Selena Gomez is no stranger to hospitalizations. The 26-year-old has been battling an autoimmune disease called lupus since 2015, which led to a kidney transplant last year that friends later revealed nearly killed her. But after two stints in the hospital in the last two weeks for a low white blood cell count (a result of the transplant), the singer and actress — understandably — hit an emotional wall. According to TMZ, Gomez reportedly had a “meltdown” at the hospital, expressing frustration and sadness, which sparked concern among her family and close friends.
The news follows months of turbulent developments for Gomez, including a breakup with singer the Weeknd (whose real name is Abel Tesfaye) and the whirlwind engagement of her longtime ex-boyfriend Justin Bieber to his on-and-off girlfriend Hailey Baldwin. After disappearing from the internet, Gomez revealed to Elle in October that she was “taking a break” from social media and had deleted both Instagram and Twitter from her phone. Two weeks ago, she shed light on why. “Kindness and encouragement only for a bit!” she wrote. “Just remember- negative comments can hurt anybody’s feelings. Obvi.”
Whether or not this was part of her effort to treat her mental health remains to be seen, but based on the TMZ report, Gomez is now receiving psychological care on the East Coast. Gomez is said to be specifically undergoing a treatment known as dialectical behavior therapy (DBT), which is used to change negative thinking. But what is DBT, and how might it help someone in her scenario?
Here’s what you need to know.
DBT is a relatively new treatment plan
While many forms of psychological treatment have been around since the early 20th century, DBT is a newer psychological approach. It was pioneered in the late 1980s by Marsha Linehan, professor of psychology and adjunct professor of psychiatry and behavioral sciences at the University of Washington in Seattle. Initially intended for patients with suicidal thoughts, Linehan’s method has become the gold standard for treatment of those suffering from borderline personality disorder, a mental illness marked by difficulty managing moods and maintaining stable relationships.
DBT is a form of cognitive-behavioral therapy
Technically speaking, DBT is a form of the most commonly used psychological treatment in the U.S., called cognitive-behavioral therapy (CBT). This method, which dates back to the late 1960s, involves shifting negative thoughts to positive ones. While CBT generally aims to unravel (or eliminate) disruptive thinking through talk therapy, DBT is different. This method entails accepting the negative thoughts as they are and then implementing new behaviors to change them.
The treatment hinges on acceptance and change
In a Borderliner Notes interview, Linehan says she created the DBT treatment after watching suicidal patients respond poorly to CBT, which left them feeling judged and frustrated. Instead, her approach hinges on — in her own words — “the technology of acceptance” and “the technology of change.” “It’s behavior therapy with a huge amount of validation,” says Linehan in the interview. “Problem solving and validation are the core components of the treatment.”
One of the benefits of this model is that it allows an honest discussion — and problem-solving approach — about dangerous habits, such as self-harm. “DBT pays enormous attention to escape behavior,” Linehan says in another Borderliner Notes interview. “Suicidal ideation functions for many as escape behavior. … Thinking that you can kill yourself is an escape from the life that you’re living.”
Mindfulness is one of the core tenets of the treatment
DBT sessions — which includes both individual and group sessions — revolves around four techniques called “modules.” These are interpersonal effectiveness, distress tolerance/reality acceptance skills, emotion regulation, and mindfulness. Mindfulness derives from Linehan’s own work with the Buddhist practice of meditation, which involves focusing on one’s breath. Patients undergoing DBT treatment are encouraged to use mindfulness as a way to control their reactions and change their patterns of thinking. (Gomez has reportedly used meditation in the past to help cope with her lupus.)
The treatment has been used successfully by other celebrities, including Pete Davidson
Gomez is hardly the first celebrity to make news for trying the treatment. Earlier this year, Saturday Night Live star Pete Davidson opened up about his experience with borderline personality disorder, which he is said to have successfully treated with DBT. “You have this thought … these feelings and urges to freak out,” Davidson told Marc Maron on his podcast, discussing how DBT works. “[So you] try waiting it out 10 minutes, try going for a walk.” Whether or not Gomez will find relief from DBT remains to be seen, but given the treatment’s robust and positive history, chances are good it will make a difference.
UPDATE: An original version of this article stated that DBT therapy can entail either individual or group sessions. In reality, true DBT therapy includes both individual sessions and DBT skills groups.
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