Helping you get through tough times

Dialectical Behaviour Therapy (DBT)

Dialectical Behaviour Therapy (DBT) is a new therapy that’s becoming more popular. Its aim is to help us change problem behaviours.

Two chairs facing one anotherWhen does DBT help?

DBT was originally created to help treat people experiencing suicidal thoughts, self harming behaviours, and personality disorders. However, today it is used to help people experiencing bipolar disorder, depression, anxiety, eating disorders and more.

How does DBT work?

DBT is a mix of Cognitive Behaviour Therapy (CBT) and mindfulness. By combining these two types of therapies, DBT helps teach people to:

  • Handle strong emotions, such as depression and the behaviours, which may arise from them
  • Trust their own emotions, thoughts, and behaviours.

Main goals of DBT Therapy

The four main goals of DBT are all focused on improving well-being. These four main goals are:

Learning to be in control of your own behaviour

If you believe you are not in control of your own behaviour, then you are less likely to be able to change it. Learning that you can control your own behaviour is empowering and allows you to make changes to behaviours you may feel need changing.

Learning to cope and experience emotions fully

Often, when we experience difficult emotions, we can shut down and try to avoid the emotion altogether. Instead of “suffering in silence,” DBT teaches us how to experience emotions without feeling overwhelmed and advises us on how best to take control over the situation.

Living life, ordinarily

Once we have learned how to cope with difficult emotions and experiences, we are taught how to handle everyday situations. This includes things like being unhappy in school, not getting along with parents or family members, and lots more.

Moving to “completeness”

Sometimes once we have completed the other stages of therapy and are feeling better, we can still feel that our lives are not quite complete. If this is the case, we can work on achieving any goals we have that will help with the sense of feeling ‘complete’. However, this stage is not always necessary.

Techniques of DBT Therapy

Within each of the stages, there are two main techniques used. These include:

Mindfulness

It’s not always easy to be aware and mindful of ourselves and our surroundings, especially when we’re going through a tough time.

We can get distracted and focus our thoughts too much on what we said or did in the past and/or worrying about the future, while almost ignoring what’s going on in the present moment.

Mindfulness helps us to observe ourselves and our surroundings without judgement. It can be easy to judge ourselves for not being happier or for feeling depressed or for looking a certain way.

Once we learn how to observe what is happening to us and around us, we are taught to describe it using non-judgemental words. This includes only listing the facts of what are going on, and not the opinions we have created about it. Read Mindfulness for more information.

Distress tolerance

Some of us are more likely than others to experience stronger emotions. No matter what the cause, in some people difficult emotions are experienced so strongly that they will do anything to avoid feeling those emotions. Learning to tolerate distress can help us express emotions in a healthier way. This is done using the acronym ACCEPTS.

  • Activities: Engaging in positive activities instead of ones that only increase pain.
  • Contribute: Helping out someone else when we are feeling down.
  • Comparisons: Comparing ourselves to how we were previously, seeing the progress we have made.
  • Emotions: Engaging in opposite emotions, like watching a comedy when feeling sad.
  • Pushing away: Taking a break from a situation when it becomes stressful. This allows us to refresh and come back to handle it when we’re ready.
  • Thoughts: Focusing on positive thoughts instead of repetitive negative self-talk and painful memories.
  • Sensations: Using bodily sensations to bring us to the here and now instead of focusing on past events, or worrying about the future.

How effective is DBT?

Although DBT is a newer type of therapy, it has been well researched. The research has shown that DBT is just as effective as using many other therapies like Cognitive Behavioural Therapy (CBT).

It is especially effective for problems with regulating emotions, substance abuse, eating disorders, and anger.

Is DBT for me?

If you have found that CBT is helpful, but you’re looking for more, DBT may be for you. If you are currently in therapy, you may want to talk to your therapist about DBT and whether it might be right for you.

If you are not in therapy, you may want to see a therapist who uses DBT and talk to them about if they think it would be a good fit for you. If you are suffering from problems regulating your emotions, anger, or an eating disorder, DBT will probably be helpful for you.

Is it difficult?

It is important to keep in mind that DBT is not a quick fix, and will require you to put in effort. In DBT, the therapist will teach you skills, and help coach you through situations. However, it requires effort on your part to start using what you learn and often includes weekly homework assignments.

It is a collaborative effort, and the therapist will help you if you have difficulty.

How long will it last?

The length of DBT can sometimes be longer, sometimes up to a year. However, how quickly you move through therapy also depends on how you are currently coping with your difficulties, and how much effort you put into therapy.

If you’re motivated, do the homework, and genuinely try, you will progress much quicker than if you do not.

What if my symptoms come back?

As with any type of therapy, there is always a risk that you will experience some symptoms again. However, through the skills you learn in therapy, you learn how to cope with this if it happens.

Additionally, you can always go back for therapy if you feel you are starting to experience symptoms again. Usually, if you do feel symptoms again, they are rarely as strong as before.

How can I get DBT?

Your GP should be able to put you in touch with a psychiatrist or a therapist who can advise you. As DBT is a newer therapy, there is no directory or widespread list that explains what hospitals or therapist provide a DBT programme. However, most GPs should know whether there are therapists in your area that provide DBT.

You may also try reading a self-help book, or reading resources online until you are able to find a therapist who provides DBT.

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This article was last reviewed on 24 March 2017

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