Dialectical Behavior Therapy (DBT) is a cognitive behavior therapy. Cognitive behavior therapy focuses on the beliefs and thoughts one has (cognitions) and the actions one takes.

Dialectical Behavior Therapy (DBT) was the first effective therapy for treating people with Borderline Personality Disorder (BPD). While no longer the only proven effective treatment, DBT has an impressive base of evidence that it works. DBT is considered one of the best treatments for Borderline Personality Disorder.

Dialectical Behavior Therapy (DBT) was developed by Marsha Linehan, Ph.D. at the University of Washington. DBT focuses on helping someone who has Borderline Personality Disorder (or some Mood Disorders) learn skills that lessen the impact of unpredictable emotions. Unpredictable emotions that are strong and distressing often occur in someone who has Borderline Personality Disorder.

Dialectical Behavior Therapy (DBT) is a combination of individual talk therapy and group therapy. Participants track their progress on diary cards.

DBT focuses on 4 main skills:

Mindfulness Meditation

Distress Tolerance

Emotional Regulation

Interpersonal Effectiveness

Mindfulness Skills

Acquiring good Mindfulness Skills is necessary to use the other three skill sets. In learning about mindfulness, DBT participants to look at situations, and describe the situations before participating in them. The goal is to slow down strong emotions that often occur in someone with Borderline Personality Disorder.

Mindfulness Skills end up being a “What do you do, and how do you do it.”

The “What you do” is: observe, describe and participate.

“How you do it” is: non-judgmentally, one thing at a time, and do what works.

You are to just observe and describe the situation non-judgmentally, without beating up either the situation or the person, focusing on one thing at a time. In the end one only wants to do what works.

Distress Tolerance Skills

Distress Tolerance Skills are about accepting both yourself and a situation, as it is, without immediately changing either yourself or the situation. Everything has to start somewhere. That acceptance doesn't mean that you have to sit back and not change it, or that you have to put up with the situation as it is.

What distress tolerance means is that you become able to look at a negative situation without the emotional upheaval that previously happened, while becoming overwhelmed and doing your best to try to escape the situation.  DBT helps people who have Borderline Personality Disorder to learn how to look at a situation, cope and then move on. This puts the person in charge of the situation instead of the situation automatically triggering behaviors.

Emotional Regulation

Emotional Regulation happens when people who have Borderline Personality Disorder (or some Mood Disorders) are able to be in charge of strong, intense feelings like suicidal thoughts, intense frustration and anxiety. Many people with Borderline Personality Disorder feel that their emotions are in charge of them, instead of the person being in charge of their emotions. The emotional regulation section helps people with Borderline Personality Disorder stay in control, teaching people to both reduce the intensity and slow the frequency of the emotion through control and regulation.

Interpersonal Effectiveness

Interpersonal Effectiveness is a series of practice situations that help people experience how to change what is happening into what they want to have happen, or to stop something from happening and change into what they want to have happen. There are a series of exercises for people to practice, which include practicing saying no, or requesting something that is wanted.

To learn more about Dialectical Behavior Therapy contact your local community mental health provider.