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Enduring traumatic experiences may have a long lasting impact on mental health. Trauma may arise from one-off or recurring incidents, making regulating emotions and behaviors challenging.

When people seek help for trauma, they may take the conventional route by taking medications or seeking therapy, like cognitive behavioral therapy (CBT).

But there’s another option.

Dialectical behavior therapy, or DBT, may benefit trauma survivors, especially Black women. DBT helps people with personality disorders learn coping and life skills to improve self-awareness and obtain a fulfilling life.

That’s why the 2023 Community Support Grant, an award created from the partnership between the Black Emotional and Mental Health Collective (BEAM) and Healthline, was given in part to the DBT Skills Group for Black Women. The group is run by Clerrisa Cooper, clinical director of North Atlanta DBT, and Winter Foddrell, a therapist at Revolution Psychotherapy.

Here’s a look into DBT and how this therapy might benefit trauma survivors, especially Black women.

DBT is a cognitive or talking therapy designed for people with borderline personality disorder (BPD) who face challenges managing their emotions. DBT aims to help people learn to accept themselves and make adjustments to control their emotions.

According to a 2016 study, DBT may also help people manage:

  • alcohol or drug misuse
  • anxiety and depressive disorders
  • eating disorders
  • emotional dysregulation
  • post-traumatic stress disorder (PTSD)
  • self-harm
  • suicidal behavior

DBT sessions help people develop:

  • mindfulness
  • distress tolerance
  • interpersonal effectiveness
  • emotional regulation skills

DBT has a unique process.

For example, cognitive behavioral therapy (CBT) helps people to recognize unpleasant thoughts and behaviors and discover logical ways to address difficult situations more effectively, according to the American Psychological Association (APA).

On the contrary, DBT focuses more on the social and emotional aspects of mental health conditions by helping people adopt healthy coping behaviors.

As mentioned, DBT is often used to manage BPD. According to a 2023 article, one aspect of DBT differs from other therapies as it hones in on finding one’s identity.

Identity disturbance, or an unstable representation of oneself, can affect people with BPD and similar mental health conditions.

A 2011 study suggests that DBT effectively addresses identity crises among women with BPD.

Why is this effective for trauma survivors?

DBT may benefit trauma survivors by addressing relational disturbances or difficulties.

“At the core of most folks who benefit from DBT, there’s some sort of history of relational difficulty, relational disturbance,” said Cooper. “Folks who have a history of trauma can oftentimes have difficulty feeling attached to themselves and feeling attached to life.”

The importance of stabilization first

DBT might be an especially effective therapy for trauma survivors because it focuses on stabilization before diving into their trauma.

Stabilization is a DBT coping skill in which people learn to self-regulate to prepare for deeper trauma work.

“Once we can stabilize you and get you more committed to staying alive, not engaging in self-harm or excessive substance use, or having sex with folks that, on the back end, you actually are starting to regret,” said Cooper. “We can get you out of engaging in those behaviors, and [when] you can stabilize that, we can start the even harder work of trauma reprocessing if that’s what you need to do.”

Stabilization is especially important in severe cases.

“When we start seeing folks, particularly for individual DBT, they’re coming in actively self-harming or suicidal,” said Foddrell. “So we work with them on stabilization and making sure that they have the tools they need to survive a crisis without making it worse.”

Trauma doesn’t develop solely from mental health conditions but from racial and gender discrimination.

People from marginalized communities, like People of Color, women, and the LGBTQIA+ communities, may develop trauma from systemic issues.

For example, People of Color may experience racial trauma as the emotional toll of stress due to race-related factors, such as discrimination, barriers to access, and stereotypes, according to the U.S. Department of Veterans Affairs (DVA).

For certain races and genders, it might be challenging to get mental health care due to systemic and cultural barriers.

Types of racism that may keep People of Color from accessing quality mental healthcare include:

  • systemic and structural
  • institutional
  • cultural
  • interpersonal

Systemic and structural racism

Systemic and structural racism are applied in laws, policies, systems, and practices that promote and condone the unfair treatment and discrimination of People of Color, which may lead to adverse health outcomes, according to a 2022 research article.

Institutional racism

In the U.S. healthcare system, the American Academy of Family Physicians (AAFP) states that institutional racism from healthcare professionals against patients of specific races and ethnicities might contribute to health disparities.

Cultural racism

A 2017 article notes that cultural racism occurs when a person believes their race and ethnicity are superior to others based on factors like language, religion, immigrant status, dependence on social welfare, and profiling. These factors may also affect mental healthcare delivery to People of Color.

Interpersonal racism

Interpersonal racism involves racial bias against another ethnic or racial group.

According to a 2022 article, healthcare bias among healthcare professionals may affect care delivery toward Black patients, ultimately leading to adverse outcomes.

Gender-related barriers to mental health care

A patient who identifies as a woman may encounter unique challenges when seeking mental health services.

According to a 2022 KFF Women’s Health Survey, even though more women sought mental healthcare, one-third reported waiting more than a month to get an appointment or couldn’t because of limited providers or costs.

Also, women tend to deal with more mental disorders than men due to social, mental, and physiological differences that arise from gender-based discrimination.

For Black women, race and gender intertwine. They may face discrimination, oppression, and systemic racism from both angles.

Black women with mental health conditions and trauma deserve a safe space to express their emotions. They may benefit greatly from a healing space where other clients and therapists affirm their identities..

Cooper mentioned that Black patients lack connection with therapists or group members who don’t share the same cultural experiences.

“That’s something that I’ve heard from a number of clients, especially my clients that have been in other DBT skills groups, where the clinicians are white or where most of the other clients in the group are white or don’t have shared identities,” said Cooper.

Having an affirming healing space for Black women lets them discuss their feelings without over-explaining to people who can’t relate.

“There’s just a foundational level of understanding and shared experience that certain things don’t have to be translated because we just know,” said Cooper. “Then, we have this other piece of awareness, where it’s like we’re also not the same.”

DBT is an effective therapy for personality disorders and trauma. It focuses on self-awareness of emotions and behaviors and encourages people to develop healthy coping skills.

Marginalized communities, especially People of Color and women, experience systemic racism and other forms of discrimination that affect access to mental healthcare.

Having a safe space to discuss trauma and mental health can greatly benefit Black women.