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What is dialectical behavior therapy? Selena Gomez's treatment explained

One of the key concepts of the treatment is “radical acceptance.”
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Selena Gomez sought treatment for anxiety and depression after she had a kidney transplant as a result of her battle with lupus.Matt Winkelmeyer / Getty
/ Source: TODAY

Almost a year after Selena Gomez revealed her bipolar disorder diagnosis in 2020, she is once again putting the spotlight on dialectical behavior therapy.

When Vogue profiled Gomez on Tuesday, the magazine described her as a “staunch proponent" of DBT, a type of psychological care the singer has undergone and praised before, and noted she's proud when her fans open up about finding help with mental health problems.

Her own diagnosis — after a long struggle with depression and anxiety — seemed to have come as a relief.

"Once the information was there, it was less scary," Gomez, 28, told Vogue.

When it comes to DBT, it has "completely changed my life,” Gomez said in a 2017 interview.

What is DBT?

Dialectical behavior therapy is heavily based on cognitive behavioral therapy, or talk therapy, according to the National Alliance on Mental Illness.

It promotes both acceptance and change in a patient, which seems contradictory, thus the reference in its name to “dialectical,” defined as the integration of opposites.

DBT was developed in the 1980s by Marsha Linehan, a psychology professor at the University of Washington. She originally designed the approach to treat suicidal behaviors, but it has since expanded to treating borderline personality disorder and other “severe and complex mental disorders,” Linehan’s biography noted. She herself struggled with mental illness and vowed to help herself and others.

“I suppose it’s true that I developed a therapy that provides the things I needed for so many years and never got,” she told The New York Times.

One of the key concepts is “radical acceptance” — or letting go of what you want and accepting what is.

“Suppressing what you want is not the way to go. You have to radically accept that you want something you don’t have and it’s not a catastrophe,” Linehan said in a video explaining her philosophy. “Reality is what it is.”

That’s critical because you can’t change anything if you don’t accept it, she noted. You have to radically accept your past and the moment you’re in right now, but you can definitely try to change the next moment, Linehan said. This way of thinking “will transform everyone… but it has to be a regular practice,” she added.

How does DBT work?

Patients who undergo DBT receive both one-on-one and group therapy. The goal is for them to “get out of hell” and build “a life worth living,” which can mean different things to different people, Linehan said.

She recognized it wasn’t enough for patients to be listened to and understood in therapy — they also had to receive instruction on how to change. So the program teaches patients various life coping skills, including:

The groups meet weekly for about 2.5 hours. The curriculum lasts 24 weeks, but it's often repeated to create a one-year program. Individual therapy sessions also take place once a week during this time. Telephone coaching is available so that patients can get help from their therapist between sessions.

Studies show DBT can be “effective at producing significant and long-lasting improvement for people experiencing a mental illness,” National Alliance on Mental Illness noted.

The approach has also shown promise in treating people with substance abuse. You can find a certified program or therapist through the DBT-Linehan Board of Certification.

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