The Role of Self-Disclosure and Irreverence in DBT: Breaking Traditional Therapeutic Boundaries
Dialectical Behavior Therapy (DBT) stands apart from many traditional therapeutic approaches in its strategic use of therapist self-disclosure and irreverent communication styles. These techniques serve specific therapeutic purposes within the DBT framework and reflect the underlying philosophy of the treatment modality.
Strategic Self-Disclosure in DBT
DBT therapists often utilize “self-involving self-disclosure,” sharing appropriate personal experiences to model effective behaviors and strengthen the therapeutic relationship. Unlike traditional approaches that maintain rigid professional boundaries, DBT recognizes the value of therapist transparency in specific contexts (Linehan, 1993a; Rizvi et al., 2013).
Self-disclosure in DBT serves multiple functions:
- Modeling: By sharing their own experiences with emotion regulation or interpersonal effectiveness, therapists demonstrate practical application of DBT skills (Koerner, 2012).
- Validation: Therapists’ willingness to share personal struggles validates clients’ experiences and normalizes difficulties (Linehan, 2014).
- Relationship Building: Appropriate self-disclosure enhances the therapeutic alliance by introducing reciprocity and humanizing the therapist (Swales & Heard, 2016).
However, self-disclosure in DBT remains judicious and client-focused, with therapists carefully considering its therapeutic value before implementation (Chapman, 2006).
Irreverence as a Therapeutic Tool
The strategic use of irreverent communication—including humor, bluntness, and unexpected responses—serves as a powerful DBT technique. Irreverence functions as a deliberate “pattern break” that disrupts rigid thinking patterns and emotional responses (Linehan, 1993b).
Irreverence in DBT sessions may include:
- Using playful or unexpected language to shift perspective
- Employing strategic humor to reduce tension
- Challenging clients’ assumptions through provocative questions
- Using metaphors or paradoxical interventions to illustrate points
This approach intentionally creates mild discomfort that promotes cognitive flexibility and prevents therapy-interfering behaviors like avoidance or intellectualization (Dimeff & Koerner, 2007).
The Egalitarian Therapeutic Relationship
DBT deliberately establishes a collaborative relationship where therapist and client work as a team rather than in a hierarchical expert-patient dynamic (Linehan, 1993a). This partnership approach:
- Empowers clients to take active roles in their treatment
- Reduces stigma associated with mental health challenges
- Encourages clients to develop their own problem-solving capabilities
- Balances acceptance and change strategies (the core dialectic of DBT)
While therapists maintain professional boundaries and expertise, they position themselves as consultants or coaches rather than authoritative figures (Robins & Chapman, 2004).
Research Support and Clinical Applications
Research indicates that therapeutic self-disclosure and relationship-building strategies positively impact treatment outcomes, particularly for clients with complex presentations like borderline personality disorder (Bedics et al., 2012). These approaches have been associated with increased client engagement, reduced dropout rates, and improved symptom management (Linehan et al., 2006).
Conclusion
DBT’s strategic use of self-disclosure, irreverent communication, and collaborative therapeutic relationships represents a thoughtful departure from traditional therapeutic boundaries. Rather than arbitrary violations of convention, these techniques serve specific therapeutic purposes aligned with DBT’s underlying philosophy and treatment goals.
As with all DBT strategies, these approaches require therapist skill, training, and ongoing supervision to implement effectively and ethically.
References:
Bedics, J. D., Atkins, D. C., Comtois, K. A., & Linehan, M. M. (2012). Treatment differences in the therapeutic relationship and introject during a 2-year randomized controlled trial of dialectical behavior therapy versus nonbehavioral psychotherapy experts for borderline personality disorder. Journal of Consulting and Clinical Psychology, 80(1), 66-77.
Chapman, A. L. (2006). Dialectical behavior therapy: Current indications and unique elements. Psychiatry, 3(9), 62-68.
Dimeff, L. A., & Koerner, K. (2007). Dialectical behavior therapy in clinical practice: Applications across disorders and settings. Guilford Press.
Koerner, K. (2012). Doing dialectical behavior therapy: A practical guide. Guilford Press.
Linehan, M. M. (1993a). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
Linehan, M. M. (1993b). Skills training manual for treating borderline personality disorder. Guilford Press.
Linehan, M. M. (2014). DBT skills training manual (2nd ed.). Guilford Press.
Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., … & Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63(7), 757-766.
Rizvi, S. L., Steffel, L. M., & Carson-Wong, A. (2013). An overview of dialectical behavior therapy for professional psychologists. Professional Psychology: Research and Practice, 44(2), 73-80.
Robins, C. J., & Chapman, A. L. (2004). Dialectical behavior therapy: Current status, recent developments, and future directions. Journal of Personality Disorders, 18(1), 73-89.
Swales, M. A., & Heard, H. L. (2016). Dialectical behaviour therapy: Distinctive features. Routledge.
