During a period of clinical depression, Brad Jacobs underwent two years of cognitive therapy. This process was a turning point, helping him reframe his perfectionistic "musts" and "shoulds" into mere preferences. This shift allowed him to accept reality, reduce stress, and operate more effectively.

DBT distinguishes between pain, an unavoidable part of life, and suffering, which is the additional distress we create by fighting reality ("this shouldn't be happening"). Radical acceptance is the skill of experiencing pain without adding the second layer of suffering from non-acceptance.

A core assumption of Dialectical Behavior Therapy (DBT) is that problems like depression or anxiety arise because individuals haven't learned the necessary skills to manage emotions or navigate relationships. The treatment is therefore focused on explicitly teaching these presumed-missing skills.

While "common factors" like empathy and validation are a crucial foundation for therapy, they are often not enough to treat moderate to severe mental health problems. These conditions require structured, evidence-based tools beyond simply having a supportive person to talk to.

You cannot think your way out of perfectionism with worksheets or intellectual exercises. Recovery is like learning to ride a bike: it requires a safe, experiential process. The therapeutic relationship provides a space to practice vulnerability and build a new, healthier way of relating to oneself, which information alone cannot achieve.

Simply layering on positive affirmations is ineffective. True mindset change requires first consciously identifying and "weeding out" entrenched negative thoughts before new, positive beliefs can successfully take root.

To combat the high stress and burnout associated with treating high-risk patients, Dialectical Behavior Therapy requires its practitioners to attend a weekly peer consultation team. This provides mutual support, skill enhancement, and a team-based approach to complex cases.

Cognitive Behavioral Therapy (CBT) has core components that distinguish it from general talk therapy. Two key indicators that a therapist is genuinely practicing CBT are the assignment of homework between sessions and a consistent focus on a pre-defined, shared goal.

Relying solely on talk therapy for a physiological problem can be counterproductive. When a patient makes no progress despite their efforts, they can develop learned helplessness and self-blame, concluding they are a "failure" and worsening their condition.