What is dialectical behavioural therapy (DBT)?


Dialectical behavioural therapy (DBT) is a psychological therapy designed to help those who experience strong emotions and engage in self-harm or other self-destructive behaviours. 

The word ‘dialectical’ means two things which are opposite but are both true. In DBT there are two main goals which may seem to be opposites; these are acceptance and change. DBT aims to help you develop an acceptance of yourself, your actions, and your emotions. As well as learning to identify and change unhealthy thoughts, beliefs, and behaviours.

DBT is beneficial for those who struggle with regulating their emotions and those who engage in self-destructive behaviours as a way of coping with strong emotions. It was originally developed as a treatment for those living with borderline personality disorder and those experiencing suicidal thoughts. Now DBT is used to treat a range of mental health conditions and issues, including self-harm, post-traumatic stress disorder (PTSD), eating disorders, substance abuse, and depression.

One of the main goals of DBT is to reduce self-destructive and harmful behaviours, such as self-harm and substance abuse. This is to ensure you are safe. Other goals include learning how to regulate and accept your emotions, identifying and changing unhealthy emotions and behaviours, improving relationships, and learning healthy coping mechanisms.

The four main skills taught in DBT are…

  • Mindfulness - Learning to focus on the present moment and accepting your feelings without judgement can help reduce emotional distress.
  • Emotion regulation - Developing ways to cope with strong emotions and learning how to gain control over your emotions.
  • Distress tolerance - Learning skills, such as distraction and self-soothing, to help you deal with strong emotions, rather than resorting to self-harm or other harmful behaviours.
  • Interpersonal effectiveness - Building healthy relationships, developing effective communication skills, and learning how to be assertive. 

Through learning to accept your emotions and develop healthy coping skills you are better able to manage strong emotions and emotional distress.