Dialectical Behaviour Therapy (DBT)
Dialectical Behaviour Therapy (DBT) is a form of talking therapy that is particularly helpful for people who experience emotions very intensely and/or have rigid ways of thinking.
It grew out of Cognitive Behavioural Therapy (CBT), which focuses on how our thoughts, feelings, and behaviours influence one another. DBT places more emphasis on emotional regulation, distress tolerance, and relationships.
The word dialectical refers to holding two seemingly opposite ideas at the same time. In DBT, this involves learning how to accept yourself and your experiences as they are, while also working towards change, particularly around patterns or behaviours that are no longer helping.
Background and development
DBT was developed in the 1970s by psychologist Marsha Linehan. It draws on both clinical research and her own lived experience of significant emotional distress and psychiatric hospitalisations.
While DBT is well known for its use with people diagnosed with Borderline Personality Disorder, it can also be helpful for a wide range of difficulties, including rigid thinking patterns, difficulties in relationships, and intense emotional responses.
Skills and application
DBT teaches practical skills that can support people when emotions feel overwhelming.
This can include learning how to tolerate distress without making things worse, and how to manage urges to self-harm. Many people find these skills useful not only in crisis moments, but also in everyday situations.
A key part of DBT is learning to find a middle ground, rather than moving between extremes. Developing the capacity to sit with distress, rather than reacting impulsively or shutting down, can make difficult situations easier to move through and can support change over time.