The Dialectical Approach

In philosophy, dialectic refers to the clash between arguments and counterarguments. The aim of the dialectical method is to resolve the disagreement through rational discussion and, ultimately, the search for truth. The idea is that you can derive the truth as contradictions arise. Each movement forward is a consequence of our reaction to the contradictions inherent in the preceding movement, which is just a fancy way of saying that it’s the dialectic that moves us forward, the synthesis of the thesis and antithesis. Well, all of this may sound like a bunch of intellectual banter. For us, it suffices to say that it’s the synthesis of our intellect and emotions that allows us to keep developing and behaving in the healthiest manner (Linehan 1993b).

Dialectics also recognize that two opposite ideas can be simultaneously correct. In philosophy, dialectical arguments use logic but don’t necessarily imply absolute truths. In other words, two opposing viewpoints can be equally “correct” based on frame of reference and personal values. This idea is clear in any political or other controversial issue; for example, your position on something like abortion or taxation is based on not only logic but also your personal values. The reason we disagree about things often boils down to what can’t be proven.

DBT helps people foster recognition of dialectical experiences in life to help combat black-and-white thinking (Linehan 1993a). Fostering dialectical awareness helps people see the black in the white and the white in the black. Note that this doesn’t involve seeing “shades of gray.” It’s not about finding a compromise between two opposing concepts but, rather, a synthesis of the two. You can be insecure and arrogant at the same time, or you can be simultaneously numb to your experiences and miserable about them, which is another dialectic your loved ones may have a difficult time understanding. Logic can’t always make sense of a situation, and emotion doesn’t always lead you to the most appropriate action, but both logic and emotion must necessarily interact with each other to achieve balance (Linehan 1993a). We will describe a few common dialectics next.

Rational vs. Emotional Mind

Paradox is unavoidable in a balanced life. The most powerful example of this is the interaction of our rational mind and our emotional mind (Linehan 1993a). The rational mind seeks solutions to problems, and thrives on finding absolute truths and universal experiences. On the other hand, the emotional mind rejects rules and acts on emotional impulse. Your emotional mind helps you pursue passions or avoid discomfort, and while these actions may bring relief in the short term, they can be destructive in the long term. For example, anxiety, discomfort, or fear of experiencing feelings of depersonalization may lead you to avoid certain social or work responsibilities. Feeling that your concentration is impaired may lead you to avoid mentally taxing activities, and sensitivity about appearing “out of it” may cause you to avoid conversation. In a sense, when you avoid life because of DPD, your emotional mind is in control.

Both your emotional and rational minds are vital to your psychological health, which is why we are all equipped with both (Linehan 1993a). If you weren’t passionate about things, you would be unaffected when bad things happened to you, you wouldn’t protect your loved ones, you would have no preference for one thing over another, and essentially, you wouldn’t be you. If you weren’t equipped with a rational mind, you would be a frantic, emotional whirl, pursuing every impulse without concern for consequence. Though these two forces are sometimes at odds, they have to somehow come up with some solution that satisfies both for you to achieve a well-balanced life. If permitted, intellect and emotion can coexist, even though they are fundamentally opposed; they just need to reach a synthesis, a solution that grows out of this contradiction. DBT refers to this synthesis as wise mind (Linehan 1993b). Wise mind incorporates intuition into this equation, which allows people to behave reasonably with regard to emotionally intense experiences. Wise mind allows you to see and experience events calmly, which allows for awareness of the whole picture.

When the emotional mind is too much in control of your life and you can’t handle intense emotions, you are emotionally dysregulated. In an emotionally dysregulated state, you not only feel miserable but also feel as if you can’t achieve your goals, and you may feel injured or alienate yourself from others; everything just seems to go sour in your life.

It may be that you had trouble responding to intense emotions (that is, you were emotionally dysregulated) prior to developing DPD, and perhaps developed DPD to protect against your reactions to strong emotions. Maybe feeling emotionally out of control was too frightening. Your ability to tolerate discomfort had worn thin, leading you to shut down and protect yourself by becoming numb and disconnected. However, this protective reaction wasn’t very effective, and it led you to once again experience extreme negative feelings of anxiety and depression—but this time, over the experience of DPD. You couldn’t tolerate feeling numb and disconnected, being unable to concentrate, feeling unable to bond with others, and not knowing when relief would come. Your preoccupation with these feelings and your quest to get rid of them, once again, gave rise to more difficulty dealing with emotions and an even lower distress tolerance. You have likely found yourself on an emotional roller coaster and in a vicious cycle.

Related to DPD, emotional dysregulation may involve avoidance of situations that elicit feelings of depersonalization or discomfort in general. Occasionally, people with depersonalization may engage in extreme efforts to “feel something,” such as cutting and other forms of self-mutilation. Cutting and other self-injurious behaviors are not the best way to get rid of numbness.

Fostering wise mind can lead to emotional regulation, which simply means developing the ability to deal effectively with your emotions; we’ll discuss how to do this later in this chapter. When it comes to DPD, emotional regulation is important because it’s all too easy to let extreme anxiety and depression take control and then to become focused only on your internal emotional state. DBT skills help regulate your emotional state.