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Selena Gomez Seeking Dialectical Behavior Therapy After Hospitalizations: What to Know

After suffering an emotional breakdown while in the hospital, Selena Gomez is seeking an unusual talk therapy treatment used to help patients cope with negative thoughts and behaviors, a source has confirmed to PEOPLE.

The 26-year-old singer is undergoing dialectical behavior therapy (DBT), a therapy method designed to help identify, and then change, negative thinking and behavioral patterns, the source says.

The singer was hospitalized twice within the last few weeks, both times for a low white blood cell count, which can be a side effect for kidney transplant patients. (Gomez had a kidney transplant last year after being diagnosed with the autoimmune disease lupus.)

During her second recent hospital visit, Gomez suffered a panic attack. “She has had a tough few weeks and the panic attack in the hospital was the tipping point,” a source tells PEOPLE.

TMZ also reports that Gomez is undergoing DBT treatment — something that she has been open about receiving in the past.

“DBT has completely changed my life,” she told Vogue in 2017. “I wish more people would talk about therapy. We girls, we’re taught to be almost too resilient, to be strong and sexy and cool and laid-back, the girl who’s down. We also need to feel allowed to fall apart.”

According to Psychology Today, dialectical behavior therapy teaches how to manage painful emotions and improve relationships by providing clients with therapeutic skills in four key areas: mindfulness, or the ability to accept and be present in the moment; distress tolerance, or the ability to tolerate a negative emotion instead of trying to escape from it; emotional regulation, or the ability to manage and change intense and problematic emotions; and interpersonal effectiveness, or the ability to “communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships.”

“DBT is a very concrete, very practical treatment, and it’s focused on helping the client to increase their coping capacity,” says Melissa Gerson, the founder and director of Columbus Park Collaborate, an outpatient treatment center in New York City with a comprehensive DBT program.

Gerson tells PEOPLE, “It’s not necessarily about doing a lot of talking about the emotional origins of your struggles or difficulties, but instead it’s more about focusing in on and increasing awareness of what’s troubling you and awareness of what you’re feeling, and then giving you a host of concrete and practical skills that you can use in that moment.”

Among those skills are self-soothing and emergency crisis skills “that help you when your feelings are really at a 10,” Gerson says.

According to the Mayo Clinic, dialectical behavior therapy was developed in the 1980s by Marsha Linehan, Ph.D., specifically to treat people with borderline personality disorder. But Psychology Today notes that it has also been used successfully to treat people experiencing depression, bulimia, binge-eating, bipolar disorder, post-traumatic stress disorder and substance abuse issues.

Dialectical behavior therapy evolved from Linehan’s efforts to improve on past treatments for suicidal women that “were so focused on changing cognitions and behaviors that many patients felt criticized, misunderstood, and invalidated and consequently dropped out of treatment altogether,” according to a National Center for Biotechnology Information article by Alexander L. Chapman, Ph.D.

DBT treatment focuses on acceptance and change as its ultimate goals. It’s about “being more aware in a nonjudgmental way of what you’re feeling in the moment,” Gerson says.

The treatment involves learning the skills from a therapist in a group setting, and then meeting individually with the therapist in between sessions. Patients also typically track their feelings and behaviors on a diary card.

“It takes about six months to get through a full cycle of DBT, to learn all of the skills,” Gerson explains. “Typically it’s recommended that after six months, you then repeat the cycle so you can reinforce the skills. So in general it should be a one-year treatment.”

Gerson notes that although DBT is a time-limited therapy that can be applied to your life in the moment, the “big-picture” skills patients learn hopefully last a lifetime.

“There are a lot of skills that involve taking care of yourself, self-soothing, bringing yourself back to baseline when you’re feeling like your emotions may be getting out of control,” she says. “These skills help you bring your behaviors under control when you’re feeling emotionally very activated or very distressed.”

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