Table of ContentsView AllTable of ContentsWhat Is DBT?Defining DialecticalHow Does It Work?Core SkillsWhen Is DBT Used?How Does DBT Help?
Table of ContentsView All
View All
Table of Contents
What Is DBT?
Defining Dialectical
How Does It Work?
Core Skills
When Is DBT Used?
How Does DBT Help?
Learn more about dialectical behavior therapy, how it works, when it’s used, and its core skills.
What Is Dialectical Behavior Therapy?
Realizing some patients needed a different kind of emotional support and skills training, Linehan created dialectical behavioral therapy.
Help Is AvailableIf you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call911.
Help Is Available
If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call911.
What Does Dialectical Mean?
In DBT, dialectical means two opposing ideas being true at the same time. Patients who haveall-or-nothing or black-and-whiteattitudes are sometimes unable to think in other ways.
DBT emphasizes the dialectic of acceptance and change.
DBT requires a fundamental shift in thinking. DBT therapists work to teach patients necessary skills, such as mindfulness and distress tolerance, to balance their emotions and change their thinking.
Here are some examples of DBT thinking:
Core Skills of DBT
There are four main core skills with DBT. These include distress tolerance, mindfulness, emotion regulation, and interpersonal effectiveness.
Distress Tolerance Skills
Often, when people are overwhelmed with emotions, they may deal with the distressing feelings in ways that help them feel better in the moment. This can include substance abuse to numb the feelings or some type of immediate self-destructive action.
But in the long-term, these methods may cause even deeper emotional pain. Distress tolerance is about learning to manage those overwhelming feelings in healthier ways.
DBT skills to improve distress tolerance include:
Mindfulness Skills
The practice of mindfulness is to be aware and focused on the present moment instead of the past.
Some DBT skills to practice mindfulness include:
Emotion Regulation Skills
Some people experience emotional extremes they cannot regulate, often when there is a history oftraumaor when they feel threatened or abandoned. This is known asemotionaldysregulation.
When they become triggered or emotionally overwhelmed, they may become highly reactive and self-destructive. Usingmagnetic resonance imaging(MRI), brain researchers have found that people with emotional dysregulation may have issues with theneurocircuitrythat regulates emotion in the brain.
Some DBT emotion regulation skills include:
Managing Extreme EmotionEmotions are chemical and physical signals in the body that communicate how you feel and what is happening. Extreme reactive emotions are quite effective when a person is facing imminent threat or danger, but not as helpful in relationships or at work. DBT was developed in large part to help people experiencing extreme emotions gain the necessary skills to manage them and improve their lives.
Managing Extreme Emotion
Emotions are chemical and physical signals in the body that communicate how you feel and what is happening. Extreme reactive emotions are quite effective when a person is facing imminent threat or danger, but not as helpful in relationships or at work. DBT was developed in large part to help people experiencing extreme emotions gain the necessary skills to manage them and improve their lives.
Interpersonal Effectiveness Skills
Interpersonal effectiveness is about improving relationship skills. Managing emotions and emotional reactivity in relationships requires setting limits and managing conflict, while also respecting others.
Some DBT interpersonal effectiveness skills include:
How Do Dialectical Behavioral Therapy Sessions Work?
The traditional format for DBT is intensive and requires that the patient do work between sessions. The four major components of DBT sessions include:
DBT was originally created for borderline personality disorder (BPD) and those with suicidal behavior and non-suicidal self-injury who may be experiencing extreme emotions. But it has also been found to be an effective treatment for other mental health issues, including:
In one study of DBT, as the participants developed more effective skills to manage their emotions, their substance use decreased too. Researchers believe this happened because their emotional coping skills increased and they had less of a need to use substances to numb their emotions.
In another study, after the first year of DBT treatment, 77% of the patients no longer met the criteria for a borderline personality diagnosis.
Summary
Dialectical behavior therapy is a type of therapy that was developed from cognitive behavioral therapy. It involves distress tolerance, mindfulness, emotional regulation, and interpersonal effectiveness skills. Although designed for people with suicidal behaviors, self-harm behaviors, and borderline personality disorder, it is an effective treatment for many other mental health disorders.
