Dialectical Behavior Therapy (DBT) is a structured program of psychotherapy with a strong educational component designed to provide skills for managing intense emotions and navigating social relationships. It has been commonly viewed as a treatment for individuals meeting criteria for Borderline Personality Disorder (BPD) with chronic and high-risk suicidality, substance dependence or other disorders. However, over the years, research and data has emerged demonstrating that DBT is also effective for a wide range of other disorders and problems, most of which are associated with difficulties in regulating emotions and associated cognitive and behavioral patterns.
The “dialectic” in dialectical behavior therapy is an acknowledgment that real life is complex, and health is not a stable thing, but an ongoing process that is shaped through a continuous Socratic dialogue with the self and others. It is continually aimed at balancing opposing forces and investigating the truth of powerful negative emotions.
DBT acknowledges the need for change in a context of acceptance of situations and recognizes the constant flux of feelings—many of them contradictory—without having to get caught up in them. Therapists help clients understand and accept that thought is an inherently messy process.
DBT specifically focuses on providing therapeutic skills in four key areas:
Mindfulness enables individuals to accept and be present in the current moment by noting the fleeting nature of emotions, which decreases their intense emotions to direct their positive actions.
DBT also instills Distress Tolerance, the ability to tolerate negative emotions rather than needing to escape from them or act in ways that make difficult situations worse.
Emotion Regulation strategies give individuals the power to manage and change intense emotions that are causing problems in their life.
Lastly, DBT teaches techniques of Interpersonal Effectiveness, allowing a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships; a core principle is that learning how to ask directly for what you want diminishes resentment and hurt feelings.