Watch the full episode and view show notes here: https://bit.ly/3Awbt2P Become a member to receive exclusive content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's newsletter: https://peterattiamd.com/newsletter/ Shireen Rizvi is a Professor of Clinical Psychology & Psychiatry at Rutgers University, where she is also the Director of the Dialectical Behavior Therapy Clinic. This episode focuses on dialectical behavior therapy (DBT), a skills-based technique which was originally developed to treat borderline personality disorder (BPD) & has since been adapted to treat depression & other mental health conditions, as well as to help people who have difficulty with emotional regulation & self-destructive behaviors. Shireen explains the origins of DBT & how its creator, Dr. Marsha Linehan, came to find a need for something beyond cognitive behavioral therapy (CBT) when attempting to treat patients with suicidal behavior. From there, Shireen dives into how DBT works to resolve the apparent contradiction between self-acceptance & change to bring about positive changes in emotional regulation, interpersonal effectiveness, mindfulness, distress tolerance, & more. She also provides examples for how one can apply specific skills taught with DBT such as accessing the “wise mind,” applying radical acceptance, using the “DEAR MAN” technique, & utilizing an emotion regulation skill called “opposite action.” Finally, she explains how the tenets of DBT offer benefits to anyone, & she provides insights & resources for people wanting to further explore DBT. We discuss: 0:00:00 - Intro 0:00:08 - The basics of dialectical behavior therapy (DBT) & how it differs from cognitive behavioral therapy (CBT) 0:06:15 - Treating depression with CBT: history, effectiveness, & how it laid the groundwork for DBT 0:15:22 - Marsha Linehan’s inspiration for developing DBT 0:20:10 - Explaining borderline personality disorder (and associated conditions) through the lens of DBT 0:38:15 - How work with suicidal patients led to the development of DBT—a dialectic between change and acceptance 0:49:04 - Details of DBT: defining the term “dialectical” and how to access the “wise mind” 0:56:29 - Practicing mindfulness and radical acceptance in the context of DBT 1:09:50 - Applying “radical acceptance” to tragic scenarios 1:16:15 - The five domains of skills taught in DBT 1:23:30 - Why Marsha chose borderline personality disorder as her focus when developing DBT 1:26:15 - Is there any benefit in doing DBT for someone without a pathological condition? 1:31:50 - The DEAR MAN skill of DBT 1:44:44 - Adapting DBT skills for adolescents and families 1:47:55 - Identifying vulnerability factors, increasing distress tolerance, and the impact of physical pain 2:01:19 - The DBT chain analysis: assessing problem behaviors and identifying vulnerability factors 2:08:15 - Why the regulation of emotions can be so challenging 2:11:58 - The importance of mindfulness skills in DBT 2:16:15 - Opposite action: an emotion regulation skill 2:23:42 - Advice for those wanting to explore DBT 2:29:13 - Finding a well-trained DBT therapist --- About: The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 45 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more. Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life). Learn more: https://peterattiamd.com Connect with Peter on: Facebook: http://bit.ly/PeterAttiaMDFB Twitter: http://bit.ly/PeterAttiaMDTW Instagram: http://bit.ly/PeterAttiaMDIG Subscribe to The Drive: Apple Podcast: http://bit.ly/TheDriveApplePodcasts Overcast: http://bit.ly/TheDriveOvercast Spotify: http://bit.ly/TheDriveSpotify Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies.