Dialectical Behavioural Therapy (DBT) was originally formulated by Dr. Marsha Linehan to treat people who have been diagnosed with borderline personality disorder. It’s a form of psychotherapy that combines Buddhist ideologies such as mindfulness (being in the moment) and acceptance (learning to accept things for what they are without trying to change them) with concepts learned in behavioural science.
Let’s delve a little deeper into this fascinating concept.
What Is Dialectical Behavioural Therapy?
By its very nature, the concept of DBT serves a dual purpose. The first is to teach people to accept their experiences, emotions, and people in their lives as they are without questioning the validity of these things. The second is to teach people to make positive changes in their lives so that they can develop the appropriate coping mechanisms to deal with particularly difficult situations and learn healthy emotion management skills.
Ultimately, the goal of this type of therapy isn’t necessarily to eliminate or control all negative thoughts; rather, it is to recognize them for what they are and acknowledge that they’re a normal part of life. Everyone feels angry, sad, depressed, and anxious from time to time—and that’s perfectly normal. It’s how we respond to these emotions that matters. And that’s exactly what DBT is all about.
How Does DBT Work?
Like all forms of psychotherapy, talk therapy, and cognitive behavioural therapy, DBT can be a lengthy journey that requires a great deal of commitment. But, it can also be very rewarding for clients, as it can lead to a great sense of self-realization. It’s a learning process that allows you to get better acquainted with yourself and work toward improving your relationship with yourself and others.
The concepts that are explored in DBT—namely mindfulness and acceptance—are universal because they can apply to every person and situation. We all need to practice a little mindfulness in order to truly learn to appreciate the little things in life—even if those little things include painful emotions. The point is to acknowledge that these negative aspects of life exist without trying to change them or allow them to take over everything else.
Close-up of people communicating while sitting in circle and gesturing
Why DBT Is Uniquely Effective
DBT for depression is very different than DBT for treating anxiety. Although a lot of the therapeutic methods and settings are the same, it’s important to remember that every person is on their own individual journey. And while you might find yourself relating to what your peers are going through, your progress will be very different than theirs.
With that in mind, there are three core components involved in DBT treatment that make it uniquely effective compared to other forms of psychotherapy:
- Group Skill Training Sessions. Participating in a classroom setting with a group of people who are undergoing the same kind of therapeutic treatment as you can help you develop the skills you need to change your perspective on certain behaviours, reactions, emotions, and situations. Through insightful interactions and homework assignments, you can learn how to improve your interactions and relationships with the people in your life.
- Individual Therapy. Next, you must learn how to put everything you learned in group therapy into real-world practice. Individual therapy involves one-on-one sessions with a professionally trained therapist where they’ll help you apply these skills to your own life.
- Phone Counselling. Perhaps one of the most important and helpful components of DBT, phone counselling allows you to contact your therapist at any time of the day or night when you need to work out a problem or situation with them. Depending on your personal, emotional, and physical needs, you can also work out a different form of communication with your therapist (i.e. e-mail, instant messaging, or text messaging) if that suits you better.
Ultimately, the point of this type of therapy is to give you the tools, resources, and support you need to make positive changes in your life and learn how to handle stressful situations in a productive way.
The Four Modules of DBT
Throughout the three above mentioned components of DBT, you’ll learn four main strategies and takeaways to help you improve the quality of your life.
- Mindfulness. This is the practice of living in the moment, focusing on what’s happening in the present rather than obsessing over things that happened in the past or are going to happen in the future. Mindfulness is simply about observing things as they are, taking in a situation, and reflecting upon the present moment while relinquishing all urges to take control. In this module, you’ll learn about different types of acceptance techniques and how to effectively apply them to situations in your life.
- Interpersonal Effectiveness. In addition to accepting things as they are, DBT also teaches you how to be more assertive in the quest for your own happiness and mental well-being. Just because you’re working toward positively impacting your relationships with others, that doesn’t mean you should sacrifice your own happiness in the process. Through this practice, you’ll learn how to strike a good balance between pleasing yourself and maintaining a healthy relationship with other people in your life. Learning to say “no” once in a while instead of being a people-pleaser is important for your own well-being as well.
- Distress Tolerance. Similar to mindfulness, distress tolerance has to do with accepting situations as they happen and facing them head-on, rather than avoiding them altogether. Distress tolerance skills such as distraction, self-soothing, improving the situation, and creating a list of pros and cons are taught during this module.
- Emotional Regulation. As simple as this concept seems, it can actually be the most challenging task for a lot of people. Oftentimes, we’re told to control our emotions or bottle them up entirely rather than expressing and dealing with them in a healthy way. This is especially true of emotions that are thought to be negative such as anger, frustration, anxiety, and sadness. Of course, there’s always an appropriate time and place to express these emotions. Emotional regulation helps you recognize these emotions as you’re feeling them, what triggers them, and how you can handle them in the moment.