Zen principles and mindfulness practice in dialectical behavior therapy

Abstract

Dialectical behavior therapy (DBT; Linehan, 1993a ) was developed as a treatment for borderline personality disorder (BPD). It involves a dialectical synthesis of the change-oriented strategies of cognitive-behavioral therapy with more acceptance-oriented principles and strategies adapted primarily from client-centered therapy and from Zen. In this paper, I note both similarities and contrasts between cognitive-behavioral therapy and Zen. I then highlight the role of Zen principles in DBT's assumptions about patients, theory of BPD, selection of treatment targets, and treatment strategies. Finally, the article describes the value of mindfulness practice for patients with BPD, how mindfulness skills are taught to patients in DBT, and benefits of mindfulness practice for therapists.