Dialectical Behavior Therapy (DBT): What it is and How it Works

Even though therapy is widely accepted, most folks are only aware of the basics. Meanwhile, myriad forms of therapy exist outside of a mainstream lens of understanding. Sometimes, this has to do with certain methods having names that appear, well… academic. For example, dialectical behavior therapy (DBT) sounds daunting. What does “dialectical” even mean?

Ideally, we will move past the title and dig deeper. After all, DBT can improve your relationships, regulate your emotions, help you develop mindfulness, and make you more amenable to stress. All this and more is accomplished by reconciling opposites and accepting reality. Let’s explore this highly effective modality.

A Little of What You Should Know About DBT

Developed about 50 years ago, DBT was initially designed to help individuals experiencing suicidal ideation. Over time, its effectiveness in managing extreme emotions has made DBT a successful choice for people with conditions and issues like borderline personality disorder, anxiety, depression, disordered eating, post-traumatic stress disorder (PTSD), substance use disorder, and more.

A factor behind its stellar track record is an acceptance that real life is tricky. It’s complicated and there’s no singular path when it comes to optimal mental health. The finish line shifts and the goalposts move. This is the “dialectic” in DBT. Despite a seeming contradiction, yes, you can accept reality while seeking to change your realities.

4 Key Components of DBT

Mindfulness: Acknowledgment of the present moment
Emotion Regulation: Identifying and managing the feelings that cause distress in your life
Distress Tolerance: If negative emotions are inevitable, it’s more helpful to develop tolerance for them than to suppress them
Interpersonal Effectiveness: Enhancing one’s communication skills is a powerful path toward healthy relationships

How Does DBT Work?

How exactly does someone accept and validate who they are while also working to change oneself? This paradoxical goal is accomplished via three types of sessions:

Weekly Individual Sessions

You meet with a certified DBT therapist for 40 to 60 minutes. Such a one-on-one setting is used to work toward goals like:

Develop a toolbox of coping skills to call on instead of making counterproductive choices
Identifying and thus limiting unhealthy behaviors (especially self-harm)
Using a journal to monitor emotions and the actions you use to manage them
Understanding how to set and attain productive, realistic goals

Group Skills Training

Unlike classic group therapy, DBT group sessions are more like a classroom. You’re there not to share personal stories but rather, to effectively learn the four key components explained above (mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness).

Phone Coaching

Since DBT can be prescribed for folks in a volatile state, it’s not unusual to require support in between individual or group sessions. With strict boundaries set, clients can reach out via phone to clarify DBT steps and skills. Such contact can be especially crucial when self-harm is a possibility.

The Fundamental Reason Why All of These Approaches Work

DBT provides you with the skills and confidence to seek out and utilize new tools instead of falling back on the destructive behaviors that had become the norm. Put simply, DBT helps you recognize and accept what’s happening and change your response to this crisis. This is made possible thanks to a commitment to mindfulness, e.g. staying in the present moment of clarity.

Does DBT Sound Like Something You Might Want to Try?

Or perhaps you’d like to start by learning more. Either way, if you want change but feel stuck when trying to make it happen, I’d love to talk with you about the potential for dialectical behavior therapy to improve your life. Let’s connect and get you scheduled for a free and confidential consultation.