Dialectical behavior therapy, or (DBT) is a type of cognitive behavioral therapy. Its main goals are to help people learn how to live in the moment, cope healthily with stress, regulate emotions, and improve relationships with others. Originally developed by Dr. Marsha Linehan in the late 1980s, DBT was intended for people with Borderline Personality Disorder (BPD) but has since been adapted for other conditions. Conditions such as self-destructive behavior, eating disorders, substance abuse, and Post Traumatic Stress Disorder (PTSD) have been successfully treated using DBT.
DBT incorporates a philosophical process called dialectics. Dialectics is based on the concept that everything is composed of opposites and that change occurs when there is a “dialogue” between these opposing forces,
Dialectics has three basic components
- All things are interconnected.
- Change is constant and inevitable.
- Opposites can be integrated to form a closer approximation of the truth.
DBT teaches many skills, not all of which are listed here. However, these are some of the main skills DBT focuses on in therapy:
Mindfulness, which is perhaps the most important strategy in DBT, teaches you to focus on the present moment. Mindfulness skills can teach you to pay attention to what’s going on inside of you (thoughts, feelings, sensations, impulses) as well as what’s outside of you (what you see, hear, smell, and touch) in non-judgmental ways. These skills will help slow down your thoughts so you can focus on healthy coping skills while dealing with emotional pain. Mindfulness can help you to stay calm and avoid engaging in automatic negative thought patterns and impulsive behaviors.
Distress tolerance teaches you to accept the current situation and what is happening with you emotionally. More specifically, you learn how to tolerate or survive crises using four techniques: self-soothing, distraction, improving the moment, and thinking of pros and cons of not tolerating distress. By learning distress tolerance techniques, you will be able to better tolerate intense emotions and cope with them in more positive ways.
Interpersonal effectiveness helps you maintain healthy boundaries in a relationship (for example, expressing needs and saying “no” when needed) while keeping that relationship healthy and positive. This happens by learning to really listen and communicate effectively while respecting yourself and others.
Emotion regulation skills help navigate overwhelming feelings. Learning these skills teaches you to identify, name, and change your emotions. By recognizing and coping with intense negative emotions (for example, sadness or anger), you can reduce your emotional vulnerability and have better emotional experiences and responses.