What is dialectical behaviour therapy (DBT)?

Dialectical behaviour therapy (DBT) is a type of cognitive behaviour therapy or talking therapy. It is designed for people with borderline personality disorder (BPD) or who have difficulties controlling their emotions.

People with BPD have difficulty regulating their very strong emotions. This may cause troubled relationships and a disturbed sense of self. They may experience self-harm or have suicidal thoughts.

DBT helps people who have trouble managing their emotions to change unhelpful ways of thinking and behaving and to accept who they are. They learn skills to build a ‘life worth living’.

When is DBT used?

DBT is used to treat problems related to borderline personality disorder, such as:

• feeling empty inside or hopeless
• low self-esteem or feelings of self-hate
• strong feelings
• intense mood swings
• risk-taking or impulsive behaviour
• unstable relationships
• self-harm
• suicidal thoughts or suicide attempts

Therapists offer DBT for other mental health conditions as well. These include:

• alcohol or drug problems
• anxiety
• depression
• eating disorders, such as binge-eating or bulimia
• emotional dysregulation
• post-traumatic stress disorder (PTSD)

What can I expect from DBT?

With DBT you learn to:

• accept who you are
• build skills to regulate your emotions
• improve interpersonal relationships

DBT usually involves acceptance and change, by:

• sessions with a therapist
• skills training in groups
• telephone coaching sessions with a therapist if you have a crisis

DBT therapists often work in teams and help each other, so they can give the best treatment possible.

A typical course of DBT involves weekly sessions. These may continue for a year but will depend upon the needs of the person.

How does DBT help?

DBT helps you manage your behaviour and emotions. It teaches you new skills to cope with day-to-day life, and finds new behaviours to replace harmful ones. It helps you understand why you struggle with the things you do.

DBT relies on a strong relationship between you and your therapist. This helps motivate you to change your behaviour and reach your goals.

The skills you will learn are:

1. distress tolerance
2. emotion regulation
3. interpersonal effectiveness
4. mindfulness

Mindfulness is being self-aware and present in the moment (the ‘here and now’). When you are mindful you can see what’s going on around you. You stop worrying about the past or the future. It helps you respond rather than react to the here and now.

Distress tolerance is learning to understand your emotions in difficult or stressful situations. It involves managing your emotions without using harmful behaviours.

Emotion regulation is being more aware of your emotions. By understanding your emotions, you have more control over them.

Interpersonal effectiveness is learning how to ask for what you need. It involves setting boundaries whilst being respectful towards yourself and others.