Dialectical behaviour therapy (DBT) was developed in the 1980s by Marsha Linehan, Ph.D., to help treat people with borderline personality disorder and those struggling with suicidal or self-harming behaviours. In the decades since, DBT has evolved into an effective tool that therapists can use to help treat issues like substance abuse, depression, anxiety disorders, eating disorders, and much more. These six key components of DBT help explain why it’s so effective at treating such a wide range of behavioural health issues.
Mindfulness
First and foremost, DBT is all about being mindful. According to Linehan’s 1993 publication of Cognitive-Behavioural Treatment of Borderline Personality Disorder, one element that characterizes those with borderline personality disorder is their tendency to overreact emotionally. To DBT practitioners, mindfulness means slowing down, tuning in to your present feelings and being fully aware (but not reactive) to them. It also involves a degree of detachment from your emotions—not suppressing them or denying them, but understanding that they are temporary and not letting yourself get swept away by them. You can practice mindfulness alone or with others; just set aside time each day (it doesn’t have to be long—even five minutes counts) for reflection.
Distress Tolerance
This skill helps individuals learn how to cope with anxiety, distress, or frustration in a healthy way. It is one of DBT’s three core mindfulness skills; it also includes Mindfulness and Interpersonal Effectiveness. Distress tolerance skills are used when you feel overwhelmed by life’s stressors, and they help teach you how to recognize and regulate your emotions so that you don’t act on them in unhealthy ways.
Interpersonal Effectiveness
One of DBT’s main goals is to help people relate to others more effectively. At its core, dialectical behaviour therapy (DBT) focuses on self-acceptance and acceptance of others, aiming to reduce interpersonal conflicts that may otherwise lead to emotional or behavioural issues. By learning how to be more effective in their relationships with family, friends, co-workers and romantic partners, those with borderline personality disorder can better control their emotions and behaviours.
DBT Self-Monitoring
DBT therapy helps you monitor and record your daily behaviours, emotions, and thoughts. This self-awareness is a critical component to practicing DBT skills like radical acceptance. In addition to keeping a journal or diary, many DBT therapists recommend downloading an app like Momentum that can help you track your life (for example, how much time you spend on work-related versus leisure activities). The app even reminds you when it’s time to reflect on your day and how you felt emotionally.
Emotion Regulation
Emotion regulation is all about being able to effectively manage your emotions and identify what triggers them. In DBT, you’ll learn how to take a non-judgmental stance toward emotional thoughts and feelings. This means that when you experience strong emotions, like anger or anxiety, you acknowledge these feelings without evaluating them as good or bad. The goal is to understand your triggers for these negative emotions so that you can react in healthy ways (like taking a walk, calling a friend or going to work out) instead of engaging in self-destructive behaviours (such as binge eating or abusing substances). Emotion regulation is closely tied with mindfulness training; after all, practicing mindfulness often involves paying attention to our thoughts and feelings without judging them.
Problem Solving
In dialectical behaviour therapy, one of the primary goals is to figure out how to deal with problems in life. As noted in our introductory explanation, people who struggle with BPD tend to be inconsistent and they often view things in extremes. They might feel everything’s either very good or very bad, which creates a great deal of emotional instability. DBT teaches problem solving as a way to put these extreme feelings into perspective and find logical solutions to issues.