Dialectical Behavior Therapy
Dialectical Behavior Therapy (DBT) teaches powerful skills for managing intense emotions, improving relationships, and building a life worth living.
What Is Dialectical Behavior Therapy?
Dialectical Behavior Therapy (DBT) was developed by Dr. Marsha Linehan to help people who experience emotions with extraordinary intensity. The word "dialectical" refers to its core philosophy: holding two truths at once. You can accept yourself as you are right now while also working to change. DBT draws from cognitive behavioral therapy, Zen mindfulness, and dialectical philosophy to create something uniquely equipped for people whose emotional world often feels overwhelming.
While originally designed for borderline personality disorder, decades of research have shown DBT is effective for depression, eating disorders, substance use, PTSD, and emotional dysregulation of all kinds. At Restored Family Counseling, our therapists incorporate DBT skills for clients who struggle with intense emotions, impulsive behaviors, or difficulty navigating relationships. DBT isn't about eliminating difficult emotions. It's about building a life that feels meaningful and connected, even in the presence of pain.
How Dialectical Behavior Therapy Works
DBT is organized around four core skill modules. Mindfulness teaches you to observe your thoughts and emotions without judgment, creating space between feeling and reacting. Distress Tolerance gives you concrete tools to survive emotional crises without making them worse, providing alternatives to the impulsive actions (substance use, lashing out, shutting down) that often compound the original pain.
Emotion Regulation helps you understand the function of your emotions, reduce vulnerability to intense episodes, and increase your capacity for positive experiences. Interpersonal Effectiveness teaches you to ask for what you need, say no without guilt, and balance competing demands in relationships.
Your therapist will tailor these skills to your specific life situations, helping you understand not just what the skills are but when and how to use them. DBT also uses chain analysis (a detailed look at the events, thoughts, and emotions that led to a problematic outcome) to identify where a different skill could have changed the trajectory. Over time, these tools become second nature.
What Dialectical Behavior Therapy Can Help With
Borderline personality disorder (BPD)
Chronic emotional dysregulation and mood swings
Self-harming behaviors and suicidal ideation
Impulsive and self-destructive behavior patterns
Intense and unstable relationships
Eating disorders including binge eating and bulimia
Substance use and addictive behaviors
Post-traumatic stress disorder (PTSD)
Chronic feelings of emptiness or identity confusion
Difficulty managing anger or rage
Is Dialectical Behavior Therapy Right for You?
DBT is especially well-suited if you experience emotions with high intensity and find that your reactions often feel disproportionate, hard to control, or slow to settle. If you've been told you're "too sensitive" or "too emotional," DBT offers a different perspective: your emotions aren't the problem. You just haven't been given the skills to manage them yet.
DBT is also a strong fit if you struggle with impulsive behaviors that create recurring problems, whether involving substances, spending, self-harm, or explosive anger. It's particularly effective if relationships are a significant source of distress, if you cycle between intense closeness and painful conflict, or find it hard to communicate your needs. You don't need a diagnosis of BPD to benefit. If you feel emotions deeply and want to learn how to honor that sensitivity while building greater stability, DBT may be what you've been looking for.
What to Expect in Sessions
Your therapist will start with a thorough assessment of your difficulties, history, and goals, then determine which DBT skills will be most immediately useful. Together you'll set clear, collaborative goals and establish a shared understanding of the work ahead. Your therapist will balance warmth and validation with a clear push toward change.
In sessions, you'll learn and practice the four skill modules through explanation, demonstration, and guided practice applied to real situations from your life. Between sessions, you may track your emotional experiences using a diary card and practice specific skills. This between-session practice is essential because DBT skills are most powerful when they become automatic, available to you in moments of crisis.
A typical course of DBT skill training unfolds over several months, with some clients finding 16 to 24 sessions provides the foundation they need. Others with more complex difficulties benefit from longer treatment. Many clients describe a transformative shift, from feeling at the mercy of their emotions to experiencing a grounded sense of agency and choice.
Frequently Asked Questions
Related Approaches
Explore other therapeutic modalities that complement Dialectical Behavior Therapy.
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