Awakening and Insight: Zen Buddhism and Psychotherapy

Underlying principle

Before we can explain the techniques and guiding rules of the therapy we have to
look at the underlying principle, because the underlying world view is determinant
for some of the important techniques.
Dialectical Behavior Therapy (DBT) is based on a specific world view which
Linehan calls a dialectical world view. She points to three important components.
First, dialectics stresses the interrelatedness or wholeness of reality. The self or person
is defined as ‘in relation’ and viewed as part of a network. Dialectics directs one’s
attention to the immediate and larger context. A second characteristic of a dialectical
world view is that reality is seen as dynamic, comprised of internal opposing forces,
out of whose synthesis evolves a new set of opposing forces. Within each thing, no
matter how small, there is polarity, and all propositions contain within them their
own oppositions. Applied to clinical practice, this principle has a profound impact.
For example, it means that dysfunction also encompasses function, distortion
accuracy, destruction construction. One of the first polarities treated in DBT is the
polarity of acceptance and change. Linehan stresses the dialectic between the need
for the client to accept herself as she is at the moment and the need for change on
her part. Finally, the dialectical world view sees reality as a wholeness continually in
the process of change. Change, rather than structure or content, is the essential nature
of life. Life is in a constant process of transformation.
Two important concepts arise out of this dialectical world view. The first was
mentioned already and consists of the emphasis on the balance of acceptance and
change. The focus is not only on change: acceptance is as important to clients as
change. A technology of encouraging acceptance is as important as a technology of
change. Linehan refers to her experience with Zen meditation as a main source for
her insight into this balance. To be able to work towards this acceptance, she uses
some techniques named core mindfulness skills. We will look at these skills more closely
in the next paragraph.
A second important concept or underlying principle is the idea of Wise Mind. Wise
Mind is a focus on the inherent wisdom of clients. DBT assumes that each individual
is capable of wisdom with respect to his or her own life, although this ability is not
always obvious or accessible. The DBT therapist trusts that the client has within
himself or herself the potential necessary for change. The essential elements for growth
are already present in the current situation. The therapist searches for the grain of
wisdom or truth inherent in each of the client’s responses and communicates that
wisdom to the client. A belief in the client’s essential desire to grow and progress as
well as a belief in his or her inherent capability for change underpins the treatment
(Linehan 1993a:33).

Techniques and guiding rules

Progress on the path is stimulated by the following components: individual
psychotherapy, skills training, telephone consultation, and consultation meetings for

NISHITANI AND DIALECTICAL BEHAVIOR THERAPY 193