What Is Dialectical Behavior Therapy (DBT)?

4 days ago

8 min read

DBT, or Dialectical Behavior Therapy, is not something that is commonly known. If you are looking to improve your emotional health, DBT is a type of therapy that you could find very beneficial. In this blog, we will discuss what dialectical behavior therapy is, who it can help, and what the process looks like when you work with a therapist. We will also cover the key skills DBT teaches so you can decide if this approach might be a good fit for you.

At Florecer Family Counseling, we are here to serve you. Our team is dedicated to helping children, teens, adults, and families with all kinds of mental health and therapy needs. If your feelings seem too big to handle, or your relationships feel stuck in the same hard patterns, then we will be here to walk with you. Whatever you are facing, you don't have to face it alone. Give us a call or schedule a 20-minute consultation today.

What Is DBT?

Dialectical behavior therapy, or DBT, is a type of psychotherapy. It helps people manage strong emotions, cope with stress, and get along better with others. It was created in the late 1980s by a psychologist named Dr. Marsha Linehan. Dr. Linehan first built DBT to help people who were in deep emotional pain. Many of them struggled with self-harm or thoughts of suicide. Over time, therapists saw that DBT could help with many other struggles, too. Today, DBT therapy is used around the world. It's one of the most well-studied therapies for people who feel their emotions very intensely.

What Does "Dialectical" Mean?

"Dialectical" is a big word, but the idea behind it is simple. It means that two things that seem opposite can both be true at the same time.

In DBT, the main balance is between two ideas:

Acceptance. "I am doing the best I can right now."
Change. "I also need to learn new ways to cope."

At first, these might seem to clash. How can you accept yourself and still try to change? But that's the heart of DBT. You don't have to hate yourself in order to grow; you can be kind to yourself and work toward something better.

Here are a few other examples of dialectical thinking:

"I feel angry, and I love this person."
"This is really hard, and I can get through it."
"I made a mistake, and I am still a good person."

Notice the word "and." DBT helps you swap "but" for "and." That small change can make a big difference in how you see yourself and others.

What Is DBT Used For?

DBT was first used for borderline personality disorder (BPD). Now it's used for a wide range of mental health needs. A DBT therapist may use this approach to help with:

Intense or fast-changing emotions
Self-harm or thoughts of suicide
Depression
Anxiety
Eating disorders
Substance use
Post-traumatic stress disorder (PTSD)
Anger, anxiety, guilt, fear, or shame that feel hard to control
Unstable or stormy relationships
Impulsive behaviors

DBT can help teens as well as adults. There is even a version made just for teens and their families. It often includes parents in some of the skills training.

DBT for Emotional Regulation

One of the most common reasons people try DBT is to get a handle on their emotions. Emotional regulation simply means being able to notice, understand, and manage your feelings.

Some people feel emotions more strongly than others. Their feelings may rise fast and take a long time to calm down. DBT for emotional regulation teaches you how to ride out those waves without being swept away. You learn to name your feelings, spot what sets them off, and respond in ways that help instead of hurt.

DBT for Anxiety

DBT for anxiety can also be very helpful. Anxiety often pulls your mind into the future, worrying about what might go wrong. DBT skills like mindfulness bring you back to the present moment. Other skills help you calm your body or your mind when worry takes over, so you can think more clearly.

The Four Main DBT Skills

DBT skills are grouped into four main areas, often called modules. Each one targets a different part of life.

1. Mindfulness

Mindfulness is the base of all DBT skills. It means paying attention to the present moment, on purpose, without judging it.

With mindfulness, you learn to:

Notice your thoughts and feelings without getting lost in them
Slow down before you react
Find your "wise mind," the balance between your emotions and your logic

2. Distress Tolerance

Sometimes life hurts, and you can't fix it right away. Distress tolerance skills help you get through a crisis without making things worse.

These skills can include:

Distracting yourself in healthy ways
Soothing yourself through your five senses
Practicing "radical acceptance," which means accepting what you cannot change

3. Emotion Regulation

These skills help you understand and manage your feelings over time. You learn to:

Name what you're feeling
Understand why emotions show up
Lower your risk of emotional overload by caring for your body, such as getting sleep, eating well, and moving
Build more positive moments into your life
Act in ways that don't feed a painful emotion

4. Interpersonal Effectiveness

This module is all about relationships. It helps you ask for what you need, say no, and handle conflict while keeping your self-respect.

