Dialectical Behavior Therapy – An Introduction

Dialectical behavior therapy
Dialectical behavior therapy


Alyssa Mandel serves as CEO and director of the Mandel Center of Arizona, where she develops individualized psychotherapeutic treatment plans to meet each client’s unique needs. Alyssa Mandel draws on elements of various methodologies, including dialectical behavior therapy.

Dialectical behavior therapy, or DBT, uses mindfulness techniques and related skill sets to help clients cope with intense emotions. The therapy arose as an intervention for borderline personality disorder, which often causes extreme and quick emotional changes. Because individuals with this disorder have not yet developed the skills necessary to respond adaptively to such changes, they are often inclined to react in charged and possibly inappropriate ways.

DBT helps individuals both with and without borderline personality disorder to de-escalate heightened emotions and respond with more adaptive pro-social behaviors. Using individual therapy, group training, and phone coaching, each client learns and practices actionable skills that strengthen his or her social-emotional competence. By the time a client has completed the course of therapy, his or her skills span the categories of mindfulness, interpersonal effectiveness, distress tolerance, and emotion regulation.


Warning Signs of Anorexia

Mandel Center of Arizona pic
Mandel Center of Arizona
Image: mandelcenter.com

Alyssa Mandel is a master of social work graduate of Columbia University and the founder of the Mandel Center of Arizona in Scottsdale. In her practice, Alyssa Mandel collaborates with psychiatrists, social workers, and nutritionists, to provide the highest level of comprehensive care for clients.

Individuals with anorexia often are adept at hiding their eating habits. With that in mind, here are some warning signs to watch for if you believe someone close to you may have the disease.

Early warning signs typically manifest themselves as an unhealthy preoccupation with food intake and/or obsessive dieting. This preoccupation with food and its relationship to body image will eventually morph into disordered eating patterns. Consistently skipping meals, denying hunger after long periods of not eating, obsession with body image, and making excuses for lack of eating are all early warning signs.

In the more advanced stages, individuals typically tend to push themselves to excessive and unhealthy levels of exercise and weight themselves constantly. Obsessively checking the mirror and complaining about weight are other signs that tend to manifest themselves, as well as decreased and/or flat moods, displaying a lack of emotional response to the world around them.

Left untreated, anorexia can be a life-threatening condition, even if the individual is not dramatically underweight. The behavior can bring about abnormal heart function and electrolyte imbalances that can eventually cause significant heart complications.

Depression Information

Feeling blue


A therapist serving both children and adults, Alyssa Mandel helps people experiencing depression and other mental health issues as director of the Mandel Center of Arizona. In preparation for her career, Alyssa Mandel earned her master of social work from Columbia University.

A serious and widespread illness, depression is a type of mood disorder that negatively impacts fundamental parts of people’s lives, including thinking, feeling, eating, and working. Rather than one monolithic mental illness, depression is a category of illness that encompasses several distinct conditions.

Each depressive illness has a similar range of symptoms. People may have depression if they feel persistently sad or worthless. Moreover, patients struggling with depression often experience fatigue and either sleep too much or too little. Suicidal thoughts also can occur in people with depression.

If a person feels depressed most of the time, doctors may diagnose that person with major depression, and if the depression persists for two or more years, doctors may diagnose that person with persistent depressive disorder. Other kinds of depression include seasonal affective disorder, a kind of depression associated with the winter, and postpartum depression, a condition that occurs following childbirth.

Facts about Bulimia


National Institute of Mental Health Image: nimh.nih.gov
National Institute of Mental Health
Image: nimh.nih.gov

Alyssa Mandel is the founder of the Mandel Center of Arizona in Scottsdale. Using a holistic approach to therapy that incorporates various techniques, including cognitive therapy, dialectical behavioral therapy, and family systems therapy, her practice offers a full range of supportive psychotherapeutic services. Alyssa Mandel often treats individuals who have eating disorders.

While bulimia is typically classified as an eating disorder, it’s important to note that this condition is a mental health disorder rather than a physiological condition. Depression is often a concurrent diagnosis with bulimia. Suffers experience guilt and shame for their condition, which is characterized by an obsessive desire to lose weight. Some are often driven to suicide. While bulimia has some characteristics of binge eating disorder, it is differentiated by induced vomiting after a binge. The combination of all these factors highlights the importance of addressing bulimia as a mental health disorder above and beyond simple dysfunctional eating.

Current data from the National Institute of Mental Health indicates that young women are more likely to experience bulimia than any other demographic. Overall, women of all ages show increased instances of the illness as compared to men, although bulimia does stratify across gender, age, and economic categories. In total, about 1 percent of adults experience bulimia in some form throughout the course of their lives.

Eating Disorder Myths


Mandel Center of Arizona pic
Mandel Center of Arizona
Image: mandelcenter.com

Alyssa Mandel holds a master of social work from Columbia University and is the founder of the Mandel Center of Arizona in Scottsdale. In her practice, she works in collaboration with psychiatrists, social workers, and nutritionists, to provide comprehensive treatment to clients. In addition to other issues, Alyssa Mandel is passionate about helping individuals overcome eating disorders.

A good deal of misinformation exists within the public consciousness about the causes and effects of eating disorders. Here are some of the most common myths and the reasons why they aren’t valid.

Myth: Eating disorders are only about food.
Truth: There are always underlying issues beyond food itself that cause a person to have an unhealthy relationship with their eating. Some use food as a means of comfort or escape from pain and trauma in their lives. Others have dysfunctional self-image issues that cause them to either starve themselves (anorexia) or binge and purge (bulimia) in the belief that they must attain a certain physical standard.

Myth: Eating disorders are a choice.
Truth: While some believe that a person can simply stop their unhealthy eating behaviors, the causes of disordered eating are deep-rooted, and sometimes out of a person’s ability to control without intervention via mental treatment and/or hospitalization. By the time a person transitions into a full-blown disorder, they have gotten to the point where the behavior is entrenched as the primary coping mechanism for dealing with intense or unwanted emotions.

Myth: Only women experience eating disorders.
Truth: While the majority of those with eating disorders are female, it is not an exclusive club. Approximately 10 percent of suffers are male. Depending on the type of disorder, those numbers can be higher. For example, when only examining binge eating disorder demographics, the number of males jumps to nearly 40 percent. Current data suggests that adolescent boys are also among those seeing the fastest rise in eating disorders.