What is DBT?

This article is part of our current series explaining what to expect from different forms of therapy that we deliver at JSA Psychotherapy.

Dialectical Behaviour Therapy (DBT) was created by Dr Marsha Linehan, who wanted to design a type of therapy to help people live a worthwhile life, even when things seem to keep getting in the way of achieving that. DBT involves finding new skills that can make it easier to build our Life Worth Living, while dealing with the obstacles that make it harder. One of the first things you will do in DBT is describe and flesh out your personal Life Worth Living. We’ll then come back to this throughout therapy to make sure we’re staying on target and use it as motivation to keep going when times are difficult.

What does ‘DBT’ actually mean?

Dialectic refers to the whole mindset of the therapy. A ‘dialectic’ is when two people work together to overcome a frustrating problem. Often it seems like there are two or more things in your mind which can’t both be true but somehow still are. A dialectical therapist will take your view seriously and won’t try to argue with you to make you change your mind. Instead, you’ll work together to find the outcome with the most upsides and the least downsides.

Behavioural refers to the aim of working out which practical methods will most help build your Life Worth Living.

Therapy refers to the partnership between you and your therapist as you work together to build this Life Worth Living. In DBT, the client and the therapist are both treated just as important as the other. After all, you’re the only person who can be the expert on your own life. The therapist takes that expertise and combines it with their knowledge of DBT methods.

DBT is very useful for dealing with overwhelming emotions. Whether this is anger, sadness, fear, loneliness or something else entirely, these emotions can crash over us like a wave. Often one emotion can trigger another which means you can experience several waves, one after another. At the peak of the wave, when the emotion seems most intense, we do whatever it takes to manage and get it over with. The problem is, sometimes these methods have a bunch of side effects or downsides.

Methods of managing the emotional waves

DBT is split into 4 main sections, each designed to be a different way of making those emotional waves a bit easier to manage. DBT aims to develop strategies with less side effects, so that we have less things getting in the way of creating our Life Worth Living.

Distress Tolerance is all about working out the practical things we can do when the wave seems at its most intense. In this module, we ask ourselves the questions;
A. What am I feeling?
B. What do I want to do to make that better? What are the pro’s and con’s of doing that?
C. Is there something else I can do to get the same pro’s and less of the con’s?

We then focus on working out what that ‘something else’ is.

Emotional Regulation looks at the actual emotional wave itself to get a better understanding of how it works. This helps us make more effective decisions when trying to put our Distress Tolerance work into practice. This module focuses on identifying, understanding and experiencing emotions in a safe way, all with the aim of helping us get a handle on them. When we have a handle on something, it often seems less overwhelming.

Mindfulness is the method of being ‘in the moment’. When we’re experiencing life in the moment, we notice how things come and go and naturally change on their own. This is also the case with our emotional waves. Mindfulness helps us not ‘grasp’ the wave, simply letting it role by. When we do this, we don’t feel the need to respond in a big way, meaning our actions will have less side effects and fewer downsides.

Interpersonal Effectiveness

Relationships are important, both for sharing parts of our life with people we care about and trust and for getting what you need in life. However, they can also be broken in a handful of moments. This module contains skills for navigating those moments in a calm, confident and assertive manner to make sure they have a stable place in your Life Worth Living.

If you would like to download an info sheet version of this article as a pdf for your own use, you can do so by clicking this link