1- There are 6 problematic behavioral patterns paired together:
- Emotional vulnerability vs self-invalidation
- Unrelenting crisis vs inhibited grieving
- Active passivity vs apparent competence
2- For each of the 3 dilemmas, there is a biological component and a social component.
3- Identifying, balancing, and synthesizing dialectical dilemmas is a goal of the DBT therapist.
Although there are plenty of skills and strategies to learn, it is essential to keep DBT theory in mind in order to effectively conceptualize a patient’s struggles and how to address them. Thinking dialectically can be challenging and understanding and applying the idea of dialectical dilemmas takes time. The concept of dialectics in the biosocial model has been explained in earlier discussions. So for our purposes, we will assume a basic understanding of both of these concepts.
What are dialectical dilemmas? Dialectical dilemmas are three pairs of fluctuating behavioral patterns that Linehan identified as essential to resolve and balance in therapy. It is the task of the therapist to keep these in mind when conceptualizing a patient.