Walking the Middle path in Dialectical Behavior Therapy

Dan Pierce from Mentally Fit and Dr. Kate Balestrieri, PSYD talk about walking the middle path in DBT, plus childhood coping mechanisms that develop naturally in response to difficult situations.

DBT Experts respond

Melissa Ifill, LCSW

I am a LCSW (NY) LCSWC (MD) with 20 years experience working with children and families in various capacities. My private practice is based in Brooklyn, NY and centers around working with young people and assisting them in coping through many life transitions while developing the skills needed to manage emotions. My passion is working with young women who are often seen as angry, uncontrollable or dysregulated and providing them with the support needed to better understand themselves and use the tools learned in session to develop the life that they want.

I agree with what Dr. Kate says about learning to "walk the middle path." We have automatic reactions to the things that occur in our lives because of our early childhood development and messaging that we receive about what is safe, what is appropriate and possible consequences (either natural consequences or those created by our family/community of origin) for not behaving a specific way.

Mindfulness teaches us to pay attention to what we are doing, get curious about the reasons we are behaving in a specific way and leave room to consider alternatives. Understanding these concepts has broad implications on the micro-level (treatment of various individuals) and macro-level (social organization/educational systems), as well. Understanding of how these learned responses impact marginalized populations is not often talked about or explored. 

Our understanding of the impact of trauma tells us that thought processes and understanding of options can be limited ('black or white thinking"). Further the choices that are considered are one's that allow the individual to feel safe, remain in their perceived locus of control and reactive (automatic, no preplanning). Teaching DBT techniques, specifically mindfulness and how to hold duality (i.e. "walking the middle path") can help students in school learn different ways to resolve conflict. It can help individuals in communities that are high crime/high poverty understand different ways to earn money or feel safe other than perpetuating the cycle. The implications for understanding the impact of trauma and for teaching people the skills to address it effects are far reaching and should be widely considered.

Sal Raichbach, PsyD at Ambrosia Treatment Center

Dr. Raichbach has over 25 years of experience as an actively licensed psychologist in Florida, New Jersey, Nevada and New York. Currently, he serves as the Chief of Clinical Compliance for Ambrosia Treatment Center.

In short, I agree with Dr. Kate. Walking the Middle Path translates to replacing an “either-or” thought process with a more collaborative style such as a “both-and” approach. Far too often we make up our minds about how we feel about someone or something using a black and white, all or nothing, decision-making method. As a result, there’s the prospect that we’ll become imbalanced by closing ourselves off to another way of thinking. For instance, if we disagree with others, it’s not uncommon to believe we’re right and they’re wrong.

But it doesn’t have to be this way. As we discuss dialectical behavior therapy (DBT), focus on the word dialectical. If we take a dialectical approach, we embrace new possibilities by appreciating alternative perspectives. When we do this, each perspective becomes an opinion rather than a supreme truth. Walking the Middle Path helps us pave the way for compromise, which can validate our feelings and those of others, and in turn bring about a more harmonious outcome.

Extreme thinking can lead to extreme reactions, either making too much or too little of a situation, and this not only affects us but also the people around us. Walking this Middle Path can make us more flexible and balanced in our own perspective, encourage us to become more open-minded, and can serve as a powerful mentality for creating feelings of tranquility and satisfaction.