Dialectical behaviour therapy (DBT), is a specific type of talking therapy. It is based on cognitive behaviour therapy (CBT), but it has been specially tailored and adapted to suit people who feel their emotions very intensely.
DBT originated from the work of renowned psychologist Marsha Linehan, who worked closely with people who were living with borderline personality disorder (BPD), or those suffering from ongoing thoughts of suicide. Today, DBT is still being used as a treatment for BPD as well as a range of other conditions, including:
Substance use disorders
Depression
Self-harm
Eating disorders
What skills does DBT help to develop?
With DBT, you will be taught to use four core skills - sometimes these are referred to as modules - in order to cope with emotional distress in a positive and productive way. Linehan refers to these four skills as the “active ingredients” of DBT.
Mindfulness and distress tolerance skills will enable you to work towards the acceptance of your thoughts and behaviours. Emotion regulation and interpersonal effectiveness skills will help you to work towards changing or adapting your thoughts and behaviours.
Mindfulness
The practice of mindfulness is all about being aware of and accepting what’s happening in the present moment - this can help you learn to notice and accept your thoughts and feelings without the fear of judgement.
Distress Tolerance
Mindfulness can go a long way to helping people, but sometimes it isn’t enough on it’s own - this is especially true in moments of crisis. This is where distress tolerance comes into play. The skills learned with distress tolerance can help to get you through any rough patches you might be experiencing without turning to potentially damaging and destructive coping mechanisms.
In times of crisis, you might have developed some coping strategies to help you work through your emotions. Some of these coping strategies such as; self-isolating or avoidance don’t do much to help in the long run, though you might feel better temporarily. Others, like substance use, self-harm or even angry outbursts might cause you or others physical harm.
Emotion Regulation
Sometimes, you might feel overwhelmed with the sheer weight of your emotions, but as hard as it might sound, it is actually possible to successfully manage them with some help.
Emotion regulation will allow you to learn to deal with your primary emotional reactions before they escalate into a chain of distressing secondary reactions. For example, a primary emotion of anger might then lead to guilt, shame, worthlessness and even depression.
Interpersonal Effectiveness
Having intense emotions and suffering from rapid mood swings and changes can make it difficult to relate to others. Knowing how you feel and what you want is a hugely important part of building fulfilling connections and relationships.
Developing interpersonal effectiveness skills can help you to be clear about these things. These skills combine essentials like listening, social skills and even assertiveness training that will help you to learn how to change situations whilst being able to stick to your core values.
What conditions can DBT be used to treat?
While DBT was initially developed to help to improve symptoms of BPD and persistent thoughts of suicide, today it is also used to help with a range of other conditions, including:
Depression; it has been found that a combination of antidepressants and DBT was more effective in treating depression in older adults, rather than antidepressants alone.
Substance use disorders; DBT is able to help reduce urges in order to shorten relapses.
Eating disorders; DBT can be used to help those with binge eating related disorders.
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