Dialectical Cognitive Therapy

Author: Tom Rhodes, MFT
You may or may not have heard of dialectical behavioral therapy (DBT). In a nutshell, this is a psychotherapeutic modality focusing on behaviors that are not helpful in getting one’s needs met in relationships and life at large and are often destructive. My sense is that the focus in this form of therapy is not the cognitive component, or core beliefs, that drive these behaviors but rather the behaviors that are negatively impacting a client’s life. It is my intention, and my passion and heart’s desire as a psychotherapist, to bring attention to these underlying core beliefs that unconsciously drive our conditioned responses to ourselves in the form of “the inner critic” and to our loved ones in relationship. It is my sense, and experience, that beginning to isolate and see through these beliefs little by little acts as a fundamental linchpin toward unlocking our inner stuckness and being less and less controlled by these beliefs.
As with DBT, what I am calling dialectical cognitive therapy (DCT) utilizes mindfulness or raw awareness as a space from which to meet our inner world and its myriad beliefs. From this “centerless center” of raw awareness, it is much easier to truly hold the tension of this fundamental dialectic. Some of you may be wondering at this point, “Well, what is this dialectic with a capital D that you’re talking about?” It is the dialectic of acceptance and change. It is my experience that we are traditionally taught, both implicitly and explicitly, that the very act of acceptance of something we want to change will never lead to change. I see this, however, as a common and unfortunate misunderstanding, or more accurately a projection onto the very meaning of the word and embodiment of “acceptance.” Acceptance does not have to include unconscious indulgence of what is being accepted nor the often associated powerlessness that comes with it. Acceptance is nothing more or less than absolute opening to “what is” and does not in and of itself include nonaction.
Deep, radical, full-on inner acceptance is the very stuff that love and transformation are made of. Thus, my deep interest in applying full, heartfelt attention to touching our deepest emotional pain and stuckness with this spacious and ever-present awareness that is, quite simply, our Self. Therapists, clients, all of us as human beings have the innate capacity to be and embody this radical acceptance that is both full and empty; we are that raw awareness that is not separate and has no need to separate from whatever our internal experience may be. What I’m calling here “not separating” from our internal, felt experience is not at all the same as getting lost in it. Rather, diving into the felt, physical sense of the feeling, at this point, and setting aside the isolated belief-thought that created the feeling and literally becoming that feeling 100%, consciously, seems to be what heals and resolves these core beliefs and the feelings that they create or copy into our bodies. A few examples of these beliefs and the accompanying feelings are “I’m not enough” = shame or despair, or “There’s something wrong with me” = shame or rage. The feeling of shame seems to pretty much always be a by-product of these core beliefs and could even be its core counterpart in the feeling realm. I think we all know what it’s like to feel shame. Again, contrary to what we are taught, when this acceptance is embodied at the very core of our being, change, whether in the form of observable action or not, seems to follow. Truth and transformation seem to thrive via the expression and embodiment of apparent paradox.
Finally, I just want to point to the therapeutic relationship itself as a vehicle through which this radical acceptance can be realized. I believe that these core beliefs are created in relationship with our primary caregivers when we are very young children, so it only makes sense that the therapeutic relationship would optimally serve to work through and resolve these beliefs. There seems to be some alchemy that happens, just like when we were young with these negative beliefs, when we are met, deeply accepted, and opened to just as we are. Just like not being met, and being dropped, rejected, and/or criticized and shut down to creates these core beliefs that we’ve internalized, these same beliefs and the accompanying feelings can be worn away by being processed and met with openness and a vital curiosity of spirit. Over time, including moments of powerful bursts of epiphany, the openness and loving attention of the therapist are invited to be internalized and infused into the client’s experience of self and of living. More accurately, I would even say that what is being internalized is actually already there in the client as unconditioned presence, simply buried or obscured in moments of stress by these conditioned beliefs.

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