Dialectical behavior therapy (DBT) is a specific type of cognitive behavioral therapy developed in the late 1980s by psychologist Marsha M. Linehan to help better treat borderline personality disorder. Since its development, it has also been used for the treatment of other kinds of mental health concerns, such as anger management, anxiety and depression.
The basics of DBT:
Mindfulness: learning to increase one’s awareness of what is happening in one’s mind and in one’s present moment (as opposed to being caught up in the thinking mind, ruminating). Emphasis is made on maintaining an open, curious, non-judgmental observation of one’s experience, as opposed to a critical (or self-critical) experience of the present moment.
Distress Tolerance: these skills help with accepting, finding meaning for, and tolerating distress. Dialectical behavior therapy emphasizes learning to bear pain skillfully.
Distress tolerance skills constitute a natural development from mindfulness skills. They have to do with the ability to accept, in a non-evaluative and nonjudgmental fashion, both oneself and the current situation. Although the stance advocated here is a nonjudgmental one, this does not mean that it is one of approval: acceptance of reality is not approval of reality.
Distress tolerance behaviors are concerned with tolerating and surviving crises and with accepting life as it is in the moment. Four sets of crisis survival strategies are taught: distracting, self-soothing, improving the moment, and thinking of pros and cons. Acceptance skills include radical acceptance, turning the mind toward acceptance, and willingness versus willfulness.
The interpersonal response patterns –how you interact with the people around you and in your personal relationships — that are taught in DBT skills training share similarities to those taught in some assertiveness and interpersonal problem-solving classes. These skills include effective strategies for asking for what one needs, how to assertively say ‘no,’ and learning to cope with inevitable interpersonal conflict.
IE skills focus on situations where the objective is to change something (e.g., requesting someone to do something) or to resist changes someone else is trying to make (e.g., saying no). The skills taught are intended to maximize the chances that a person’s goals in a specific situation will be met, while at the same time not damaging either the relationship or the person’s self-respect.
People struggling with intense emotions are frequently angry, intensely frustrated, depressed and anxious. Those grappling with these concerns might benefit from help in learning to regulate their emotions.
Dialectical behavior therapy skills for emotion regulation include:
- Learning to properly identify and label emotions
- Identifying obstacles to changing emotions
- Reducing vulnerability to “emotion mind”
- Increasing positive emotional events
- Increasing mindfulness to current emotions
- Taking opposite action
- Applying distress tolerance techniques
I completed the first level of DBT training in 2012 and have incorporated DBT elements into my work with clients since that time. If you are looking for a fully-certified DBT therapist, there are others in our area that can help you.