Dialectical behavior therapy (DBT) has become a powerful tool in the therapy field, especially for those struggling with emotional regulation and interpersonal relationships. First introduced and developed in the 1970s, it has long become a staple in many practices, such as addiction and recovery work, mental health practices, and more.

Read on to discover more about DBT, explore its main skills, and learn how to apply its basic techniques into your daily life.

What Is DBT (Dialectical Behavior Therapy)?

Dialectical behavior therapy (DBT) is a cognitive-behavioral treatment developed by American psychologist Dr. Marsha Linehan [1] in the late 1970s. It was originally designed to help individuals with borderline personality disorder (BPD), but has since expanded to address various mental health conditions. DBT combines cognitive-behavioral techniques with principles of mindfulness and acceptance to help people navigate and manage emotions while improving their interpersonal effectiveness.

Dialectical behavior therapy derives from the concept of dialectics, which focuses on discussing the truth and balancing opposing forces. It focuses on teaching four different core skills: mindfulness, acceptance and distress tolerance, emotional regulation, and interpersonal effectiveness. The goal of dialectical behavior therapy is to help individuals find happiness within their life and use its core tenets as guiding principles to stay grounded and happy.

What Is DBT Used For?

Although originally intended to help those who have borderline personality disorder, it has since been widely applied to many populations and individuals. Individuals who have the following struggles could benefit from learning the DBT skills:

• Depression
• Anxiety disorders
• Eating disorders
• Substance abuse
• PTSD
• Anger management

DBT is intended for helping individuals who experience emotional dysregulation, self-destructive behaviors, and chronic feelings of emptiness or instability. It is not recommended for individuals with intellectual disabilities or psychotic disorders.

What Are the 4 DBT Skills?: Listed

The DBT skills are considered practical tools to help individuals manage emotions, improve relationships, and have healthier coping habits to stress. They are the basic tenets of dialectical behavior therapy. 

Let’s go more in-depth into the four DBT skills. Read on to learn more.

1. Mindfulness

Mindfulness is all about staying grounded. To do this, an individual must pay full attention to the present moment at hand, without any judgment. This involves observing thoughts and emotions as well. Mindfulness can help people respond to situations more effectively and logically, rather than from a place of reactive impulsivity.

When trying to learn and practice the DBT skill of mindfulness, there are a couple of different exercises to get started on. For example:

• Mindful breathing, where you count your breaths and breathe deeply
• “Breathing colors,” where you inhale and think of one color, then exhale and think of a different one
• Practicing compassion for others by meditating and wishing others love and peace
• Mindful movement, such as focusing on your muscles working in tandem when you are exercising
• Mindful eating, such as recognizing the texture, smell, and color of the food you are eating

2. Interpersonal Effectiveness

The second core DBT skill is interpersonal effectiveness. Unlike the introspection of mindfulness, interpersonal effectiveness focuses on relationships and considering those around you. With interpersonal effectiveness, individuals will be able to begin establishing boundaries, expressing needs and desires, act with assertiveness, and exhibit active listening.

The following is a breakdown of interpersonal effectiveness skills:

• Communication Styles. Focus on identifying personal communication styles for mindful interaction.
• Skills of Assertiveness. Teach how to express opinions, emotions, and needs clearly, honestly, and respectfully.
• Listening and Validation. Emphasize attentive and mindful listening skills.
• Barriers to Interpersonal Effectiveness. Address common obstacles in effective communication.
• Trust in Relationships. Explore building trust and honesty in relationships.
• Interpersonal Boundaries. Discuss awareness of boundaries for productive outcomes.
• Modulating Intensity. Navigate making requests assertively.
• Resistance and Conflict. Master effective communication in challenging situations.

3. Distress Tolerance

This DBT skill helps individuals cope with difficult situations without the need for self-destructive behaviors. This skill is particularly important to manage emotional pain and stress. An example of distress tolerance is using distraction techniques, such as going for a walk, to temporarily divert attention from a distressing emotion. ONce the distraction is over, an individual is usually in a calmer place.

• Example: One example of distress tolerance in action is practicing the “STOP” skill. To do this skill, you must:

• Stop whatever you’re doing.

