What is Dialectical Behavioral Therapy (DBT) & How Can It Help?

Do you…

Feel overwhelmed by intense emotions?

Have behaviors that you want to change?

Do you use food and/or alcohol to cope?

Do you have impulsive or reactive behaviors?

Do you find it difficult to maintain relationships?

Would you like to create a life worth living?

If you answered “yes” to any of these questions, or if you have other concerns about your emotional well-being, then DBT may be helpful to you. 


What Is Dialectical Behavioral Therapy (DBT)?

Dialectical Behavior Therapy aims to find balance and get unstuck from extremes using behavioral-based talk therapy. The D in DBT stands for Dialectics, which means synthesizing or integrating opposite ideas, thoughts, or behaviors. A key goal of DBT is to cultivate acceptance and balance in the world around us by finding the truth in opposing forces. By cultivating balance and acceptance, we decrease suffering and increase acceptance for ourselves and others. DBT is focused on not only creating a life worth living but also a life worth loving.

Through Dialectical Behavior Therapy, we learn to accept thoughts and feelings without judgment while letting go of our past and future so we can live in the present. By focusing on the present, we are able to control and regulate our emotions, resulting in better balance and healthier relationships.

Marsha Linehan created DBT to treat clients who had not responded to other types of therapy. Evidence supports the use of DBT with a wide range of disorders, including borderline personality disorder, anxiety, bulimia, PTSD, substance abuse, bipolar disorder, and many other mental disorders.


What Is Wise Mind?

It is impossible to understand DBT without addressing the three states of mind. The three states of mind are (according to DBT): Reasonable Mind, Emotional Mind, and Wise Mind.

Reasonable mind refers to our rational and intellectual mind; it is the mind that focuses on facts and logic to solve problems. Reasonable mind is beneficial in many ways. Having a reasonable mind helps us solve complex problems, but when we focus exclusively on them, we ignore the importance of our values and emotions.

The opposite of a reasonable mind is an emotional mind. In this mind, you are only motivated by emotions, disregarding logic and reason completely. In the absence of an emotional mind, we would not be able to understand our emotions or how they affect our behaviors and thoughts. Additionally, we would be unable to feel positive emotions such as happiness and love. On the other hand, by focusing only on the emotional mind, we ignore facts and logic, affecting our ability to make effective and adaptive decisions.

A Wise Mind combines both of these minds and values both emotion and reason equally. Our wise mind allows us to make decisions based on reason and values at the same time. In addition, a wise mind allows us to experience emotions (even strong ones) as they arise and pass.


The Four Modules of DBT

DBT has four main modules of skills: Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. Let’s discuss each skill:

Mindfulness – Learning to be present-focused and nonjudgmental of ourselves and others.

In order to practice mindfulness, you must learn how and what it is, be mindful of your current emotions and thoughts, and cultivate love and kindness towards yourself and others.

One way to practice mindfulness in our daily lives is to walk mindfully (observing your surroundings and being present in the moment) or do a task mindfully (one-mindfulness – not multitasking but focusing on one task at a time).

Distress Tolerance – Learning how to tolerate stress and negative emotions when they arise so that they do not become paralyzing It is through Distress Tolerance (DT) skills that we can put space between the event/emotion and ourselves, allowing us to decompress and return to the situation with a wise mind rather than one ruled by emotions. One such skill is STOP (Stop, Take a step back, Observe, and Proceed Mindfully). Before reacting, we need to STOP. Then, we need to physically or mentally distance ourselves from the situation or emotion. After that, we need to pay attention to or observe what is going on both inside and outside of us. By observing, we can tap into our wise mind. Our next step is to use that information to Proceed Mindfully. In this step, we aim to ask ourselves, “How do we want this situation to be resolved? Or “What would be effective in this situation?”

Emotional Regulation – Learning how to better understand and handle our emotions so that we have more control over our thoughts, feelings, and behaviors. Our ability to check the facts is an important emotional regulation skill that can assist us in seeing that our feelings and thoughts are not reality. In turn, this skill allows us to change our emotional response to situations by allowing us to focus on the facts rather than our interpretations.

Interpersonal Effectiveness – Learning how to better navigate relationships.

A person’s interpersonal effectiveness includes communication skills, the ability to build relationships, the ability to set boundaries, the ability to advocate for one’s own needs and wants, and the ability to end toxic relationships.

Among the interpersonal effectiveness skills are GIVE and FAST. When we communicate and interact with others, GIVE (G=Gentle; I=Interest; V=Validate; E=Easy manner) reminds us to validate and respect them, while FAST (F=Fair; A= no Apologies; S=Stick to values; T=Truthful) teaches us to validate and respect ourselves without lying or manipulating them. 


How Is DBT Different From CBT?

Both Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) focus on behavior, but they are also quite different. 

Cognitive Behavioral Therapy focuses on restructuring thoughts to change self-destructive behaviors and is based on the belief that our thoughts and behaviors influence our feelings. In Cognitive Behavioral Therapy, logic and reason are used to direct responses and change emotions.

In contrast, Dialectical Behavior Therapy is more about finding balance through navigating dialectics, getting unstuck from extremes, validating our emotions, and addressing and changing behaviors.


DBT Is a Diverse and Flexible Therapy

DBT is applicable to many issues, concerns, and distress we experience in life. We all navigate dialectical dilemmas more often than we think and run into situations where we are stuck or are having difficulty gaining perspective. Through DBT, we learn concrete, measurable, and validating skills and knowledge that help us overcome our barriers and cope better with life’s challenges. You might enjoy DBT if you prefer a therapist who gently challenges you while remaining aware of your concerns, distress, and experiences. We want to set you up for success, not failure. Small steps lead to big steps, which lead to leaps! No matter what type of counseling or therapy you’re looking for, we can help. Contact us today for a free consultation to learn more.


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