By Ho Shee Wai

Director / Registered Psychologist

Imagine navigating life’s emotional storms with the confidence of a seasoned sailor, equipped with the skills to ride the waves rather than be capsized by them. Dialectical Behaviour Therapy (DBT) offers just that — a transformative approach that empowers individuals to master their emotions, build healthier relationships, and embrace life’s challenges with resilience.

What is Dialectical Behaviour Therapy (DBT)

Dialectical Behaviour Therapy is an evidence-based treatment developed by Dr. Marsha Linehan. DBT is used mainly for treatment of borderline personality disorder (BPD), which is characterized by suicidal behavior. Along with treatment of BPD, it has also been used to treat other disorders such as eating and substance abuse disorders. DBT uses strategies that improve coping and regulation of emotion, and mindfulness skills. The significance of DBT is that it is the only treatment shown to be effective in reducing suicidal behavior.

In Dialectical Behavior Therapy (DBT), the dialectical philosophy of balancing opposites is central to its therapeutic approach. Here’s how the concept plays out in DBT:

Acceptance and Change:

DBT emphasizes the need to accept one’s current situation and emotions while also striving for change. This dual focus recognizes that individuals can simultaneously accept themselves as they are and work toward becoming the person they want to be.

Mindfulness and Emotion Regulation:

DBT teaches mindfulness skills to help individuals be present and fully aware of their thoughts and feelings without judgment. This acceptance helps them better regulate emotions and make conscious choices in response to their experiences.

Interpersonal Effectiveness:

In relationships, DBT promotes balancing assertiveness (standing up for oneself) and empathy (understanding others’ perspectives). This balance helps individuals navigate interpersonal conflicts more effectively.

Distress Tolerance:

DBT includes skills for tolerating distressing situations without resorting to harmful behaviors. This approach encourages individuals to accept the pain of their current experience while also developing strategies to manage and change their responses.

Overall, the dialectical approach in DBT fosters a more nuanced understanding of emotions and behaviors, helping individuals integrate oppositional feelings and perspectives for greater emotional resilience and well-being.

Who Can Benefit from DBT?

1. Borderline Personality Disorder (BPD):

DBT was originally designed for individuals with BPD, a condition characterized by intense emotional instability, impulsive behavior, and difficulties in relationships. DBT helps by teaching skills for emotional regulation, interpersonal effectiveness, distress tolerance, and mindfulness, enabling individuals to manage their symptoms more effectively.

2. Anxiety Disorders:

People with anxiety disorders can benefit from DBT’s mindfulness and distress tolerance skills. These tools help individuals recognize and manage anxiety-provoking situations, reducing overall anxiety and enhancing coping strategies.

3. Depression:

DBT can be effective for those struggling with depression, particularly when combined with emotional dysregulation. The skills taught in DBT help individuals identify negative thought patterns and develop healthier coping mechanisms, fostering a greater sense of control over their emotions.

4. Post-Traumatic Stress Disorder (PTSD):

Individuals with PTSD often experience intense emotions and flashbacks. DBT can help them manage these symptoms through mindfulness practices and distress tolerance techniques, allowing for safer emotional processing and integration of traumatic experiences.

5. Substance Use Disorders:

DBT can aid individuals struggling with substance use by addressing underlying emotional issues and teaching skills for managing urges and cravings. The focus on acceptance and change supports recovery efforts.

6. Eating Disorders:

DBT is also beneficial for those with eating disorders, as it helps individuals regulate emotions and develop healthier coping strategies related to food and body image.

Real-Life Applications

Other than those with mental health challenges, DBT is effective with daily struggles that everyone faces in their lives.

1. Relationship Issues:

DBT equips individuals with interpersonal effectiveness skills, which are crucial for navigating complex relationships. This includes learning to communicate needs assertively, set boundaries, and empathize with others, leading to healthier, more stable relationships.

