An Overview of Dialectical Behavior Therapy (DBT)

You feel like your emotions are a runaway train. They are intense, overwhelming, and they change in an instant, leaving you feeling out of control and exhausted. You might find yourself in chaotic relationships or engaging in impulsive behaviors to try to cope with the emotional pain. If this sounds familiar, a powerful, skill-based therapy called Dialectical Behavior Therapy, or DBT, might be able to help.

At Televero Health, we know that for people who struggle with intense emotional dysregulation, traditional talk therapy isn’t always enough. DBT was specifically designed to provide concrete skills to help you manage these overwhelming emotions and build a life that feels more stable and meaningful.

What Is DBT and Who Is It For?

DBT was originally developed by Dr. Marsha Linehan to treat Borderline Personality Disorder (BPD), a condition characterized by severe emotional instability. However, it has since been proven to be highly effective for a wide range of other issues where emotional dysregulation is a key feature, including substance use disorders, eating disorders, PTSD, and chronic depression.

The “dialectic” at the heart of DBT is the integration of two seemingly opposite ideas: acceptance and change. DBT helps you to accept yourself and your reality exactly as they are in this moment, while also teaching you the skills you need to change your behaviors and build a better life. It’s a balance of “I am doing the best I can” and “I can do better.”

The Four Modules of DBT Skills

Standard DBT is a comprehensive program that includes individual therapy, phone coaching, and, most importantly, a weekly skills training group. In this group, you learn a curriculum of practical skills that are broken down into four modules.

1. Mindfulness

This is the core skill of DBT. It teaches you how to pay attention to the present moment without judgment. For someone with intense emotions, their attention is often stuck in the past (ruminating on painful memories) or in the future (worrying about what might happen). Mindfulness skills, like observing your thoughts without getting caught up in them, help you to get grounded in the here and now, which is the only place you can make a change.

2. Distress Tolerance

What do you do when you are in an intense emotional crisis and you can’t make the situation better right away? Distress tolerance skills are for surviving these crisis moments without making things worse. They are short-term coping strategies to help you get through the pain without resorting to impulsive or self-destructive behaviors. Skills include things like distracting yourself, self-soothing through your five senses, and using techniques like intense exercise or holding ice to calm your body’s “fight-or-flight” response.

3. Emotion Regulation

While distress tolerance is for surviving a crisis, emotion regulation skills are for the long-term work of reducing your emotional vulnerability. This module helps you to understand the function of your emotions, to identify them accurately, and to learn strategies to change them when they are not helpful. You learn practical skills for increasing positive emotional experiences and for reducing the intensity of negative ones.

4. Interpersonal Effectiveness

Intense emotions can make relationships chaotic and difficult to navigate. This module is essentially a masterclass in social skills. It teaches you how to be more effective in your relationships by learning how to:

  • Ask for what you want and need in a clear and respectful way.
  • Say “no” and set healthy boundaries.
  • Navigate conflict without destroying the relationship.
  • Maintain your self-respect in your interactions with others.

DBT is a very active and practical form of therapy. It is not about endlessly talking about your past; it is about learning and practicing concrete skills in the present to build a “life worth living.” For those who feel lost in a sea of overwhelming emotion, DBT can provide a life raft and a compass to navigate their way to calmer shores.

Key Takeaways

  • Dialectical Behavior Therapy (DBT) is a skill-based therapy designed to help people who struggle with intense, overwhelming emotions.
  • The core of DBT is the “dialectic” of balancing acceptance of your present reality with the work of changing your behaviors.
  • DBT teaches practical skills in four key areas: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.
  • It is an active, evidence-based treatment that can help you to manage your emotions, improve your relationships, and build a life that feels meaningful.

Ready to take the first step? We can help. Get started with Televero Health today.