What is DBT??

What is DBT? I’m so glad you asked!

Dialectical Behavior Therapy (DBT) is a unique and powerful therapy. It's changed my life, and it's changed (and even saved) the lives of thousands of people. That's why I love telling people about it! Consider this page your DBT 101.

tl;dr: DBT is a research-backed treatment that teaches dozens of skills for improving emotion regulation, relationships, and self-understanding.

DBT skills are life skills—they can help anyone. You can learn them.

Full DBT can be helpful in treating BPD, (c)PTSD, self-harm, depression, anxiety, substance use, and other mental health struggles.

DBT can help highly sensitive people, neurodivergent people, LGBTQ+ people, and people of diverse cultures, ethnicities, and languages.

What’s “Dialectical” Mean?

Dialectics is a worldview that recognizes two seemingly opposite things can actually be true at the same time.

Dialectics can help you better understand yourself and your contradicting experiences. Like how you can feel incredibly angry at someone you love. Or, how you can feel lonely in a crowded room. Or, how you can work towards self-improvement while simultaneously practicing self-acceptance.

Finding the nuanced truth between “opposites” can be super helpful for navigating conflict and improving relationships.

It’s also super helpful when you’re an emotionally sensitive person who goes through a lot of emotional ups and downs—which is why DBT focuses on dialectics so much.

DBT Helps People Understand and Cope with Emotions

American psychologist Dr. Marsha Linehan originally developed and studied DBT as a treatment for people with borderline personality disorder (BPD) who struggled with intense emotions and suicidal behaviors (just like she had earlier in her life).

Research now shows DBT is helpful for much more than BPD—I’ll talk about that more below.

That’s because DBT is designed to improve emotional regulation: how someone understands, uses, copes with, and lives in balance with their emotions.

It can help anyone improve their emotional resilience or decrease impulsive behaviors, including self-harm, disordered eating, or substance abuse.

It can be particularly helpful for highly sensitive or neurodivergent people who feel emotions easily or intensely.

If it sometimes feels like emotions are driving the car of your life and you're just along for the ride, DBT can help put you back in the driver's seat. It does that, in part, by teaching DBT skills.

DBT Teaches Dozens of Concrete Coping Skills

A key feature of DBT is DBT skills. These skills cover four main modules*:

  • Mindfulness. Skills for improving attention and increasing wisdom and peace. By practicing being in the present moment, exactly as it is, you can learn to live a more embodied, liberated, and authentic life.

  • Distress tolerance. Skills for coping with the most painful experiences in life. When you can't change reality or change how you feel about it, you can use distress tolerance skill to survive stressful times without acting impulsively, dissociating, or suppressing.

  • Emotion regulation. Skills for understanding, feeling, using, and changing emotions. This module can help you work with your emotions in order to increase your overall joy and emotional resilience.

  • Interpersonal effectiveness. Skills for improving communication and relationships. You can learn how to better assert yourself, say no, and navigate conflict, respecting both your needs and the needs of other people.

Really, these are life skills.

By covering a wide array of topics, DBT skills offer wisdom for almost any area of life. They offer small, tangible steps for feeling grounded when your world feels chaotic, unstable, or uncertain.

In my experience, when life gets tough, it’s incredibly comforting to have the DBT skills in your back pocket.

DBT is All About Finding Overall Fulfillment and Joy

Many of the DBT skills can be used to eliminate emotional suffering and cultivate more joy.

But, DBT does not guarantee a life without pain. It’s not trying to eliminate all of your “negative” emotions—just your suffering about life’s stressors and disappointments. It's also not a suicide prevention program.

Rather, DBT offers a pathway to building a "Life Worth Living.” Each person gets to define this life for themselves. What gives you the most pleasure? What are you personal values? What gives your life the most meaning?

Whatever life would give you the most peace and joy, even when it continues to be painful—that’s your life worth living.**

DBT’s primary goal in treatment is helping people reach this most-fulfilling life.

DBT is Evidence-Based and Adaptable

Decades of research show that comprehensive DBT can help people with BPD. (So if you’ve heard the terrible message that “BPD is untreatable,” please know that’s a myth!)

While DBT was originally created to treat self-harm and BPD, research now shows that DBT can help people with (c)PTSD, substance use disorders, ADHD, some eating disorders, and more.

Research also shows that DBT skills alone can be helpful for depression, anxiety, anger, and coping with life’s general stressors.

Additionally, DBT therapists and researchers have put a lot of work into making DBT work for different people. DBT can be helpful for autistic people and ADHDers, for example. And, it can be helpful for people all over the world, across various languages and cultures when it’s adapted to fit their specific needs.

Research also shows DBT can help LGBTQ+ people—I’ve personally witnessed DBT be particularly powerful for queer people.

OK, sound great. But what actually is it?

Full DBT psychotherapy is often called “adherent” or “comprehensive DBT.”

Comprehensive DBT always includes four main parts:

  • weekly individual DBT therapy

  • weekly DBT skills group (or some other form of dedicated skills learning)

  • as-needed phone coaching between sessions

  • weekly consultation team (for your therapist)

There are a ton of special guidelines, principles, and techniques that make each of these individual components "real" DBT. (To learn more, check out this Psychology Today article.)

Traditional DBT takes at least six months, because that's how long it takes to go through one "round" of typical DBT skills group. Many people choose to attend group for multiple rounds, staying in comprehensive DBT for 12 or 18 months—and sometimes even longer.

Wow, Do I really need all that?!

Maybe not!

It’s understandable if you read the above and feel intimidated. Adherent, comprehensive DBT is a pretty hefty commitment in time, energy, and (usually) money.

Good news: while some people need adherent DBT, many people don't.

As I already mentioned, research shows that just learning DBT skills can improve mental health for a lot of people! Luckily, there are a ton of books, videos, online support groups, online forums, and other resources where you can learn the DBT skills in ways that are cheaper and easier to access than comprehensive DBT.

If you struggle with BPD, self-harm, heavy substance use, frequent dissociation, or impulsive behaviors that cause you problems, you are likely to benefit more from comprehensive DBT with a therapist (rather than self-learning DBT skills). But, DBT self-help could still support you! A licensed mental health professional could help you decide what treatment is best for you, too.

Want to Learn More?

This post from the University of Washington (where DBT’s creator Dr. Marsha Linehan worked) is another helpful resource.

If you're an audio/visual learner, I’ve talked about DBT on tons of podcasts—this one from Psych Talk with Dr. Jessica Rabon provides a good overview. I also love this video from UCSF—it's about DBT for adolescents, but it provides a bunch of information relevant to DBT for adults, too.

If you’re sold and want to learn some DBT skills ASAP, you can find resources here!

If you want to find a DBT therapist, check out this page.

If you have any specific questions about DBT that you can’t find answers for, please reach out. I’m always happy to support people in getting the help they need!

*These definitions are based on what I wrote in my deck of DBT coping skill cards.

**If you have no idea what gives you most joy and fulfillment, you’re not alone! I write more about figuring out your life worth living in this free handout if you want to explore more.