Dialectical behavioral therapy (DBT) works around developing four major skills: mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation.
Dialectical behavioral therapy (DBT) is a therapeutic approach that’s been found effective for managing mental health conditions like personality disorders and eating disorders.
But understanding and developing DBT skills can actually benefit anyone who wants to cope better with life’s challenges in general.
Dialectal behavioral therapy (DBT) is a very intensive program composed of individual psychotherapy, group sessions, phone coaching, skill training, and a consultation team of therapists.
DBT builds upon the concepts of cognitive behavioral therapy (CBT). It helps you develop concrete skills that you can use to cope when life feels overwhelming.
The word dialectical in DBT comes from the term dialectics. In DBT, this means that everything is composed of opposites, and those opposites can co-exist.
The DBT approach is based on the belief that change and relief come from accepting opposing emotions, thoughts, and behaviors.
DBT was originally developed to treat borderline personality disorder (BPD) and for people with suicidal thoughts or engaging in self-harm behaviors.
DBT has since been found to be
DBT skills are aptitudes and tools you can develop to better cope with all types of challenges.
A dialectical behavioral therapist can help you learn to replace ineffective behaviors and thoughts with more effective ones so you can manage life’s stressors and difficult emotions.
The main goal of DBT is to help you develop four major skills:
- mindfulness or being in the present
- distress tolerance or reacting less often or less intensely to distress
- interpersonal effectiveness or having more satisfying personal interactions
- emotional regulation or recognizing and controlling your emotions
You can use these DBT skills in all aspects of your life, particularly those you may find more challenging.
Mindfulness is a foundational DBT skill that can help you better cope with stressors.
Mindfulness is about the intentional observance of the here and now. It helps you stay away from worrying about the past and the future.
In DBT, mindfulness skills help you discover who you are, what you want, and how you can control your emotions and mind.
There are two types of mindfulness DBT skills: the what and the how skills.
The what skills refer to the things you do to cope. These include:
- observing: seeing what happens without labeling it
- describing: putting in words what you observe
- participating: involving yourself
The how skills are about the way you do those things you do to cope. These include:
- non-judgmentally: challenging negative self-talk and thoughts
- one-mindfully: doing one thing at a time
- effectively: doing what actually works for you and not what you think is right
The goal of practicing mindfulness skills is to develop a “wise mind,” which is a balanced combination of emotion and reason.
Interpersonal effectiveness refers to a set of DBT skills that aim to help you establish and maintain healthy relationships with yourself and others. These skills teach you to speak up for your own needs, set boundaries, and respect yourself.
For example, saying no is an interpersonal effectiveness skill that helps you care for yourself and let other know what you really want.
Interpersonal effectiveness skills have three main goals:
- objective effectiveness: getting what you want
- connection effectiveness: improving and maintaining your relationships
- self-respect effectiveness: cultivating self-respect
Distress tolerance is another foundational DBT skill that helps you cope with painful situations. The idea is to use helpful coping mechanisms when you’re facing emotional pain.
Distress tolerance skills involve doing things that can help you stay away from intense pain so you can deal with it once you’re prepared.
For example, grounding techniques like taking a cold shower or engaging in intense physical activity are distress tolerance skills in DBT.
Radical acceptance is another DBT skill that can help you learn to tolerate distress.
Radical acceptance helps you move toward a place of acceptance of your situations, thoughts, and emotions that are unchangeable.
With this DBT skill, you notice and act intentionally to accept things as they are without trying to change them. Radical acceptance doesn’t mean you approve of the situation but rather that you accept it as it is so you can move on.
Emotional regulation, the fourth of the core DBT skills, teaches you how to gain control over your emotions rather than letting your emotions control you.
Emotion regulation skills involve:
- reality checking
- acceptance of emotions
- learning opposite actions of behaviors associated with specific emotions
In opposite action, for instance, you do the opposite of what your emotion tells you to do.
For example, if you feeling very sad and self-critical, your emotions may be telling you to lie down in a dark room. Opposite action would be getting out of the house, getting sunlight, and watching the sunset.
When you practice opposite action, you’re not letting your emotions have the reins. Instead, you’re cultivating awareness of your feelings (“I know how I feel”) and being intentional about taking an action that allows you to walk a different path.
Dialectical behavioral therapy is a psychotherapy approach that aims to help you cope with everyday and extraordinary challenges by developing specific skills.
The main DBT skills are mindfulness, interpersonal effectiveness, distress tolerance, and emotion regulation. Anyone can use these for any type of challenge.
If you find it difficult to form stable interpersonal relationships, stay in the here and now, or regulate your emotions, DBT skills may help get to a place of greater peace and acceptance.
For more information on DBT skills, you may want to consider these books:
- “DBT skills training handouts and worksheets” by Marsha Linehan, PhD.
- “DBT principles in action: Acceptance, change, and dialectics” by Charles R. Swenson
- “The dialectical behavior therapy skills workbook for anxiety: Breaking free from worry, panic, PTSD, and other anxiety symptoms” by Alexander L. Chapman, PhD.
If you’re looking for a therapist but aren’t sure where to start, Psych Central’s How to Find Mental Health Support resource can help.