Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT): Walking the Middle Path

What is DBT?

Balance and resilience

Dialectical Behavior Therapy (DBT) is a highly effective, evidence-based treatment that helps individuals manage intense emotions, improve relationships, and develop healthy coping strategies. Originally developed by Dr. Marsha Linehan for individuals with borderline personality disorder (BPD), DBT has since been widely used to treat various mental health challenges, including anxiety, depression, PTSD, self-harm, and emotional dysregulation.


DBT integrates cognitive-behavioral therapy (CBT) techniques with mindfulness strategies, creating a balanced approach to managing emotions and improving overall well-being. By combining acceptance and change, individuals learn to regulate emotions, tolerate distress, and build healthier interpersonal relationships.

The Four Core Skills of DBT

Mindfulness

Staying present in the moment.

Distress Tolerance

Calm crisis management.

Emotion Regulation

Emotional intelligence mastery.

Interpersonal Effectiveness

Building stronger relationships.

The Four Core Skills of DBT

Mindfulness: Staying Present in the Moment.

Mindfulness is a foundational component of DBT that helps individuals become more aware of their thoughts, feelings, and surroundings without judgment. This practice enhances self-awareness, emotional control, and focus, reducing impulsivity and stress.

Mindfulness techniques in DBT include:

  • Observing and describing emotions without reacting impulsively
  • Practicing deep breathing and grounding exercises
  • Engaging in present-moment awareness to reduce anxiety and distress

Distress Tolerance: Managing Crisis Without Reacting Impulsively

Distress tolerance teaches individuals how to handle painful emotions and stressful situations without resorting to self-destructive behaviors. Instead of avoiding discomfort, individuals learn to accept and navigate distress in healthier ways.

Distress tolerance techniques include:

  • The STOP Skill (Stop, Take a step back, Observe, Proceed mindfully)
  • Self-soothing strategies using the five senses
  • Distraction techniques to prevent emotional overwhelm

Emotion Regulation:  Understanding and Managing Emotions

Emotional regulation skills help individuals identify, understand, and control their emotions rather than being controlled by them. This skill set is particularly helpful for those experiencing intense emotional fluctuations.

Key emotional regulation techniques:

  • Identifying and labeling emotions accurately
  • Reducing emotional vulnerability through self-care and healthy habits
  • Increasing positive emotional experiences to build resilience
Interpersonal Effectiveness: Building Stronger Relationships

Many individuals in DBT struggle with maintaining healthy relationships due to difficulty expressing needs or setting boundaries. This module focuses on improving communication, building self-respect, and fostering meaningful connections.


Interpersonal effectiveness skills include:

 
  • Assertiveness training for effective communication
  • Learning to say “no” and set boundaries
  • Balancing priorities and demands in relationships

Why is DBT therapy helpful?

DBT therapy has transformed the lives of many by offering practical and effective tools to manage emotions, improve relationships, and enhance overall mental well-being. If you’re struggling with emotional regulation or unhealthy coping mechanisms, DBT can be a helpful therapeutic approach for you.


DBT helps a person understand what they are feeling inside and teaches skills to listen to one’s emotions, understand what those emotions are telling them, and proceed handling situations and relationships in a mindful, calm state. One goal of DBT is to say in the present moment. When we focus on the future we create anxiety, and when we dwell on the past we can become sad and depressed. DBT provides tools to stay present, to minimize these risks. In the end it is a structured, goal-oriented approach that helps reduce self-destructive behaviors and improve relationships.

"The real enemies of our life are the 'oughts' and the 'ifs.' They pull us backward into the unalterable past and forward into the unpredictable future. But real life takes place in the here and now."
Henri Nouwen
Here and Now