managing symptoms is a prerequisite for more extensive trauma work, making this approach logical and therapeutic in nature.

In contrast, approaches that suggest addressing trauma-related symptoms first may lead to difficulties if clients lack the emotional regulation skills to cope with the ensuing distress. Similarly, avoiding discussions of trauma entirely would not be congruent with DBT's principles, as it emphasizes validation and acceptance of one's experiences. Focusing directly on traumatic stress immediately may not align with DBT's staged treatment approach, which prioritizes skills training and emotional regulation before tackling trauma directly.