DBT Central

What Is Dialectical Behavior Therapy?

If you’re looking to build skills like mindfulness and emotional regulation in therapy, DBT could be a good option for you.

Dialectical behavior therapy (DBT) is an effective, science-backed therapy that helps people — many of whom experience significant mental health challenges — build a life they find worthwhile.

In DBT, you identify what this kind of life looks like for you and learn the skills to make it happen.

While DBT can help regardless of whether you have a mental health diagnosis, it’s often used to support people who experience:

What’s the theory behind DBT?

Psychologist Marsha Linehan, PhD, developed dialectical behavior therapy in the 1980s for people with suicidal thoughts who also often lived with BPD.

BPD is a mental health condition that involves:

an unstable sense of self
intense emotions
impulsive actions
relationship difficulties
black and white thinking

The first word in DBT, “dialectical,” captures the treatment’s foundation. Dialectic philosophy features these core beliefs:

All things are interconnected.
Change is constant and inevitable.
Opposites can be integrated to get closer to the truth.

In other words, two seemingly opposite things can actually be true at the same time. For example, it’s important to accept where you are and strive to grow. It’s important to recognize that you’re doing your best and keep trying.

At its root, DBT takes a biosocial approach to understanding how people’s symptoms arise and continue.

For example, many people with BPD grew up in an invalidating environment and tend to experience emotions intensely. Living in an environment where you don’t have support or acceptance of your needs can perpetuate or worsen those symptoms.

How does DBT work? Techniques and more

Dialectical behavior therapy is based on cognitive behavior therapy (CBT). CBT has a long track record of success, with hundreds of studiesTrusted Source confirming its effectiveness.

In CBT, you identify important-to-you goals and overcome obstacles that prevent you from achieving these goals. You learn skills to change unhelpful thoughts and behaviors.

The same is true for DBT, which is highly structured and teaches critical skills through these four modules:

Core mindfulness

Core mindfulness skills, adapted from Eastern meditation practices, teach you to become more aware of the present moment. You learn to focus on one thing at a time, without judging yourself or others.

Distress tolerance

When difficult situations arise, instead of getting stuck in thought patterns that don’t help you process the situation (like thinking “this isn’t fair!”), distress tolerance teaches acceptance. Accepting things you don’t have control over can help you solve problems and improve low moods.

To prevent impulsive or self-harming behavior, this module also teaches you constructive, in-the-moment alternatives. These include distraction and self-soothing techniques, like doing a deep breathing exercise, taking a walk, or listening to your favorite music.

Interpersonal effectiveness

In this module, you learn the skills to create healthy relationships while taking care of yourself. Interpersonal effectiveness includes working through conflict, listening well, and clearly asking for what you need.

Emotion regulation

Emotion regulation skills help you label your emotions without judging them. You learn how different emotions shape your behavior and what obstacles prevent you from managing your emotions.

Plus, you learn to avoid situations that typically trigger strong emotions and pursue events that boost positive emotions.

What are some common goals in DBT?

DBT’s ultimate goal is to help you live a life you feel good about. A meaningful, fulfilling life looks different for each person. This is why therapists help people hone in on what’s important to them.

Another critical goal of DBT is to address behaviors that pose a life-threatening risk, such as suicidal thoughts, suicide attempts, and self-harm.

It’s also important to address behaviors that interfere with therapy and prevent you from making progress. Therapy-hampering behaviors can include anything from missing appointments to arriving late or not completing homework.

As a team, you and your therapist will identify behaviors you’d like to decrease along with behaviors you’d like to increase. For example, someone might use DBT to address behaviors related to alcohol use or binge eating disorder.