You might learn how to:

Make clear, calm requests
Set healthy boundaries
Keep relationships strong during hard talks
Stand up for yourself without harming the relationship

DBT uses easy-to-remember phrases to help you recall these skills in the moment. For example, "DEAR MAN" is a guide for asking for what you want. Each letter stands for a step, like "Describe" the situation and "Express" your feelings. Your therapist will walk you through these tools one at a time.

DBT vs CBT: What's the Difference?

You may have heard of cognitive behavioral therapy, or CBT. It's one of the most common types of therapy. So how do DBT vs CBT compare?

DBT actually grew out of CBT. Dr. Linehan started with CBT, then found that some people needed something more. Many of her clients felt judged when therapy focused only on changing their thoughts and actions. She added acceptance and mindfulness to create a better balance.

Here's a simple way to think about it:

CBT often focuses on:

Spotting unhelpful thoughts
Challenging and changing those thoughts
Changing behaviors that keep problems going

DBT often focuses on:

Balancing acceptance and change
Managing very intense emotions
Building practical skills for crisis moments
Improving relationships
A more structured program that may include group skills training

Neither one is "better." They're just different tools for different needs. A therapist can help you figure out which approach, or which mix of the two, fits you best.

What Is the DBT Process Like?

Starting any new therapy can feel a little scary. What will you actually do? Will it be hard? Let's walk through what the DBT process often looks like.

Traditional DBT usually has a few main parts. Not every program uses all of them, but here's what you might see:

One-on-one therapy. You meet with your DBT therapist, often once a week. Together, you work on your goals and talk about what's going on in your life.
Skills training. This can be done individually or in a group. You learn and practice the four DBT skill areas with your therapist and/or with others who are working on similar goals.
Phone coaching. In some programs, you can reach out to your therapist between sessions for quick help using a skill in a hard moment.

Tools You Might Use Along the Way

Diary cards. These are simple daily logs. You track your feelings, urges, and which skills you used. They help you and your therapist see patterns.
Chain analysis. When something hard happens, you and your therapist trace the steps that led up to it. This helps you find where you could try a different choice next time.
Life Vision. This activity helps you focus on identifying how you are already working on some areas of your life and the goals you want to reach in the future.
Homework. You'll practice skills between sessions. Real life is where the change happens!

How Long Does DBT Take?

A full DBT program often lasts six months to a year. Others use a shorter, more flexible form of DBT, depending on their needs. Everyone moves at their own pace. There's no race to the finish line.

Common Myths About DBT

It's easy to feel unsure about a therapy you've never tried. Let's clear up a few common myths.

"DBT is only for people with Borderline Personality Disorder (BPD)." Not true. DBT started there, but it now helps with many struggles, from anxiety to anger to relationship problems.
"I'll have to share everything in a group." Skills groups are more like a class. The focus is on learning skills, not sharing your deepest secrets. This is something you do with your individual therapist.
"DBT means I'm too emotional." Feeling deeply is not a flaw. DBT simply gives you tools to work with your emotions instead of against them.
"It's too much work." DBT does take practice. But the skills are simple, and you learn them one step at a time.

Is DBT Right for You?

How do you know if DBT might help? Ask yourself:

Do my emotions often feel too big to control?
Do I act on impulse and regret it later?
Do my relationships feel stormy or unstable?
Do I struggle to calm down once I get upset?
Have other types of therapy not helped as much as I hoped?

If you said yes to any of these, DBT may be worth exploring. The best next step is to talk with a therapist. They can learn more about you and help you decide on a plan.

If you are ever in crisis or having thoughts of hurting yourself, please reach out for help right away. You can call or text 988 to reach the 988 Suicide and Crisis Lifeline at any time.

Find Balance With Florecer Family Counseling

When you are struggling to control your emotions, it can often be difficult to navigate everyday life. DBT is a treatment that is designed to help you develop your emotional control and help you with other mental health struggles such as anxiety, PTSD, or depression. At Florecer Family Counseling, our therapists will take time to understand your needs and help you through whatever mental health challenges you might be experiencing. We are here to serve you and to assist with all your mental health and therapy needs. Give us a call or schedule a 20-minute consultation today to learn more about how we can help you.

Frequently Asked Questions

How is DBT different from regular talk therapy? In regular talk therapy, you mostly talk through what's going on in your life. DBT does that too, but it also teaches you clear skills to handle strong feelings, stress, and hard relationships.

Do I need a diagnosis like BPD to start DBT? No. DBT can help anyone who struggles with big emotions, stress, anxiety, or relationship problems, with or without a diagnosis.

What happens during a typical DBT individual therapy session? You and your therapist look at your week, often using a diary card, and talk about any hard moments. Then you work together on the skills that can help you handle those moments better next time.

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