Dialectical behavior therapy: Skills to manage emotions

Dialectical behavior therapy (DBT) sounds a lot like Cognitive behavioral therapy (CBT). DBT is based on CBT, one of the most commonly practiced forms of psychotherapy. The idea that there are better ways to think about our feelings is the core concept behind cognitive behavioral therapy. Dialectical behavior therapy takes this concept a step further. DBT focuses on helping people who tend to have extreme emotional reactions. Above all, this form of therapy teaches people how interact with the environment in a healthier way.

What is the difference between CBT and DBT?

CBT focuses on how your thoughts, feelings and behavior influence each other. Dialectical behavior therapy emphasizes regulating emotions, being mindful, and learning to accept pain. CBT seeks to give patients the ability to recognize when their thoughts might become troublesome. CBT then gives them techniques to redirect those thoughts. DBT focuses on helping people change their behavior patterns, rather than to trying to think or talk through the issues they are struggling with

Who is dialectal behavior therapy for?

Dialectical behavioral therapy was created to treat borderline personality disorder. The first major study was done by Dr. Marsha Linehan in 1991. However, research shows that DBT has also been used successfully to treat people experiencing depression, bulimia, binge-eating, bipolar disorder, post-traumatic-stress disorder, and substance abuse. DBT skills are good for those who wish to improve their ability to regulate emotions, tolerate distress and negative emotion, be mindful and present in the given moment, and communicate and interact effectively with others. DBT often is the most effective therapy for those who struggle with self-harm behaviors like cutting and chronic suicidal ideation. Sexual trauma survivors also respond well to DBT techniques.

How does DBT work?

As its name suggests, dialectics, or the idea of balancing opposites, is a major part of DBT. The therapist consistently works with the patient to find ways to hold two seemingly opposite perspectives at once. This promotes balance and avoids black and white—the all-or-nothing styles of thinking. In service of this balance, DBT promotes a both-and rather than an either-or outlook. The dialectic at the heart of DBT is acceptance and change.

Dialectical behavior therapy provides individuals with new skills to manage painful emotions and decrease conflict in relationships. This type of CBT helps those who have developed patterns of intense emotional reactions and impulsive behaviors in response to what patients describe as overwhelming feelings of pain and rejection. DBT specifically focuses on providing therapeutic skills in four key areas.

1. Mindfulness focuses on improving an individual's ability to accept and be present in the current moment.
2. Distress tolerance increases a person’s tolerance of negative emotion.
3. Emotion regulation covers strategies to manage and change intense emotions that are causing problems in a person’s life.
4. Interpersonal effectiveness consists of techniques that allow a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships.

What does DBT treatment involve?

DBT does not differ dramatically from how you would visit your doctor in other forms of talk therapy. However, DBT does tend to require greater commitment on the part of both the therapist and the patient alike to develop a satisfying and meaningful life. Generally speaking, there are three major components of DBT in its standard, outpatient form.

• Weekly individual (one-to-one) therapy sessions: The content of these therapy sessions generally revolves around targeting a high-priority event that occurred within the past week, helping the patient identify all the factors that led up to and followed the event and then determining and practicing new ways of responding in the similar situations.
• Weekly skills-training sessions: Usually in the form of group therapy, this part of DBT involves teaching patients specific skills designed to help improve their life in the four major areas we mentioned above.
• As-needed consultation with your doctor outside of sessions

About Talkiatry

Talkiatry is a local, accessible and complete mental healthcare solution that accepts insurance. We close the gap for individuals who want to get better, but feel that mental health care has been challenging to navigate up until this point and want a more convenient way to take the first step. Talkiatry takes the traditional local mental health visit and combines it with technology, scale, efficiency, and design to provide the best possible environment for healing.

Talkiatry is a mental health practice, and our clinicians review everything we write. However, articles are never a substitute for professional medical advice, diagnosis, or treatment. If you think you may need mental health help, talk to a psychiatrist. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.