What is Dialectical Behavior Therapy (DBT) and How Can It Help You?
Welcome to Your Crash Course in DBT!
Working through overwhelming emotions is challenging. Sometimes they can feel like a giant wave in a tsunami, or music blasting from a speaker at full volume with no way to turn it down—loud, intense, and seemingly impossible to control. Maybe you have coping skills that help sometimes, but not when your emotions feel like “too much.” If you’re looking for practical, evidence-based tools to manage intense emotions, Dialectical Behavior Therapy (DBT) might be exactly what you need.
What Is DBT?
Dialectical Behavior Therapy (DBT) was developed by psychologist Marsha Linehan in the 1970s, initially intended to help individuals with Borderline Personality Disorder. Over time, DBT has proven effective for a wide range of mental health challenges beyond its original purpose.
The term “dialectical” refers to the synthesis of two opposing ideas. DBT helps reduce black-and-white thinking by teaching people how to find the middle ground—or the “gray”—in emotional situations.
DBT is commonly used to treat:
Emotional dysregulation
Relationship issues
Suicidal thoughts
Self-harm
Substance use
DBT is beneficial for both adolescents and adults who experience intense emotions. It focuses on four core skill areas: Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness.
The Four Pillars of DBT: Core Skills That Build Emotional Resilience
1. Mindfulness: Staying Present in the Moment
Mindfulness is at the heart of DBT. It teaches us how to center ourselves in the present, rather than being overwhelmed by the past or anxious about the future.
DBT breaks mindfulness into three states of mind:
Emotion Mind – ruled by feelings and impulses
Reasonable Mind – ruled by logic and facts
Wise Mind – the balanced middle, integrating emotion and reason
How to Practice Mindfulness:
The “What” Skills:
Observe – Notice what’s happening internally and externally. What do you feel in your body? What do you see around you? Use your senses to observe things.
Describe – Put words and only facts to what you observe without assumptions or inferences.
Participate – Engage fully in the experience. We want to fully participate in the mindfulness activity, in your surroundings, and in yourself.
The “How” Skills:
Non-judgmentally – Let go of evaluations. Release all judgements, both negative and positive. This is something many people struggle with, however mindfulness helps us to recognize when they’re appropriate or helpful.
One-mindfully – Focus on one task or moment at a time. This is the opposite of multi-tasking.
Effectively – Do what works, not what “should” work. Trying to make yourself do a mindfulness activity that doesn’t work for you won’t help you.
Mindfulness Exercise:
Pick a small object nearby (like a pen, a rock, a piece of decor). Setting a timer for five minutes, observe it closely. Sit comfortably and take a few deep breaths. Describe its texture, temperature, and color. Practice observing, describing, and participating non-judgementally, one-mindfully, and effectively. If your mind wanders, that’s okay! Gently bring yourself back to the exercise. Once the exercise is over, you’ll likely have noticed some things about the object you’ve overlooked before.
2. Distress Tolerance: Managing Crisis Without Making It Worse
Distress tolerance skills help you handle intense emotions during crises without resorting to harmful behaviors. These tools help you:
Survive emotional storms without acting impulsively
Accept reality, even when it’s painful
Build emotional resilience
Sometimes the coping skills we typically use don’t work when we’re completely emotionally dysregulated. Have you ever felt extremely anxious and doing a breathing exercise didn’t feel enough for you? Using a crisis survival skill could be helpful in that situation.
Distress Tolerance Exercise: Try the TIPP Skills
TIPP helps change your body’s chemistry to calm down quickly:
T – Tip the Temperature: Splash cold water on your face or use a cold pack.
I – Intense Exercise: Move your body quickly—run, jump, or dance.
P – Paced Breathing: Inhale for 5 seconds, exhale for 7.
P – Paired Muscle Relaxation: Tense muscles on the inhale, release on the exhale.
3. Emotion Regulation: Understanding and Shaping Your Emotions
Emotion regulation helps you identify, understand, and manage your emotions—especially when they threaten to overwhelm you. It teaches how to:
Name emotions clearly
Reduce the intensity of painful emotions
Build emotional resilience and balance
Sometimes it’s difficult to put a name to the emotion we’re experiencing. And sometimes, we know exactly what we’re feeling and would rather feel something else in that moment for various reasons. Emotion regulation helps us change our emotional responses. It can also help us determine if our emotional responses fit the facts of a situation.
Emotion Regulation Exercise: Practice Opposite Action
Use this skill when your emotions don’t fit the facts or would lead to unhelpful actions.
Steps:
Identify the emotion you want to change.
Check the facts—does the emotion fit the situation? (Example: “irritation” fits the facts when someone cuts you off while driving, “road rage” does not.)
Describe the urges your emotion is prompting. What does the emotion make you want to do? (Example: If you’re sad, it might make you want to lie in bed all day.)
Ask Wise Mind: Will acting on this emotion help or hurt?
Choose the opposite behavior. (Example: the opposite of lying in bed all day is getting up and going outside for a walk.)
Act opposite all the way (Example: sitting up in bed is not fully the opposite of lying in it.)
Repeat until your emotion shifts.
4. Interpersonal Effectiveness: Building Stronger Relationships
These skills help you navigate relationships, communicate assertively, and set healthy boundaries. Goals include:
Getting your needs met
Maintaining and improving relationships
Ending unhealthy dynamics
Walking the middle path in interactions
Sometimes it can be difficult to set boundaries, negotiate with people who have authority over us, and express our feelings without impacting relationships. These skills help us improve our social skills, be more assertive, and be better listeners. If you have a hard time saying “no” to people, these are good skills for you to learn.
Interpersonal Effectiveness Exercise: Try the GIVE Skill
Use GIVE to communicate effectively while preserving relationships:
G – Be Gentle: No threats, attacks, judging, sneering, blame or criticism.
I – Act Interested: Show you’re listening and engaged. This includes facing them, letting them finish speaking, and being patient if they wish to discuss the matter at a different time.
V – Validate: Acknowledge the other person’s feelings. Use both words and actions to validate who you’re speaking to. This shows you understand them.
E – Use an Easy Manner: Stay light, open, and approachable. This could be adding some humor into the conversation, smiling, and being lighthearted. We want to leave our attitude at the door.
Is DBT Right for You?
DBT is a flexible, evidence-based therapy that can be adapted to your needs—whether in structured treatment or as part of a DBT-informed approach. If you struggle with emotional outbursts, unhealthy coping mechanisms, or relationship stress, DBT may be a powerful tool to help you move forward.
Whether you're working with a therapist or exploring tools on your own, DBT offers practical, empowering strategies to build a more balanced emotional life.
