What is Dialectical Behavior Therapy?

The main reasons DBT is so effective in such a wide range of problems, is that it teaches people to manage their overwhelming emotions more effectively.
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There are so many different types of psychotherapy out there nowadays, if you're dealing with emotional problems, how do you know what will be most effective for you? In my experience as a psychotherapist, clients benefit the most from working with a therapist who is flexible, and who tailors therapy to meet the needs of the client, rather than trying to fit the client to a specific mold. Dialectical Behavior Therapy (DBT) offers a wide range of skills a therapist can choose from, to suit the needs of clients at any given time.

DBT is a psychotherapy model that was created by psychologist Marsha Linehan. Originally, the treatment was created to treat an illness characterized by severe problems with managing emotions, called borderline personality disorder. But over the years, research has shown that DBT is very effective in treating a range of other illnesses as well, including mood disorders, anxiety disorders, eating disorders, and substance abuse. One of the main reasons DBT is so effective in such a wide range of problems, is that it teaches people to manage their overwhelming emotions more effectively, and helps people learn to handle distress in healthier ways, without losing control.

Answer the following questions to see if the DBT skills might be helpful for you:

  • Do you often find yourself living in the past, ruminating or dwelling on things that have happened, or living in the future, worrying about what might happen?

  • When you're experiencing a crisis, do you tend to make the situation worse by behaving in self-destructive ways (such as using substances, harming or threatening to harm yourself, lashing out at the people you care about, excessive spending, gambling, or disordered eating)?
  • Do you find that you react emotionally to situations that others don't, that your emotional response is more intense, or that it takes you longer to calm down from that emotional reaction than others?
  • Are your relationships chaotic? Do you have difficulties asserting yourself, asking for what you want or saying no to others' requests? Do your relationships often end before you want them to?
  • If you answered yes to any of the above questions, DBT skills will likely be helpful for you.

    There are four sets of skills in DBT:
    1. Core Mindfulness Skills teach you to live your life more in the present moment, rather than experiencing painful emotions that come from constantly thinking about the past or the future.
    2. Distress Tolerance Skills focus on helping you to learn to cope with crisis situations in healthier, less self-destructive ways.
    3. Emotion Regulation Skills help you to manage your emotions more effectively, and to tolerate your emotions when you can't change them or reduce their intensity.
    4. Interpersonal Effectiveness Skills help you to maintain relationships through acting assertively, and through taking good care of yourself.

    The major emphasis of DBT is learning to tolerate emotional pain, which means that most of us could probably benefit from these skills, whether we have a mental illness or not! Essentially, these skills help us to live a healthier, happier life. But for people who have debilitating illnesses such as borderline personality disorder, mood and anxiety disorders, and general problems regulating or managing their emotions, DBT offers the hope of living a more positive and productive life.

    Sheri Van Dijk, MSW is a mental health therapist in private practice and at Southlake Regional Health Centre in Newmarket, Ontario, Canada. She is author of The Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder:
    Using DBT to Regain Control of Your Emotions and Your Life
    (2009) and co-author of The Bipolar Workbook for Teens: DBT Skills to Help You Control Mood Swings (2010).

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