DBT in Brief

I went to the woods because I wished to live deliberately
— Henry David Thoreau


DBT teaches skills that help us achieve a life worth living.  Using skills allows us to change our behavior and be more effective in our lives.  It has four modules:  Mindfulness, Interpersonal Effectiveness, Emotion Regulation and Distress Tolerance.

By Karin Gillard

DBT Modules

  • Mindfulness nudges us to be more present in our lives.  It awakens us from our automatic behaviors and choices; we become more deliberate in our lives and the interactions we have with others.
  •  Interpersonal Effectiveness guides us in obtaining new relationships, improving current relationships and ending destructive relationships.  
  • Emotion Regulation teaches us about emotions, coping with emotions and ultimately changing unwanted emotions.  
  • Distress Tolerance skills focus on coping with intolerable emotions, thoughts, and situations.  These skills together provide a path to a life worth living.  

What is Dialectical?

Linehan believed that introducing a dialectical philosophy would help patients to succeed in therapy.  Often, we think in extremes which cause suffering.  The dialectic is the idea that two opposing ideas come together and create a new idea.  We do not need to think or act in extremes.  We can find new paths when we feel trapped.  We can challenge our extremes in the thinking that causes suffering.  The dialectic provides a way through our urges to act ineffectively.  We are never trapped.  We can find new paths to freedom.

Acceptance and Change

Accepting ourselves is the first task in DBT.  We have done our best with all our life experiences up to this point and time.  We did not approach our lives to be deliberately ineffective or to be unhappy.  We made choices in the hopes that they would bring change and happiness to us, even if misguided.  We are the collection of all these choices, decisions, behaviors and we need to accept that we arrived at the present having done our best.  Acceptance of ourselves and our past is not only the most accurate choice, but pragmatically helps us.  Acceptance of ourselves reduces suffering. 

Our second task is to change.  Acceptance and change are a dialectic – the primary dialectic in DBT.  If we accept ourselves for who we are, then why do we need to change?  We accept ourselves as a springboard into a new life by enacting changes.  This is the starting point that with skillful behavior we can change and obtain a life worth living.  The reality is that acceptance is not enough to feel better, we need to do things differently to cope with and reduce our suffering.  In the past, we have tried to change but were ineffective by grabbing onto behaviors that did not work.  DBT provides skills that are effective and more useful than the destructive and ineffective behaviors that we have previously relied on.  DBT skills have been used for 30 years and have a proven track record.  With hard work and perseverance, they can be life altering and provide a way through suffering

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