Dialectical Behavioural Therapy (DBT) is an evidence-based therapy that's been shown to provide excellent outcomes for lots of mental health concerns. Originally developed for the treatment of borderline personality disorder, DBT now has evidence that shows it's effective for any condition that results in difficulty regulating emotions & behaviours.

Here are 10 ways DBT could benefit you...

1. Emotion Regulation

Traditional cognitive behavioural therapy (CBT) is one of the most common therapies practiced, & chances are if you've had therapy before, you've done some CBT. CBT can be very effective for the treatment of anxiety & some other mental health conditions, however, for some people, the focus on thoughts & perceptions only goes so far. Some people can get very skilful at identifying problematic thoughts & beliefs, but it still doesn't change how they feel.

DBT goes a few steps further than traditional CBT, in that emotion regulation skills are at the core of the therapy. We still cover traditional CBT concepts, such as the role of thoughts & how they interact with emotions- but we go even further.

Emotion regulation skills are actually mostly emotion acceptance skills. We try to build our acceptance of emotions, whilst changing our relationship with those emotions- particularly the uncomfortable ones. In DBT we learn to observe & describe our emotions- without judgement. This allows us to choose how we want to respond, rather than engaging in a automatic reaction.

2. Balancing Acceptance & Change

Many western psychological therapies focus heavily on change. In other words, we identify some problem in our lives, & try to change it or ourselves to feel better.

In DBT, we recognise that there are some things that need to change. It may be that we need to learn new skills to stop problem behaviours, & create the quality of life that we want. However, if we only focus on change we are likely to encounter a problem... there are some things in life we can't change (a lot actually)! If we are only focused on change, what do we then do with all that stuff we don't like but can't change today? We might even notice how this adds to our frustration & stress when we keep trying to change what we can't.

The answer is acceptance. Acceptance skills are a core part of DBT, & we recognise that in some areas we need to push for change- but in other areas we need to try to accept. Acceptance skills are widely acknowledged in eastern philosophies as key to emotional growth & inner peace.

So in DBT, we are always looking towards balancing acceptance & change... & building wisdom to know what to apply where.

3. Practical Skills

DBT is a skills based therapy, which means we acknowledge that to change & accept more in our lives, we need to learn & practice new skills. Nothing changes if we don't change our actions!

DBT teaches specific skills in how to get through times of very high distress. We often need to learn what to do to help our body chemistry first, in order to be able to get through times of very high distress.

It's well known that our brains function differently when we are highly distressed, so we have to address the brain issue at a body level...then we can apply more sophisticated psychological skills as we start to calm down. But if we don't learn how to change our body chemistry, we will continue to struggle to get through high distress.

4. Strong Therapeutic Relationship

Research shows conclusively that the best predictor of improvement through therapy is a good relationship with your therapist. DBT recognises the importance of this relationship, & focuses on establishing & keeping a strong therapeutic relationship- even if therapy gets tough some times.

Many clients I see have had difficult or traumatic interactions with people in the past, so forming a relationship with a therapist can feel really scary. In DBT, the therapist aims to have 'unconditional positive regard' for the client. That doesn't mean I agree with everything my clients do! But I aim to fully understand why they do these things, so we can move towards acceptance or change in those areas, without judgment.

5. Phone Coaching

DBT is unique in that it offers phone coaching between sessions for clients & their therapist. The client can contact their therapist for brief, skills focused assistance (usually via sms, but can be phone calls too).

Phone coaching is encouraged when a client is struggling with an episode of high distress, but wants to try to use skills to get through it without engaging in problem behaviours. Sometimes a client might have already tried some skills, but feels they're not helping. Or they might have forgotten what skills they could try. In these situations, it's extremely helpful to be able to text your therapist & they can give you some ideas for skills to try.

Phone coaching acknowledges that it's the application of skills in real-life, crisis situations that is often most difficult to do. For people who use phone coaching, they generally find it very helpful in creating real change in their patterns of behaviour.

6. Mindfulness as a Core Skill

Mindfulness is a term that is being talked about in many different contexts lately, & it means different things to different people. I like to define mindfulness as paying attention in the present moment, with awareness, & without judgement.

This attitude of mindfulness underpins everything we do in DBT, & we aim to bring mindfulness to all the skills as we learn & practice them.

Building awareness of thoughts, emotions & physical sensations is vital in order to consider how we want to respond to them. If we're not aware of what our thought, emotions or body is doing, we have no chance to change our patterns of response & reaction.

Non-judgment is certainly the more difficult part of mindfulness practice, however it is often where true healing starts to happen. In DBT we draw attention to how often & easily we make judgements- about ourselves & others- & how this can create rigid patterns of thinking that keep us stuck in harmful patterns.

By learning how to bring a non-judgemental attitude to our daily lives, we create space for greater acceptance of ourselves & others.

7. Validation

DBT is a very validating therapy. We explore how there are always reasons why we do things- even if we feel like we don't know what those reasons are!

Sometimes emotional patterns can feel confusing, or we feel our emotions get triggered for no reason. In DBT, we build awareness to how our emotions work, & come to realise there is always a trigger for an emotion- we just need to know what to look for. When we can understand the concept that our emotions always have a reason, we can be more validating & accepting of our emotions- even if they are distressing at the time.

Learning to validate our emotional experiences leads to significant improvements in how we feel about ourselves & our experiences.

8. Evidence Base

DBT has a strong evidence base behind it. It has been studied thoroughly in a multitude of research settings, & has been shown to be very effective for the treatment of borderline personality disorder, drug & alcohol addiction, eating disorders & mood disorders.

Evidence is important when deciding to embark on therapy. You want to know that independent research shows the therapy works & that is has a strong scientific & ethical basis.

9. You Don't Have to be 100% Committed to Change

Many people come to DBT with mixed feelings about change. They may recognise that change is needed, in that their lives have become unmanageable. However, they may be reluctant to let go of certain behaviours that, although have negative consequences, they feel help them cope with daily life & times of stress.

This ambivalence about change is accepted as a common & understandable starting point. DBT does not insist that someone has full commitment to change- but asks that they be willing to explore different possibilities, including what the trade-off might be between change vs non-change.

10. A Different Approach

I commonly see clients who have tried lots of different psychological treatments & therapies in the past, but none have really helped creating lasting & meaningful change. Most of them do very well in DBT.

DBT is a different form of therapy which blends concepts from western & eastern psychologies to provide a different approach.

If you have tried other treatments, but are still not where you want to be in your life, give DBT a go!

Alex.