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Dialectical Behavior Therapy: Not Just for Mental Illness

Dialectical Behavior Therapy: Not Just for Mental IllnessWhen I was studying psychology in college, I remember having a particular distaste for the behavioral approaches of B.F. Skinner. Defining the sacred depths of being human by behavioral impulses akin to a mouse motivated by cheese was not for me. I was much more into psychoanalytic therapy and Jung.

How then later did I come to embrace cognitive behavioral and related therapies that spell out that we are, essentially, just a mess of behaviors (good and bad)?

If you dig into your family dynamic, and maybe establishing relationships with others from equally dysfunctional backgrounds, you are bound to have a change of heart about old Skinner. Maybe there is something to behaviorism after all, and it can jibe with the deeper therapies that ask you to reflect on early places of pain and identity-molding.

Dialectical Behavior Therapy (DBT) is particularly of interest not just to me, but folks trying to come to grasp with certain subsets of mental illness — borderline personality disorder, bipolar and other depressive disorders. But its principles can be significantly farther-reaching than mental illness circles alone.

There are 4 critical components to the DBT methodology. The categorical names alone should conjure hope for those suffering from mental illness symptoms and individuals afflicted with interpersonal issues at home and in workplace: mindfulness, interpersonal effectiveness, distress tolerance and emotion regulation.

Any reader of Daniel Goleman’s Emotional Intelligence, with an introduction by the Dalai Lama, knows that mindfulness is at the core of human attempts to find balance and centeredness in our own body, as well as connection to others. Nothing is more key for individuals with beginner-level trust in family or therapists or slowly-developing insight into dysfunctional ways of relating to colleagues.

Interpersonal effectiveness involves “strategies” — practical, effective means of dealing with thought, mood and behavioral maladjustments. Yes, actual skills are taught, driven by goals for different situations. (Sound like business counsel?) This is invaluable to those with borderline personality disorder, who “possess good interpersonal skills in a general sense” but are unable to have self-insight to get past “problematic situations” when stress hits.

Now, what better need do we have as humans than to develop distress tolerance? It can help us in our workplace, for ill loved ones, and for ourselves when debilitated by depression, addictive thoughts, or the surfacing of manic traits. This is integral to DBT’s beauty. As in Alcoholics Anonymous, where people are encouraged to discern between what can be changed and what can not, distress tolerance skills involve “the ability to accept, in a non-evaluative and non-judgmental fashion, both oneself and the current situation.”

The heart of helping ill individuals and ourselves lies, I believe, in letting this mindset seep in, allowing for gentle, passive strength. (Not to mention that this simple maxim is a behavioral powerhouse when artfully practiced and applied, and can profoundly affect our professional, family and social life.) “Self-soothing” and “pros and cons” work are two tactics in the distress tolerance strategy, one whose benefits to mentally ill family systems can certainly be equally applied to the needy masses of a larger society.

The last outlined DBT component is emotion regulation, so critical to disorders such as bipolar, where emotional intensity and stress make for frequent anxiety. But we all have encountered situations with bosses and friends that contain these elements. How do we identify obstacles and triggers, and then work on changing emotional patterns? And can we increase positive emotional experiences? Like the mouse after his cheese, is it not possible to stack the deck a certain way in families, in the workplace and within the mental health system so that the satisfaction of getting a little more of that nibble — stability, harmony, collaboration — can happen more effectively and more often?


Want to learn more about dialectical behavior therapy?
Follow our blog, Dialectical Behavior Therapy Understood or read the article, An Overview of Dialectical Behavior Therapy.

Dialectical Behavior Therapy: Not Just for Mental Illness

Lisa A. Miles

Lisa A. MilesLisa A. Miles has been uniquely blending her expertise in self-development, mental health and the creative arts for over 25 years. Based in Pittsburgh, Penn., she is a coach/ consultant who advises individually and for business, author of two books (one about an institutionalized artist), professional speaker, and composer/ performer on violin and mandolin (including collaborative work with Jungian therapists). Also available as a coach working virtually, Lisa is included in the international Life Quality Improvement directory. Please check out her webpage at

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APA Reference
Miles, L. (2018). Dialectical Behavior Therapy: Not Just for Mental Illness. Psych Central. Retrieved on October 29, 2020, from
Scientifically Reviewed
Last updated: 8 Jul 2018 (Originally: 1 May 2013)
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
Published on Psych All rights reserved.