Dialectical Behavioral Therapy

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What is DBT?

Dialectical behaviour therapy (DBT) is a type of talking therapy with a strong educational aspect. DBT is primarily adapted for people who feel emotions very intensely. It teaches them skills to recognise, understand, and label their emotions, as well as the ability to manage them properly, in order to improve their relationships with the people surrounding them.

‘Dialectical’ means that two things that seem opposite can both be true. In other words, rather than viewing things in extremes of black and white, DBT focuses on the path in the middle. For instance, accepting how you are behaving now and wanting to change your behaviour would seem contradictory, but a better way to describe it is “I am doing the best I can for now and I will improve in the future”.

The four skills focused on in DBT are:

Mindfulness

Being present in the current moment and paying attention to the fleeting nature of your thoughts. This will enable you to separate your thoughts from your identity and actions.

Distress tolerance

Tolerating negative emotions in the moment instead of escaping them by engaging in unproductive or harmful actions.

Emotional regulation

Identifying, being more aware of your intense emotions and learning strategies to control them.

Interpersonal effectiveness

Communicating with others in an assertive and respectful manner to improve social relationships. 

How DBT works

DBT typically includes personal sessions with a therapist, combined with weekly group sessions led by a therapist who teaches the skills involved in the DBT model and gives ‘homework’ to help strengthen the skills. Most participants usually keep a daily journal to track their progress on practicing the skills as well as their emotions and behaviors.

Uses of DBT 

DBT was originally developed to address symptoms of borderline personality disorder, including self-harm, emotional dysregulation and suicidal thoughts and actions. It is also used to treat:

• Depression
• Trauma
• Eating disorders
• Substance use disorders

However, the skills as taught by DBT are able to help anyone deal with intense emotions and navigate difficult social situations with more efficacy.