DBT Overview: What is DBT?

Have you ever been caught in an emotional whirlwind that feels like a never-ending spiral? Or like you’ve fallen into a pit of emotions and can’t pull yourself out? Or even that negative thoughts constantly cloud your mind. If you resonate with any of these statements, DBT could help you overcome these thoughts. But what is DBT? And how can it help you in therapy?

Dialectical Behavior Therapy, or DBT, was developed by Dr. Marsha Linehan in 1987. Although Borderline Personality Disorder (BPD) was the original diagnosis DBT sought to treat, it has been proven to be successful in treating eating disorders, substance use disorders, post-traumatic stress disorder (PTSD), suicidal ideation, and self-harming behaviors. DBT is founded on the belief that people struggling with their mental health can learn effective coping strategies.

There are four key interventions that make up DBT: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. These skills are broken into two categories, acceptance skills, and change skills. Mindfulness and distress tolerance teach us how to accept our thoughts as they are, whether positive or negative, and how to navigate the feelings associated with these thoughts. Emotional regulation and interpersonal effectiveness teach us how to identify our needs and change our emotions.

Mindfulness

Mindfulness is the first skill taught in DBT and creates the foundation for the other skills to follow. Marsha Linehan describes mindfulness as “the act of consciously focusing the mind in the present moment without judgment and without attachment to the moment.” Mindfulness is not just a state of calm but rather has to do with the quality of one’s current awareness or presence. In a therapy session, your clinician might walk you through a mindfulness exercise and help you identify thoughts throughout the exercise. The therapist might encourage you to practice the same mindfulness exercise outside of the session and record your thoughts afterward.

Distress Tolerance

Distress is a natural part of life that we cannot avoid. However, at times it can become overwhelming and begin to affect our everyday lives. Regulating one’s levels of distress follows the natural progression of mindfulness. The skills taught in the distress tolerance phase will teach you how to get through a crisis and accept things as they are. At its core, distress tolerance is “the ability to perceive one’s environment without put- ting demands on it to be different; to experience one’s current emotional state without attempting to change it; and to observe one’s own thoughts and action patterns without attempting to stop or control them.”

Emotional Regulation

Being vulnerable and accepting emotions is the core of emotional regulation. By being able to not only name our emotions but also allow ourselves to feel them, we can begin to understand what purpose our emotions are serving us, either positively or negatively. In noticing this change, we can begin to change the way we see our emotions.

Interpersonal Effectiveness

Identifying needs, being able to say “no,” and managing interpersonal conflict are the core strategies and skills that are built when working on Interpersonal Effectiveness. The goal is to be able to get what you need from relationships while being respectful to yourself and others. A common DBT exercise within this module is the DEAR MAN which stands for:
Describe the current situation
Express your feelings
Assert yourself
Reinforce

Stay Mindful
Appear confident
Negotiate

What does this look like in therapy?

DBT can be used in either an individual or a group therapeutic setting. DBT interventions often use worksheets or role-play activities to practice the skills.

Think DBT is right for you? Schedule a session with a Better Life clinician today!

Sources:

DBT Skills List. (n.d.). DBT Self Help. Retrieved March 16, 2023, from https://dbtselfhelp.com/dbt-skills-list/

Dialectical Behavior Therapy | Behavioral Research & Therapy Clinics. (n.d.). Retrieved March 16, 2023, from https://depts.washington.edu/uwbrtc/about-us/dialectical-behavior-therapy/

Floyd, E. (2019, October 28). Accepting Reality Using DBT Skills. Skyland Trail. https://www.skylandtrail.org/accepting-reality-using-dbt-skills/

Linehan, M. (2015). DBT skills training manual (Second edition). The Guilford Press.