Dialectical Behaviour Therapy (DBT) was developed by Marsha Linehan in the late 1980s. Along with Acceptance and Commitment Therapy (ACT), it is considered a “third wave” Cognitive Behaviour Therapy (CBT) because it blends the insights of mindfulness with the theory of CBT.
DBT is a highly effective form of therapy for people dealing with overwhelming emotions, attachment difficulties, suicidality, self-harm, or Borderline Personality Disorder (BPD). It has four main parts: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
1. Mindfulness. The simplest definition of mindfulness is given by Jon Kabat-Zinn, who says that mindfulness is the capacity to pay attention, non-judgmentally, to what’s happening in the present moment. This is much easier said than done, but it is a skill that forms the foundation of DBT.
2. Distress tolerance. Distress tolerance flows out of mindfulness, and it basically means the ability to accept and bear painful situations, thoughts, or feelings that cannot be changed. Sometimes being a human is just painful, so DBT teaches skills about how to respond wisely to suffering rather than reacting compulsively and making it worse.
3. Emotion regulation. Regulating emotions means learning ways to make your inner world less of a roller coaster. Being able to name and express feelings is a very helpful skill in itself, along with skills for how to respond to feelings with self-soothing or appropriate action. General self-care is also an important part of emotion regulation, since living a balanced and healthy life makes us less susceptible to extremes.
4. Interpersonal effectiveness. Interpersonal effectiveness means being able to live harmoniously with other people. It includes being able to express emotions, to ask for what you need, to say no, and to set boundaries with people to protect yourself from being worn out. Building communication skills is the most important part of developing interpersonal effectiveness.