Just because you’ve decided to attend therapy sessions doesn’t mean you’re actually trying therapy. Practitioners of dialectical behavior therapy (DBT) have identified what they called therapy interfering behavior, or TIBs. As the name implies, such behaviors (intentional or not) get in the way of a productive therapy session.
DBT is designed to reduce such impediments to progress. For DBT therapists, of course, life-threatening behaviors would be the highest priority. After that, eliminating therapy interfering behavior is paramount. The idea is to identify and address these behaviors before they fully sabotage the therapist-client relationship. Dealing with TIBs is also an excellent way to model effective communication.
Often, therapy interfering behaviors are attempts to cope. Avoiding homework might protect someone from feeling like they’ve failed. Changing the subject may help someone avoid painful emotions. Shutting down can be a way to stay safe when things feel overwhelming. In DBT, we look at these behaviors with curiosity, not criticism.
Therapy-interfering behaviors are often not unique to therapy—they are the same patterns that show up in daily life. Avoiding difficult emotions, procrastinating on tasks, arriving late, or pulling away to escape shame or discomfort are all examples of behaviors that can interfere both inside and outside of sessions.
Because these patterns emerge in real time during therapy, they give us a valuable opportunity to understand them, work through them, and begin replacing them with more skillful, effective responses
What Are Some Therapy Interfering Behaviors?
Dialectical behavior therapy doesn’t label therapist-client problems as flaws in one’s personality. Instead, it’s all about recognizing behaviors and then managing them. Addressing TIBs removes a major obstacle to the client’s recovery.
It’s important to note that TIBs are not onetime situations. Anyone can have something interfere with an individual session. Rather, a therapy interfering behavior is part of an ongoing pattern. To follow are some obvious examples of TIBs:
- Showing up late to sessions
- Canceling sessions (especially last-minute cancellations)
- “Forgetting” to pay for sessions
- Not doing any of the homework assigned by the therapist
- Frequently threatening to quit therapy
- Not reaching out for phone coaching
- Not having the diary card done for session or doing it right before session
More covert or subtle TIBs examples include:
- Behaviors that shut down the productivity of sessions, such as presenting as unsure of yourself, e.g. not answering questions or saying “I don’t know,” yelling at or criticizing the therapist, and uncontrollable sobbing
- Not acknowledging a problem or downplaying the severity of that problem
- Derailing the focus of a session particularly to topics that are unrelated to treatment
- Not setting clear treatment goals
- Cryptically hinting at self-harm or self-destructive acts
- Only reporting negative updates while downplaying anything positive
- Only reporting positive updates and downplaying negative updates
Why Therapy Interfering Behavior is Important to Address in DBT
One expects a certain amount of confusion when attempting to heal from emotional wounds. TIBs, on the other hand, can completely sidetrack any realistic efforts at treatment. Even when the client’s intention is to cooperate, TIBs can emerge and disrupt.
An experienced DBT therapist is adept at recognizing these patterns before they can take hold. Addressing TIBs is a giant set toward both a better client-therapist relationship and making solid progress in terms of treatment. A therapist will not expect their client to initiate this process. The onus on the counselor to redirect the sessions in a productive way.
How DBT Addresses TIBs
Before initiating a conversation about therapy interfering behavior with a client, a therapist will do some valuable prep work. This process includes:
•Analyzing the TIBs and attempting to discern a motivation
•Coming up with empathetic and non-judgmental ways to ask about the TIBs
•Choosing the best possible time to introduce this topic
Once the discussion has been initiated, it is essential for the therapist to maintain the client’s participation. This can be done via:
Confirmation: Make sure the client fully understands what is being said and why. Ask the client to repeat back what they are hearing. Then, have the client clarify if they are willing to work on doing things differently as it is “getting in the way of making the kind of progress” they deserve.
Collaboration: Once the client understands and commits to change, this must be a collaborative effort. Both parties can work together to set goals and identify what role each of them will play.
Therapy interfering behaviors can slow progress, and they can be frustrating for both clients and therapists. Addressing them is not a one-time conversation — it’s an ongoing, shared commitment to the work of therapy.
Importantly, therapy interfering behaviors don’t mean therapy isn’t working. Often, they show up when therapy is reaching vulnerable, meaningful areas. In our Adult DBT Program, these moments are not reasons to give up. They are opportunities to learn new ways of staying present, communicating needs, and building trust.
Working through TIBs together can become one of the most meaningful parts of treatment. This is one of the many ways DBT helps people create real, lasting change. A good DBT therapist is willing to have hard conversations and to tolerate their own discomfort in service of your growth.
An important part of this process is working with what shows up in the room in real time. When therapy interfering behaviors occur, therapists help clients notice and tolerate the emotions underneath them — often shame, fear of disappointment, or vulnerability. These experiences are frequently the same ones that lead to avoidance outside of therapy, such as withdrawing from expectations or becoming overwhelmed when anticipating others’ reactions. By staying present with these emotions in session, clients learn that difficult feelings including shame — can be experienced, tolerated, and reduced over time. Moments of not meeting expectations become opportunities to build emotional resilience rather than reinforce avoidance.
DBT therapists may also intentionally use metaphors as a DBT strategy to provide feedback while maintaining validation and collaboration. Metaphors help describe what is happening in therapy in a way that reduces defensiveness and strengthens partnership. For example, therapy can be understood as the therapist and client sitting in the same rowboat, working toward the same destination. The therapist may describe therapy interfering behaviors as moments when the boat begins taking on water not to blame the client, but to highlight how certain behaviors affect progress ( like poking holes in the row boat) while emphasizing that both therapist and client are working together to repair the situation and keep moving forward.
If you’d like to learn more, we invite you to reach out to set up a free consultation