Dialectical Behavior Therapy

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Dialectical behavior therapy (DBT) provides clients with new skills to manage painful emotions and decrease conflict in relationships. DBT specifically focuses on providing therapeutic skills in four key areas. First, mindfulness focuses on improving an individual's ability to accept and be present in the current moment. Second, distress tolerance is geared toward increasing a person’s tolerance of negative emotion, rather than trying to escape from it. Third, emotion regulation covers strategies to manage and change intense emotions that are causing problems in a person’s life. Fourth, interpersonal effectiveness consists of techniques that allow a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships.

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DBT is especially effective for people with the following problems:

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• Painful emotions that are experienced as intolerable

• Quickly shifting between different emotions and moods

• Feeling controlled by your emotions

• Intense self-hatred and shame

• Prone to irritability and anger

 

DBT also addresses other difficulties:

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• Relationships difficulties

• Intense fears of abandonment and sensitivity to criticism

• A profound sense of emptiness or emotional numbness

• Self-defeating behaviors that are impulsive or destructive

 

What Are the Main Strategies that Make DBT Effective?

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DBT utilizes scientifically-established strategies for improving emotion regulation, and the approach is called “dialectical” because it seeks to balance therapy strategies that appear opposite. Specifically, it includes many strategies aimed to change the individual's behaviors, thoughts, emotions, relationships, and life problems, while at the same time the therapist validates that the person and their struggles make complete sense, helping the person to fully accept themself and their emotions. The change strategies are cognitive-behavioral therapy (CBT) strategies, including problem-solving, skills training, developing more effective thinking, behavioral activation, and exposure therapy. The primary acceptance skill is mindfulness, which involves learning to focus your attention, and learning to see things for what they are, including your thoughts, emotions, and other people, without getting caught up in assumptions, interpretations, or judgments. Mindfulness is used as a way to decrease suffering by developing the ability to better tolerate emotional pain and accept yourself, your past, and your current life.