2. Emotional Dysregulation:

Many people face challenges in managing their emotions. DBT provides practical tools to help individuals recognize emotional triggers and employ skills like mindfulness to stay grounded. This leads to improved emotional responses and a decrease in impulsivity.

3. Self-Harm:

DBT directly addresses self-harm behaviors by teaching distress tolerance skills and alternative coping mechanisms. This helps individuals find healthier ways to manage emotional pain and reduce the likelihood of turning to self-injury.

4. Coping with Life Transitions:

Life changes—such as job loss, relationship breakups, or health crises—can be overwhelming. DBT’s emphasis on mindfulness and acceptance helps individuals navigate these transitions by fostering resilience and adaptive coping strategies.

5. Managing Stress:

DBT’s skills can help individuals develop better stress management techniques, allowing them to respond to stressors more effectively rather than reacting impulsively or becoming overwhelmed.

6. Enhancing Overall Quality of Life:

By integrating the skills learned in DBT, individuals can improve their overall emotional health and well-being. They gain a greater sense of control over their lives, leading to improved relationships, enhanced self-esteem, and a more fulfilling life experience.

What does a DBT session looks like?

A typical Dialectical Behavior Therapy (DBT) session can vary depending on your psychologist, counsellor, and psychotherapist and the specific focus of the session. However, there are common elements that characterize most DBT sessions. Here’s an overview:

Structure of a DBT Session

1. Check-In

At the beginning of a session, your psychologist, counsellor, and psychotherapist usually starts with a check-in. This is a time for clients to share updates on their emotional state, significant events since the last session, and any challenges they faced. This helps your psychologist, counsellor, or psychotherapist understand the client’s current situation and emotional context.

2. Review of Homework

DBT often involves assigning homework or practice tasks based on the skills learned in previous sessions. During this segment, clients discuss their experiences with these assignments, what worked, what didn’t, and any insights gained. This reinforces learning and encourages skill application in real-life situations.

3. Teaching New Skills

A key component of DBT sessions is the introduction of new skills. The psychologist, counsellor, or psychotherapist may present concepts from the four main modules of DBT.

1. Mindfulness: Skills to enhance present-moment awareness and acceptance.

2. Distress Tolerance: Techniques for managing crisis situations without resorting to harmful behaviors.

3. Emotion Regulation: Strategies for understanding and managing intense emotions.

4. Interpersonal Effectiveness: Skills for improving communication and relationship management.

Your psychologist, counsellor, or psychotherapist explains the new skills and provides examples or role-playing opportunities for practice.

4. Application of Skills

After introducing new skills, your psychologist, counsellor, or psychotherapist may engage the client in discussions about how to apply these skills to specific situations they are facing. This might involve problem-solving exercises or role-playing scenarios to practice the skills in a supportive environment.

5. Reviewing Crisis Situations

Your psychologist, counsellor, or psychotherapist and client may explore any crises or emotional challenges that arose since the last session. Your psychologist, counsellor, or psychotherapist helps the client analyze these situations, reflecting on what skills were used (or not used) and how they can approach similar situations in the future.

6. Setting Goals

Towards the end of the session, your psychologist, counsellor, or psychotherapist and client may set specific goals for the upcoming week. This could involve practicing particular skills, applying techniques to real-life situations, or addressing specific challenges.

7. Closure

The session typically ends with a brief summary of key points discussed and a reminder of the homework. Your psychologist, counsellor, or psychotherapist may also ask how the client feels about the session, reinforcing the importance of self-reflection and emotional awareness.

Overall, a DBT session is highly structured yet flexible, emphasizing skill development, emotional awareness, and practical application. The collaborative relationship between your psychologist, counsellor, or psychotherapist and client is crucial, as it creates a safe space for learning and growth. This combination of theory, practice, and personal reflection helps individuals develop the tools they need to navigate their emotional challenges more effectively. Book in a session with a DBT trained therapist in our team now.