What Is DBT, and Who Does It Actually Help?

Dialectical Behavior Therapy grew out of cognitive behavioral therapy and was developed by Dr. Marsha Linehan. The word dialectical points to its central idea: two things that seem opposed can both be true. You can be doing your best, and still need to change something.

That balance of acceptance and change is why DBT translates so well beyond its original use, into everyday anxiety, depression, grief, and relationship stress.

The four skill areas

• Mindfulness: noticing what is happening inside you without immediately judging or fixing it.
• Distress tolerance: getting through an intense moment without making it worse.
• Emotion regulation: understanding what your emotions are asking for and lowering your vulnerability to overwhelm.
• Interpersonal effectiveness: asking for what you need and saying no while keeping the relationship intact.

Who tends to benefit

I often use DBT skills with clients who describe themselves as feeling everything intensely: people whose anger arrives before their words do, who spiral after conflict, who cannot come down after a hard day, or who swing between shutting down and lashing out.

DBT is not about muting feeling. Emotions carry information. The goal is to hear the information without the wave knocking you over.

Practicing skills in Encinitas

In sessions in Encinitas, we practice these skills against the real details of your week (the commute, the coworker, the text thread, the 2 a.m. thoughts) so they are available when you actually need them.