Dialectical Behavioral Therapy

Dialectical behavior therapy (DBT) has proven to be an effective cognitive therapy for more than forty years.  Developed by psychologist Marsha M. Linehan, the treatment was initially geared to treat those struggling with borderline personality disorder (BPD). Linehan built upon the foundation of cognitive behavioral therapy (CBT), focusing more on clients that struggled with severe emotional disorders. However, DBT is also effective toward those with other mental health disorders.

DBT aims at underlying thoughts that can influence emotions. Those that struggle with DBT tend to feel emotions more intensely, so DBT emphasizes working on skills to handle these emotions. As talk therapy, DBT offers a safe and supportive therapeutic environment for clients to begin opening up and contending with what’s going on in their inner world. 

DBT is like cognitive behavioral therapy, but goes beyond just identifying negative thoughts or emotions. DBT actually encourages clients to feel the emotions so they can begin working through them. DBT therapists will help clients learn how to deal with those emotions in the moments they are experiencing them. 

Psychosocial Aspects


DBT spends time focusing on the client’s psychosocial areas, such as their relationships with family, friends, partner, etc. The dynamics between family members are oftentimes focused on first, as this tends to be where some faulty patterns or negative thoughts originated. 

Along with treating those with BPD, this type of treatment is also quite effective for those who struggle with addiction issues, depression, and eating disorders. Treatment will help clients begin to look at life with a mindful perspective. This means being aware of the present moment and paying attention to how you feel. 

Learning how to feel the tough emotions without reacting intensely, and coping with them in healthy ways, can help clients feel less suffering and more peace and joy. 

Four DBT Components

  1. Mindfulness:
    Mindfulness techniques are widely used in DBT treatment. To be mindful means to be aware of life as it is happening, rather than get caught up in the past or the future. It allows clients to pay less attention to the ego and more attention to staying present. Being able to experience life more at the moment can help people regulate their emotions better.
  2. Interpersonal Boundaries:
    For those struggling with intense negative emotions, DBT can help them learn how to set and keep boundaries. First, they will learn how to tap into their own wants and needs. Then, they’ll be able to learn how to speak those wants and needs in a healthy way to others. They learn that it’s alright to feel their feelings and voice their concerns, as well as say “no”. This assertiveness training will help the client in all their relationships.
  3. Tolerance of Distress:
     Life throws things that cause pain and distress. It’s inevitable. Learning how to accept and tolerate that distress can help you live with less stress, anxiety, depression, and more. To practice distress tolerance, you can learn tools like mindfulness, self-soothing, distracting, focusing on the pros, and breathwork. You can learn to accept yourself and the situation at any given moment, accepting reality moment by moment with the belief that you can get through whatever comes your way. In other words, you learn how to bear pain in skillful ways.
  4. Emotional Regulation:
    Those with BPD or substance abuse issues can experience strong emotions such as rage, depression, anxiety, frustration, fear, and more.  DBT can be an effective tool for learning how to regulate such emotions, helping clients learn:
  • How to recognize emotions as they arise.
  • To see what’s keeping them from modifying emotions.
  • To increase positive emotions.

For example, if you start to feel angry and scream, “I’m a horrible person”, you’ll learn how to recognize that emotion, feel it, but choose to limit negative thoughts concerning it.  To feel angry does not mean you’re horrible. It simply means you feel an intense emotion that is trying to inform you of something. You can learn to modify the thoughts about the emotion, which oftentimes decreases the intensity of it. 

DBT treats conditions and disorders like:

DBT may include weekly individual therapy sessions, as well as periodic group sessions. 

Treating Addiction With DBT


If you’re struggling with addiction to alcohol or drugs, DBT is a type of therapy that can equip you for a better, sober life. Whether in an addiction rehab or attend counselling with a therapist who uses DBT, you’ll be able to receive therapy that helps you identify negative emotions and behaviours that cause you to drink or drugs. Then, you’ll learn how to change them into positive ones that can help you with continued recovery success.

Substance abuse is oftentimes marked with self-destructive thoughts, emotions, and behaviours. Much of this goes on without the person’s awareness in the subconscious. DBT will help the person become more familiar with what’s going on under the surface, changing what needs to be changed in order to live a healthier emotional life. 

In addiction recovery, DBT can help you come to terms with where you’re at in life, create goals for a better future, manage cravings, manage your emotions better, find solid support, and create a relapse prevention plan. 

DBT also helps clients learn important life skills for remaining sober and creating the kind of life they desire. Skill building is learned in sessions, as well as with homework assignments between sessions. It may also include the client keeping a diary card that has their treatment goals listed so the client can see it often. Changes or modifications are made, as necessary.

DBT is oftentimes used in residential and outpatient settings. Setting small, incremental goals to remain abstinent tends to work well for clients. This could mean setting the goal to remain sober for one day. When the person completes that goal, they set another goal. Setting smaller goals helps the client feel less overwhelmed and more optimistic about accomplishing them. 

Reach Out For Help

If you’re struggling with addiction or intense negative emotions, treatment is available. Have two diagnoses, such as substance abuse and a mental health disorder, is called a dual diagnosis. Many addiction treatment centers are equipped to provide dual diagnosis treatment. You simply have to reach out for help. 

Know that you can overcome addiction and better manage or overcome other issues you may be struggling with. Make a call today and take that first step toward recovery.

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