What is Dialectical Behavior Therapy?

What is Dialectical Behavior Therapy | Dragonfly Psychological Services

What is DBT? | Dragonfly Psychological Services

Dialectical Behavioral Therapy (DBT) offers new avenues to manage painful emotions and trauma. DBT was originally developed to assist in treating borderline personality disorder, an illness categorized as having a pattern of varying moods, self-image and behavior. Since clinicians and therapists began using DBT, more research has been done that shows DBT also has potential in helping clients who suffer other mental issues, such as:

  • depression
  • bulimia
  • binge-eating
  • bipolar disorder
  • post-traumatic-stress disorder
  • substance abuse

Components of DBT

One powerful component of Dialectical Behavioral Therapy is its cognitive approach. There are certain thoughts, beliefs, and assumptions that increase the difficulty of life’s challenges such as:

  1. “Everything has to go smoothly for me to enjoy myself “
  2. “When I express feelings of vulnerability, I’ll be completely rejected by my significant other”
  3. “If I am forced to do something uncomfortable, I won’t be able to complete the task.”
  4. “I can’t feel any anger without it getting the best of me”
  5. “If the people I love hurt me, that means they don’t really love me”

With a cognitive approach the framework of these thoughts can be rewritten in a more thoughtful and open-minded way.

  1. “There can be hiccups or major setbacks and I can still enjoy myself.”
  2. “When I express my vulnerability, I can gain the respect of my significant other by being open.”
  3. “I can finish any uncomfortable task with the right attitude toward completion.”
  4. “ I can use my elevated anger as an opportunity to strengthen my self-control skills”
  5. “The people I love are not perfect people, they can love me and still hurt me unintentionally at times.”

Another pillar of DBT is its emphasis on therapist support. Therapist coach their clients on ways they can realize and advance their strengths. This builds on their overall self-confidence as well as their ability to feel like they can overcome emotional obstacles.

And finally, DBT group participants learn by collaborative effort. Many individuals find the idea of being in a group frightening at first, and hesitate to engage with others in their learning.  After being in the presence of others who experience similar fears and pain and struggles, participants in DBT groups almost universally report being deeply glad they joined. Before long, DBT groups become a deep source of comfort where it is safe to be vulnerable.

DBT helps clients gain new strengths in confronting and managing their emotions and circumstances through four focus areas.

The Four Main Focuses of DBT Therapy

DBT uses a cognitive-behavioral approach that incorporates emotion and psychosocial support. The theory behind this approach is that some people are more prone to certain emotional challenges and hyperactive emotional responses. In this case, DBT aims to provide methods for clients to cope with these sudden surges of emotion. DBT also offers skills to repair relationships and set healthy boundaries, resulting in smoother interpersonal relationships.

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Mindfulness: improves the ability to accept and be consciously present in the moment.

Distress Tolerance:  helps clients increase their ability to withstand negative emotions as opposed to escaping them.

Emotion Regulation: strategies to manage and change intense emotions that cause problems

Interpersonal Effectiveness:  techniques to communicate with others assertively while maintaining respect and strengthening relationships.

What to expect with DBT

Unlike other forms of therapy, DBT is especially powerful because individuals enjoy personal and private sessions with their therapist, as well as additional opportunities to analyze and practice their new skills in DBT skills groups. Therapists still provide personalized attention to address specific needs, help their clients create and set new goals, help to apply these skills in everyday life, and address obstacles before they occur.

In addition to the individualized treatment, clients also enjoy the challenge and camaraderie of the DBT skills group. Often held once a week, DBT skills groups last between one to two hours, and meet for a total of six months. Groups are led by therapists who are thoroughly trained in DBT skills and there are often assignments for clients to work on over the week. In some scenarios, in place of a group, DBT skills can be assigned to individuals or couples to work on, on their own time or terms with their therapist.

How does Dialectical Behavioral Therapy Work?

If you want to understand how DBT therapy works, consider the original illness Borderline Personality Disorder. Those who suffer from BPD are often experiencing intense emotions that create impulsive behavior and decisions. These actions often have very stressful consequences within the clients’ closest relationships.

Part of the reason for these intense emotions is extreme, rigid, black-and-white, all-or-nothing perspectives that a person may hold.

With this in mind, therapists aim to help their clients see how it is possible to hold two seemingly opposite perspectives at once. This initial step allows the client to then recognize that there is a balance, a grey area in life, instead of an all-or-nothing, black-and-white outlook. When this balance is recognized by the client, the therapist can then go on to suggest new perspectives where BOTH realities are possible, as opposed to an either-or mentality. The point of this therapy is to evolve the thinking process from simple and rigid view-points to more sophisticated and open-minded ones. This allows the brain to accept forward-progress in the areas in which clients struggle.

Quick Fact: The therapy gets its name from the philosophical perspective on dialectics. Dialectics: is a term for a method of argument that involves some form of contradictory process between opposing sides, which is then synthesized into a solution that incorporates both.

Is Dialectical Behavioral Therapy a Match for You?

If you are someone who is open to trying new approaches to changing your emotional health, there is a great possibility that DBT could make an improvement in your life. Your next step is to seek a therapist who is knowledgeable about the practice of Dialectical Behavioral Therapy. With more therapists incorporating telehealth sessions into their practice, now is the perfect time to reach out to a therapist who will do more than just listen. You can find a therapist who will take the time to teach you coping skills and work collaboratively to help you build your strengths.  It’s time to make a change for the better and DBT could be a great launching point to do that.


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