Dialectics, in Dialectical Behavior Therapy, refers to the process of investigating and synthesizing apparently opposing or contradictory ideas. In DBT, there might be your truth and my truth, but there is no search for absolute truth. Instead, there is a dialog about our contradictory positions in which both can find a new meaning. It is not a search for resolution by establishing right and wrong, but a development of understanding, over time, that may never result in a final truth or indisputable fact.
In a dialectical world view, change is considered a continuous and essential part of life. In therapy, both the client and the therapy itself are in a state of transformation.
This is a particularly difficult and important process for people with Borderline Personality Disorder (BPD), whose behaviors and relationships reflect a pattern of extreme impulsive reactions and intensity. Their lives are frequently unstable, with unrelenting crisis and chaotic interpersonal relationships. In this state, understanding without a final truth and the idea of change can be terrifying.
The Dialectic of Acceptance and Change
The core dialectical strategies in DBT are problem solving and validation strategies. At the heart of the treatment is the balance of the opposing acceptance and change based treatment strategies. The treatment strives to validate a personâ€™s responses as understandable and, at the same time, show them as dysfunctional and in need of change. The balance between the need for acceptance strategies and change strategies is also in constant flux, requiring flexibility from the therapist. This ever shifting balance is why dialectics is at the core of the treatment.
Linehan M. Cognitive Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press; 1993.