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  • Monika La Nuez, LCSW

What is DBT and How Does it Work?

Perhaps you are looking into therapy and wondering what kind of therapy you would like to try. You’ve possibly heard about DBT here and there and have wondered about what this particular type of therapy is all about. As a DBT therapist, I have seen how the use of DBT has helped clients heal, grow, and flourish. I’d like to share some more info today about DBT and how it may be helpful toward your own healing and therapy goals.


DBT (Dialectical Behavior Therapy) is a type of psychotherapy that encourages the use of skills in several important areas in order to approach crises more effectively and gain relief from strong and difficult emotions. Skills are divided into the four following modules:


Mindfulness Skills: DBT encourages the use of mindfulness as a way of building awareness of our thoughts, feelings, surroundings, and physical sensations. In order to be able to start resolving some of our challenges and struggles, we must first be able to become aware of, observe, and label the obstacles that are getting in the way of our happiness. Mindfulness skills also help us to stay in the present moment. Often, clients share that their thoughts are focused on the past or the future, robbing them of the ability to enjoy or appreciate their lives in the present moment. Mindfulness skills can also help to achieve a sense of increased calm, perspective, and balance. For more information, check out these posts about the benefits of mindfulness and some creative ways to be mindful.


Distress Tolerance Skills: Distress tolerance skills are skills that are designed to help handle crisis situations more effectively, without making these situations worse. Distress tolerance skills can be highly effective in quickly reducing emotional dysregulation. When we are emotionally dysregulated and can’t figure out a way of managing our emotions in the moment, we tend to react in ways that we later regret. By using distress tolerance skills to help regulate our emotions when stressed or in crisis, we can move forward with resolving conflicts in ways that feel effective, helping us preserve relationships or identify much needed solutions to problems.

Emotional Regulation Skills: Emotional regulation skills are meant to help us become more aware of and understand the function of our emotions. We’ve often developed numerous myths and limiting beliefs about our emotions that end up getting in the way of observing our emotions and figuring out what our emotions are trying to communicate to us. Emotional regulation skills help us to stop judging our emotions and learn to sit and cope with difficult and unwanted emotions. By building up our emotional regulation skills, we can learn how to be less afraid of and make peace with our emotions, charting the path toward emotional freedom.


Interpersonal Effectiveness Skills: Our relationships tend to be the biggest source of both joy and frustration in our lives. Often, we feel unskilled with how to ask for what we want or need from others, how to engage in ways in our relationships that build up our self-respect, how to set boundaries, or how to validate and kindly tend toward those people in our lives whom we most care about. As a result, we tend to experience significant stress and dissatisfaction in many of our relationships, thus contributing to feelings of depression, anxiety, or sadness. Interpersonal effectiveness skills help us learn how to communicate more effectively in our relationships, how to validate other people’s emotions, and build our self-respect within our interactions with others. These tools can lead to more fulfillment in our relationships and remove many of the barriers to our well-being and happiness.


The Significance of the Dialectic: People are often curious about the “D” in DBT. The “D” refers to the concept of the dialectic, where two seemingly opposed ideas can both be true at the same time. This concept can be incredibly empowering and freeing in that it allows people to start seeing how they can feel many different feelings all at once, including feelings that seem contradictory or conflicting. By learning to think more dialectically, we learn how to accept and become more validating of our emotional experiences, rather than judging, pushing away, or invalidating our feelings.


Within a DBT therapy session, your therapist will listen for areas of your life where certain DBT skills may be helpful or beneficial, and will then share specific skills and approaches that could be useful in your daily life. At times, you may receive handouts or exercises to work on between sessions to help you practice these skills. Because DBT is a behavioral therapy, you may be encouraged to look at behavioral changes you can make to help shift how you feel as well as shift thought patterns and beliefs that are limiting you.


Ultimately, clients express their appreciation of DBT as a result of feeling that they have been given tangible, concrete tools that they can use in numerous facets of their lives. Clients also begin to feel relief as they approach life more dialectically and begin validating and normalizing their varying emotions. I have witnessed so many people grow and flourish through the use of DBT and invite you to consider how this type of therapy can lead you toward your goals for healing, peace, and increased happiness.



DBT can help with depression, anxiety, and relationship challenges



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