A Word From Verywell
If you are suffering from suicidal ideation, self-harm behaviors, or another mental health condition, you are not alone.Resources are availableto help. If you are interested in exploring or think you could benefit from dialectical behavior therapy, talk with a healthcare provider or mental health professional about getting a referral to a DBT therapist in your area.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cavicchioli M, Barone L, Fiore D, et al.Emotion regulation, physical diseases, and borderline personality disorders: conceptual and clinical considerations.Front Psychol. 2021;12:567671. doi:10.3389/fpsyg.2021.567671Linehan MM, Wilks CR.The course and evolution of dialectical behavior therapy.APT. 2015;69(2):97-110. doi:10.1176/appi.psychotherapy.2015.69.2.97McKay M, Wood JC, Brantley J.The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation & Distress Tolerance. 1st edition. New Harbinger Publications.Axelrod SR, Perepletchikova F, Holtzman K, Sinha R.Emotion regulation and substance use frequency in women with substance dependence and borderlinepersonality disorder receiving dialectical behavior therapy.Am J Drug Alcohol Abuse. 2011;37(1):37-42. doi:10.3109/00952990.2010.535582Linehan Institute: Behavioral Tech.For what conditions is DBT effective?.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cavicchioli M, Barone L, Fiore D, et al.Emotion regulation, physical diseases, and borderline personality disorders: conceptual and clinical considerations.Front Psychol. 2021;12:567671. doi:10.3389/fpsyg.2021.567671Linehan MM, Wilks CR.The course and evolution of dialectical behavior therapy.APT. 2015;69(2):97-110. doi:10.1176/appi.psychotherapy.2015.69.2.97McKay M, Wood JC, Brantley J.The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation & Distress Tolerance. 1st edition. New Harbinger Publications.Axelrod SR, Perepletchikova F, Holtzman K, Sinha R.Emotion regulation and substance use frequency in women with substance dependence and borderlinepersonality disorder receiving dialectical behavior therapy.Am J Drug Alcohol Abuse. 2011;37(1):37-42. doi:10.3109/00952990.2010.535582Linehan Institute: Behavioral Tech.For what conditions is DBT effective?.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cavicchioli M, Barone L, Fiore D, et al.Emotion regulation, physical diseases, and borderline personality disorders: conceptual and clinical considerations.Front Psychol. 2021;12:567671. doi:10.3389/fpsyg.2021.567671Linehan MM, Wilks CR.The course and evolution of dialectical behavior therapy.APT. 2015;69(2):97-110. doi:10.1176/appi.psychotherapy.2015.69.2.97McKay M, Wood JC, Brantley J.The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation & Distress Tolerance. 1st edition. New Harbinger Publications.Axelrod SR, Perepletchikova F, Holtzman K, Sinha R.Emotion regulation and substance use frequency in women with substance dependence and borderlinepersonality disorder receiving dialectical behavior therapy.Am J Drug Alcohol Abuse. 2011;37(1):37-42. doi:10.3109/00952990.2010.535582Linehan Institute: Behavioral Tech.For what conditions is DBT effective?.
Cavicchioli M, Barone L, Fiore D, et al.Emotion regulation, physical diseases, and borderline personality disorders: conceptual and clinical considerations.Front Psychol. 2021;12:567671. doi:10.3389/fpsyg.2021.567671
Linehan MM, Wilks CR.The course and evolution of dialectical behavior therapy.APT. 2015;69(2):97-110. doi:10.1176/appi.psychotherapy.2015.69.2.97
McKay M, Wood JC, Brantley J.The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation & Distress Tolerance. 1st edition. New Harbinger Publications.
Axelrod SR, Perepletchikova F, Holtzman K, Sinha R.Emotion regulation and substance use frequency in women with substance dependence and borderlinepersonality disorder receiving dialectical behavior therapy.Am J Drug Alcohol Abuse. 2011;37(1):37-42. doi:10.3109/00952990.2010.535582
Linehan Institute: Behavioral Tech.For what conditions is DBT effective?.
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