Dialectical Behavioral Therapy (DBT)

Have you ever felt like your emotions sometimes take the wheel, steering you in directions that you don’t want to go? Or felt as though your emotions are bigger or smaller than how others are responding, and you’re not sure why? 

Dialectical Behavioral Therapy (DBT) may be the guide that you’re looking for. DBT is a type of interactive talk therapy designed for folks of all ages that experience emotions intensely and that are dealing with difficulties regulating their emotions (and their behaviors that come from those emotions). 

The “big picture” goal of DBT is to help a person get closer to the life they imagine for themselves, or their life worth living. To do this, DBT combines the work of cognitive behavioral therapy (CBT), mindfulness, and behaviorism. 

In more familiar terms, this means we look at: emotions, thoughts, urges, body sensations, actions, and consequences to actions. Then we work to figure out how all of those pieces work together to understand how to get people closer toward the life they want to be living. 

This means that in DBT, the “work” focuses on helping people understand more about what happens in their brain and body when they are feeling intense emotions, and gaining more insight into what happens as a result of having these big emotions. For some, this might mean they are dealing with behaviors that are getting in the way of what they want to have, do, be, or accomplish in life. 

Skills in Dialectical Behavioral Therapy

Therapy sessions and groups in DBT provide opportunities to learn and practice skills in five core areas:

• Mindfulness: being fully aware and intentional  
• Distress Tolerance: making it through difficult moments or crises without making the situation worse (which we have all done at times)
• Emotion Regulation: having a greater understanding and sense of control over what happens when you are feeling intense emotions
• Interpersonal Effectiveness: assertiveness and being skillful with getting your needs met and strengthening relationships with others 
• Walking the Middle Path (Dialectics): finding a balance between two things that seem to be completely opposite (ex: I can appreciate who I am and how far I have come, and also I can want to change my life)

As people learn, practice, and use these skills outside of therapy, the individual therapy sessions also focus on using tools such as behavior analysis (or looking at patterns) to understand what might be repeating in thoughts, emotions, or behaviors. Through that work, folks can identify behaviors and responses that help support their goals, and those that get in the way of their goals.

Who Could Benefit from DBT?

The short answer is — anyone.

We all have difficult emotions and thoughts, and every human out there has actions or choices that sometimes get in the way. DBT has been proven to really help with a variety of different needs and issues in therapy, particularly for people who experience some of these things:

• Borderline Personality Disorder
• Suicidal ideation, actions, or previous suicidal behaviors
• Thoughts of harming self or others
• Dysregulated eating (binge eating, purging, restriction, etc.)
• Difficulties in relationships with friends and families
• Substance use concerns
• Identity exploration and development
• Depression
• Anxiety
• Post-traumatic Stress or PTSD
• Impulsivity or a hard time stopping behaviors that don’t help goals 

Typically treatment in DBT happens in chunks of 6 months at a time, with ongoing discussion about whether or not another chunk would be beneficial. Comprehensive DBT also includes a weekly DBT skills training group — separate from individual therapy — kind of like a tutor for skills, rather than a process group or talk therapy group.

Want to Know More?

If you’re still wondering if DBT is the right fit for you, one of the best ways to get more information to clarify whether it would be a good fit is to speak directly with a DBT Therapist. An intake session will give you the chance to discuss your goals, what’s going on for you currently, and to help decipher whether pursuing DBT will best support you. If DBT sounds like it could be a good fit for you, let’s connect and explore it more together.