EMDR, CBT, and DBT Explained
6-minute read
EMDR, CBT, and DBT Explained
6-minute read
EMDR. CBT. DBT. If you’re looking for information on mental health challenges and their treatment, you may find yourself lost in a sea of abbreviations, complex terms, and jargon.
Whether you’re a Veteran seeking treatment, a family member helping a loved one find or navigate care, or just an interested person reading about mental health challenges, these unfamiliar terms can form barriers to understanding.
The terms listed above are names of common, highly effective therapies for different mental health challenges. But what do they mean and how do they work? Let’s explore EMDR, CBT, and DBT and how they help Veterans manage various mental health conditions.
What is CBT?
CBT, or cognitive behavioral therapy, is a talk-based treatment that focuses on the connections between a patient’s thought patterns, behaviors, and mental health symptoms. It is used to treat various conditions, including depression, insomnia, and substance use disorders. The use of CBT varies slightly depending on the condition being treated. In general, patients receiving this treatment will work regularly with a therapist to:
- Identify unhelpful thoughts or triggers (things that set off negative feelings or behavior)
- Set treatment goals
- Use real-life practice, discussion, and feedback to find and put into action behaviors, activities, and thought patterns that help improve their symptoms
“Cognitive behavioral therapy really, really made a difference in my life,” says Manuel, a Navy Veteran. He sought treatment after his unhealthy drug use led first to crime and then to a prison term. “I was just this pattern of destruction,” he says, “and, in the most unthinkable places, people cared about me.” CBT helped Manuel understand the traumas behind his drug use. He later combined that treatment with EMDR and DBT (both described below). With the stability this therapy provided, Manuel was able to further his education, get a good job, and become a better father. “I still have a lot of work to do, but now I have the tools,” he says.
CBT also made a difference for Army Veteran Drew. He had experienced the trauma of war during his deployment to Afghanistan, and when he returned to civilian life the full weight of that experience took hold. He pushed everyone away, losing touch with friends and loved ones. Finally, with no remaining friends and out of touch with his family, he sought help from VA. There, treatment with CBT helped Drew learn to deal with the stress in his life. “It’s allowed me to be more open and honest with people,” he says. “It was like I had this huge burden come off my shoulders.” He adds, “Getting help brought me together with a lot of people that I had pushed away.”
What is EMDR?
EMDR—which stands for eye movement desensitization and reprocessing—typically pairs the patient’s eye movements with the processing of traumatic memories. It can also involve nonvisual cues, such as alternating tones or alternate-side tapping. EMDR is commonly used to reduce the symptoms of PTSD.
According to the VA National Center for PTSD, in an EMDR therapy session, the patient will recall a traumatic memory while focusing on a back-and-forth movement (for instance, a light or the provider’s finger). They will continue to do this until the distress of the memory lessens. Eventually, as treatment progresses, the patient will think of something positive as they recall the traumatic event. All of this takes place under the close guidance of a provider, with preparation, discussion, and reassessment.
Jeff, a U.S. Army Veteran, received EMDR to help him with PTSD, anxiety, and the effects of traumatic brain injury after serving overseas. His wife urged him to seek help after he started having thoughts of suicide. In his EMDR sessions, Jeff says, “They’ll hold something up and you’ll talk about your troubling past, like that soldier that died, and you’ll have to follow it with your eye while you’re talking.” Over time, Jeff’s work in therapy began to improve his interactions with his wife and kids. He notes that even in his daily life, he now uses alternate-side tapping to help him process troubling situations.
For Bridget, a Navy Veteran, EMDR was one of several treatments she received for PTSD and the effects of traumatic brain injury. She had gone through a grueling military Survival, Evasion, Resistance, and Escape program and later experienced domestic abuse. For Bridget, DBT gave her practical skills for managing her mental health, while EMDR has worked on what she calls the “somatic side.” She explains, “It’s bypassing the thinking brain. It’s getting into the body where a lot of the trauma lives. This stuff is going to live with me for my life, but I know now how to find the tools when I need them instead of burying it and feeling so much shame about it.”
What is DBT?
DBT—dialectical behavioral therapy—teaches skills for controlling harmful and impulsive behaviors; decreasing suicidal thoughts and actions; and improving symptoms. It is commonly used to treat substance use disorder, PTSD, depression, and borderline personality disorder. It can also help patients with relationship challenges.
DBT works by teaching patients problem-solving and coping skills. Typical parts of the treatment are:
- Weekly sessions with a provider to discuss treatment goals, progress, and challenges
- A weekly skills group to learn and practice coping skills and apply them to specific events and challenges in the patient’s life
- Homework to practice skills and track progress
As noted above, Veterans Bridget and Manuel benefited from the use of DBT in conjunction with other treatments. Christina and Joseph also received this therapy.
Joseph, an Army Veteran, entered therapy after long-term substance misuse caused him to lose his job and his home. After attending a few programs that didn’t click for him, he started seeing a therapist who he felt really held him accountable. This connection made the difference. The therapy, including DBT, equipped him with techniques that he continues to use to maintain his progress. For instance, he says to himself, “Feeling a little anxious? Where is this coming from? Why is this coming from? Recognize it. Stop. Take a look at it.”
Air Force Veteran Christina received DBT after experiencing military sexual trauma, which led to her medical discharge. She also received CBT and cognitive processing therapy. For her, therapy represents a commitment to herself. She says, “If I’m hurting, that means I still have more work to heal. Doesn’t mean that I’m not where I need to be. It means that right now, this is what needs to be addressed.”
Reaching out for help is the first step
If you or a loved one is seeking help with a mental health challenge, the important thing is to take that first step. Help is available, no matter what you or your loved one is experiencing. Every treatment approach is tailored to the individual.
These 6 Veterans want other Veterans to know that healing is possible:
Christina: “For men and women that are experiencing military sexual trauma, acknowledging that this has happened is your first step. Taking a moment and saying, ‘No, this is not my fault,’ is your second step. Your third step is looking in the mirror and saying, ‘I’m worth it, and I’m going to find a way to get better.”
Drew: “Don’t give up. Keep fighting. If you fight hard enough, you’ll find somebody out there that will take your hand and help guide you to where you need to be.”
Manuel: “It doesn’t mean that you’re weak when you go look for help. A therapist is not somebody that wants to know all your deepest secrets, it’s somebody that wants to bring out the best in you.”
Bridget: “There is something going on in your area that’s a Veterans group that’s doing something creative. So connect to the community because that’s something that changed things for me drastically.”
Jeff: “My advice is go for it. Take that first step. Go see someone if you’re even semi-worried about how you’ve been acting around other people. If you think you have to rein yourself in for any reason, go talk to someone. You know, it’s just going to build strength later on.”
Joseph: “Just keep on doing what you need to do to keep yourself in a good mental state. Life’s going to show up, and you’re still going to face it, whether on the battlefield or in the streets.”