• Take a step back from the emotions in an effort to widen perspective and see the whole picture, not just your current emotions.

• Observe your body and the physical sensations in it.

• Proceed mindfully after you have acknowledged and noticed your emotions and your body. After doing so you can continue on with the situation at hand if you feel you have the capacity to do so.

4. Emotion Regulation

This DBT skill helps individuals manage intense emotions in a healthier way. Emotion regulation focuses on understanding, labeling, and accepting emotions without letting them spiral out of control. This skill reduces emotional vulnerability and helps individuals navigate difficult situations with greater emotional balance. An example of emotion regulation is practicing mindfulness to stay present and avoid emotional overwhelm.

Example: One example of emotion regulation is using the “PLEASE” skill, which involves:

• Physically treating illness or discomfort.
• Leading a balanced lifestyle with adequate sleep, diet, and exercise.
• Eating healthily to support emotional well-being.
• Avoiding mood-altering substances.
• Sleeping well.
• Exercising regularly.

What Are the Core DBT SKills Used For?  

Each skill is used for a different purpose. For example:

• Mindfulness is meant to help individuals be aware and focused on the present moment, keeping them grounded.

• Interpersonal Effectiveness is to improve communication and relationship-building.

• Distress Tolerance helps folks learn how to survive crises without making them worse.

• Emotional Regulation is focused on helping people understand where intense emotions come from and how to deal with them.

DBT Therapy Techniques

Techniques are multifaceted and include different things. DBT can be included in individual therapy, group therapy, or even phone coaching. Each aspect of DBT is meant to work together to support the development and application of DBT skills in everyday life.

DBT for Depression

In the context of depression, DBT appears to work similarly to other methods of therapy for depression. However, in one study [2], a clinician saw that DBT significantly improved depression symptoms in individuals compared to psychoeducation.

DBT for BPD

Originally developed for BPD, dialectical behavior therapy has a longstanding history of helping individuals who have borderline personality disorder. As a matter of fact, it is currently the only technique that is empirically supported [3] in BPD treatment.

How to Learn DBT Skills

DBT skills are typically learned by speaking to a licensed therapist and attending therapy over the course of months to years. However, there are different ways to begin incorporating the DBT principles into your daily life.

1. Understand Examples of DBT Skills

To learn the DBT skills, you must understand what they mean. In order to do so, it is easiest to hear or think of examples of each skill. For instance, reading about the distress tolerance skill and then thinking about a scenario in which it was employed could help you model your own actions after the scenario.

2. Go to Therapy

One of the best ways to learn DBT skills is to go to therapy. Many therapists are specifically trained and certified in helping indivdual’s learn about DBT skills.

3. Download a DBT Skills Cheat Sheet

Last but not least, download a DBT skills cheat sheet. This is a great starting point to familiarize yourself with the skills of mindfulness, interpersonal effectiveness, distress tolerance, and emotional regulation.

Get DBT Treatment for Drug & Alcohol Addiction at Gratitude Lodge

At Gratitude Lodge, we are fully committed to offering you all the resources available so you can begin your recovery journey in the best way possible. Part of those resources are having DBT-trained therapists as part of our staff. When you come to Gratitude Lodge, you’ll have access to all kinds of treatment modalities; from medication to talk therapy, we consider who you are as a person to administer the care you need—not just what you are addicted to.

Along with renowned treatments and therapies, Gratitude Lodge is hailed as one of the best addiction treatment centers in California. From our luxurious facilities and amenities to our compassionate staff, your stay at Gratitude Lodge will help you begin a sustainable recovery. Many of our own staff and founders are in recovery themselves, which means you’ll always be in an environment where you are treated with true understanding.

In addition to DBT therapy, we offer the following personalized treatments:

• Talk therapies
• Motivational therapies
• Counseling
• Family therapy
• MAT (medication-assisted treatment)
• Group therapy
• Holistic treatments
• Aftercare

Get started on your recovery journey by calling 844.576.0144.

Sources

[1] https://my.clevelandclinic.org/health/treatments/22838-dialectical-behavior-therapy-dbt

[2] https://www.ncbi.nlm.nih.gov/books/NBK525629/#sec1_3

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007584/