What is Dialectical Behavioral Therapy (DBT)?

Dialectical Behavior Therapy was originally developed by Marsha Linehan (1993) as a treatment for Borderline Personality Disorder (BPD).

The focus in DBT is on the integration of acceptance and change. A primary component is Mindfulness, which originates in the practice of Buddhism and entails a present-centred approach and emphasis on moment-to-moment experience.

Essentially, Cognitive Behavioral Therapy (CBT) was integrated with this concept of mindfulness in an effort to help patients with BPD, who usually have histories of invalidation from one or more caretakers, to balance their need for validation with effective strategies for change.

Many patients with BPD suffer from chronic emotion dysregulation and Linehan’s model was created primarily to deal with this issue, which she was finding much resistance to using classic CBT.

DBT treatment involves four major modules: Core Mindfulness Skills, Interpersonal Effectiveness Skills, Emotion Regulation Skills, and Distress Tolerance Skills.

Since its inception, DBT has been shown to be effective for a variety of conditions besides BPD, ranging from depression and anxiety to substance abuse, to anger management. It has also been extremely beneficial for those who want some help with regulating their emotions and/or increasing their repertoire of coping skills for life circumstances.

I have found the integration of CBT and DBT with an underlying psychodynamic model of conceptualization to be very beneficial for my patients. One thing that I find to be of universal benefit to almost everyone is the incorporation of Mindfulness.

Awareness is probably the foundation of and the single most critical ingredient in making changes in one’s life. Mindfulness boosts the process of becoming more aware of oneself tenfold.

What’s better is that most people can do it and find that it has life-changing consequences for them.