Dialectical Behaviour Therapy (DBT) is a form of psychotherapy that was originally developed to help people with borderline personality disorder and emotional dysregulation. However, its use has broadened to encompass a range of other mental health issues, such as depression, addiction, and eating disorders.
DBT therapy is considered to be effective for helping people with tendencies to self-harm or who may be at risk of suicide. It was created by Marsha Linehan in the late 1980s as a method of treating patients who were experiencing persistent suicidal thoughts.
The term ‘dialectic’ refers to two opposing facts or situations that can both be true at the same time. When applied to the context of DBT, this means focusing equally on accepting a situation and acknowledging the need for change.
This may seem to be contradictory at first glance, but a skilled therapist will be able to help the patient work out a balance between the two opposing needs of acceptance and change, and find a way forward. This allows for a situation that tends not to be static, but fluctuates and evolves over time, and acknowledges that real life is often complex and confusing.
A typical DBT session may involve elements of mindfulness, which helps people to focus on the here and now rather than letting their minds linger on past experiences or worry about the future. It enables an individual to simply be present in the moment without judgement, by becoming aware of their breathing and sensory experience of their surroundings.
A core element of DBT involves distress tolerance, which helps the patient find a way to tolerate a distressing emotion or stressful situation without attempting to fight it, change it, or escape and hide from it. This can reprogramme the brain to act in more constructive ways when faced with a triggering situation, rather than resorting to unhelpful behaviour.
DBT also works with the patient to develop strategies for emotional regulation, which helps them to deal with or reframe difficult emotions. This may be through uncovering and understanding the reasons for these emotions, working to become less sensitive or vulnerable to the emotions, and emphasising positive emotional experiences.
Finally, DBT typically aims to equip people with the interpersonal skills to be assertive and respect their own needs while building healthier relationships with others.
As you have probably now realised, DBT can be a complex and demanding process, and it’s crucial that you spend some time choosing the right therapist. Look for a practitioner who is registered with the UK Council for Psychotherapy (UKCP), and has specific DBT qualifications.
The therapist should have extensive experience at delivering DBT, and their areas of expertise should resonate with your particular issues, whether that’s self-harm, eating disorders, addiction, or other mental health challenges.
Ask the therapist questions about how the therapy is delivered, such as remotely, one-to-one, or in groups, and how long the average course of therapy is. Finally, it’s important that you feel comfortable in their presence and that you can be open and honest with them without fear of judgement.