What is Dialectical Behavioural Therapy and how can it help you?
Updated: Feb 25
Dialectical Behaviour Therapy (DBT) is a kind of mental health therapy created in the 1970s by psychologist Marsha Linehan. It is a type of talk therapy that provides you with skillsets for coping with emotions so you can respond to them in healthier ways. DBT is often used in group therapy, but it also can be implemented by a therapist in an individual setting.
DBT was initially developed to help people with borderline personality disorder overcome suicidal thoughts and urges, but has now also become a recommended treatment for mental health issues such as bipolar disorder, eating disorders, self-injury, and substance abuse.
The key element of DBT is the concept of dialectics- the existence of opposites- in which case, individuals are taught to both accept their current circumstances and problematic behaviours and also work towards changing their lives through developing new, healthier behaviours and skills.
What are DBT skills?
DBT skills involve four main components: 1) mindfulness, 2) distress tolerance skills, 3) emotional regulation skills, and 4) interpersonal effectiveness skills. All of these elements can help you through emotional experiences in different ways. Read on to learn more about how DBT skills can help you better manage your mental health.
Learning to practice mindfulness will help you live more fully in the present moment and worry less. This is why mindfulness has become such an essential tool for mental health. When you experience overwhelming emotions after something stressful, you may get stuck worrying about the future or ruminating about the past. Mindfulness helps you regain control of your thoughts rather than letting them run away with you.
Cultivating increased awareness through mindfulness will help you notice when you’re wasting mental energy ruminating about something bad that happened yesterday or are worried about something in the future. Through that awareness, you will be able to focus more on positive thoughts about the present.
Improve: Your ability to think clearly, concentrate, and gain control over your thoughts.
Reduce: Racing thoughts and rumination that can trigger episodes of depression and anxiety.
2. Distress Tolerance Skills
The purpose of learning distress tolerance skills is to provide you with a skillset you can rely on when you are in an emotional crisis. Distress tolerance skills are there to help you get through the troubling situation and to be able to handle your emotions in a way that does not lead to destructive behaviour.
Distress tolerance skills will…
Improve: Use of coping skills, a healthy sense of self-esteem, and the ability to tolerate uncomfortable emotions.
Reduce: Self-destructive behaviours, and anger towards yourself.
3. Emotional Regulation Skills
The purpose of DBT emotional regulation skills is to help you develop an understanding of your own emotional reactions. Emotional regulation skills teach you how to control and reduce the impact of your emotional pain. One example of an emotional regulation skill is learning to name and validate the emotions you experience. Doing so will give your emotions less power over you.
Emotional regulation skills will…
Increase: Acceptance of your emotions, mood stability, and control over emotions.
Decrease: Negative judgments for having emotions, feelings of losing control or being overwhelmed,and impulsivity.
4. Interpersonal Effectiveness Skills
Interpersonal effectiveness skills are designed to enhance your ability to communicate effectively with others, which will help you achieve more balance in your relationships. Interpersonal effectiveness skills can improve your assertiveness, help you recognize when relationships have become unhealthy, and prioritize your goals for developing better relationships.
Interpersonal effectiveness skills will…
Improve: Your ability to get your needs met and gain support from your loved ones in healthy, appropriate ways
Reduce: Unhealthy one-sided relationships, volatile or turbulent relationship patterns.
DBT for Mental Health Disorders
Borderline Personality Disorder
If you have borderline personality disorder (BPD), you feel emotions intensely, and may fear abandonment, experience suicidal ideation, and have tumultuous relationships. BPD can feel like an emotional rollercoaster, but DBT therapy will help. DBT has been designed to help you overcome and better cope with the challenges you suffer from having BPD.
Bipolar Disorder (BD), not to be confused with BPD, is a mood disorder characterized by high and low moods. People with BD experience depressive episodes and either hypomanic or manic episodes. Often when going through a manic episode, it’s common to experience tensions with relationships, but having developed interpersonal effectiveness skills can help in those situations. And the mindfulness skills learned in DBT can help with the racing thoughts and intense emotional experiences that can occur with mood episodes.
While Cognitive Behavioural Therapy (CBT) is often the therapy of choice for eating disorders, research has found that DBT is especially helpful for those who suffer from binge eating disorder and bulimia nervosa. This is because binge eating and purging episodes are often triggered by overwhelming emotions. For some people with eating disorders, having strict control over their diet is a means to cope with difficult emotions. However, DBT teaches healthier, more adaptive ways to cope with intense feelings. DBT skills can be a valuable tool for those suffering from any type of eating disorder.
DBT is often the therapy of choice for those who have both borderline personality disorder as well as a co-occurring substance abuse disorder. DBT can help with goal setting and reducing unhelpful behaviours such as numbing intense emotions with substances, and instead, teach individuals how to deal with uncomfortable emotions and bothersome thoughts that underlie the urge to use. Healthy coping skills are taught in replace of substances.
Suicidal Ideation and Non-Suicidal Self-Injury
Research on DBT has also found that this type of therapy reduces suicide attempts and other symptoms of self-harming behaviour. When DBT was originally created by Marsha Linehan, one of the primary goals was to reduce suicidal thoughts and suicide attempts. DBT is also helpful in managing impulsive urges to self-harm. The skills learned in DBT can also serve as a critical toolset to prevent suicide in those who have suicidal thoughts.
Is DBT for me?
If you struggle with destructive behaviour, tumultuous relationships, and overwhelming emotions, DBT can assist you on the road to recovery. DBT can help you develop acceptance of yourself and your experience with mental health difficulties. By applying the skills you learn in DBT, you will experience more stable moods, an improved ability to cope, and a more productive and fulfilling life.
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