Validation is a core concept in DBT... but what does it mean?

July 24, 2017

 

The term validation is one you will hear often in DBT sessions, whether it is an individual or a group session. Validation is a core DBT strategy, but ....what does validation actually mean? 


Validation means being non-judgemental of one’s own or another person’s emotions, thoughts and behaviours, and communicating that the emotions, expectations, behaviours and so on, are understandable and make sense in the context of the current moment and own’s one or the other person’s life history to this point.  


Validation does not require agreement with the other person’s emotions, thoughts, actions and so on. We can validate someone’s experience without feeling, thinking or behaving the same way ourselves. Consider a woman who is frightened of dogs. She was chased by a large dog when she was young, and got trapped by a wall with the dog jumping up at her face. When confronted with a dog now she has the thought “this dog might jump up at me”, she feels anxious, and she wants to avoid situations where dogs might be off their leads. A dog lover with no fear of dogs would not think, feel or behave in the same ways, but can validate that the woman's experience makes sense, is understandable, given her history. Validation means that a person’s experiences are accepted, are taken seriously, and are not discounted or minimized. 


Marsha Linehan, the clinical psychologist who developed Dialectical Behaviour Therapy DBT, describes six levels of validation, each level being more complete than the previous level. Let’s use an example to illustrate these six levels. Your friend has to have a needle biopsy done and is frightened of medical procedures in general, and specifically she hates needles. 


Level 1 validation is active listening while your friend is talking about the procedure and her fears associated with it. Active listening involves giving eye contact, nodding, obviously paying attention and so on. 


Level 2 is reflecting back what your friend has said. This means repeating their thoughts, assumptions and so on. Thus your friend feels heard and understood.


Level 3 is articulating what may be unsaid. In our example, you might say “Are you frightened by the feeling of loss of control?” or “I’m wondering if you are worried about what the test might show”. This is a kind of “mind-reading”, and must be done gently without insistence - if we insist we are right and know better than our friend about what she is feeling, our attempts to be validating quickly become very invalidating!


Level 4 is validating in terms of causes. This is based on the fundamental DBT assumption that all behavior is caused, and so is by definition understandable. In our example you might say, “it makes sense that you would be anxious about this – you have never had that procedure done before” or “Last time you had a medical procedure done it was very painful, so it makes sense that you would be worried this time”.


Level 5 validation involves acting on the situation. Here, we are communicating that I accept and understand your experience, and I will make adjustments to support, accommodate, or help with that. “Would you like me to go with you to the procedure?” is Level 5 validation because it involves an understanding and acceptance of your friend’s fear and an intention to help in some way.


And Level 6 is what we call in DBT Radical Genuineness. This includes treating your friend as an equal, being empathic about her difficulty without treating her as helpless or hopeless, without upping or downing her.


These six levels of validation occur during all DBT sessions, and validation is a central component of the treatment. Many people who participate in DBT have had a significant history of invalidation – in other words, their private experiences (thoughts, beliefs, emotions, sensations) have been ignored, trivialized, criticized, ridiculed or punished by those around them. This creates a sense that the private experiences are wrong, stupid, senseless, destructive and so on, which of course can contribute to ongoing problems in accepting and then regulating those private experiences. Being validated by a DBT therapist, balanced with appropriate DBT change strategies, is often an extremely important component of the treatment, and helps participants develop a healthier, accepting relationship to their ongoing private experiences. In other words, participants learn the important DBT skill of self-validation. 


If you would like to learn more about DBT, or about validation specifically, please  contact me to discuss making an appointment. I look forward to hearing from you!


 

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