DBT Basics: Questions and Answers about Dialectical Behavior Therapy

I get a lot of calls asking about DBT and though it would be helpful to provide some answers to these common questions. So, without further ado …

What is DBT?

  • Dialectical Behavior Therapy is a collection of life skills broken into 4 modules. These skills help to increase awareness, challenge opposing forces, and create change. Mindfulness is the core module, as it is sprinkled into each skill. Here you learn how to increase your awareness of the present moment and simplify varying aspects of life. Distress Tolerance helps you to put up with your distress in order to better manage it. Emotion Regulation provides tools to be more in-tune with the ebbs and flows of emotions, so you are less vulnerable to the intensities. This module also helps you get into the drivers seat, instead of hanging on for an emotional ride. Interpersonal Effectiveness helps you to build healthy relationships, including the relationship you have with yourself. During therapy, you will also keep and complete a daily log to review with your counselor.

Who can benefit from DBT?

  • Almost anyone! DBT was originally designed as treatment for individuals with Borderline Personality Disorder, but is now used for so much more. Research continues to show improvements in individuals who self-harm, struggle with suicidal thinking, make impulsive choices, and have difficulty managing emotions and navigating relationships. Most people can also learn to be more present, tolerate pain, challenge cognitive distortions, build a strong sense-of-self, notice irritability before it increased to rage, and let go of judgments that hold you back. A small fraction of the many benefits. I would add that those around you can benefit too, as they will not only notice a change in you, but will also pick up on your new role-modeled behaviors.

How long does it take to learn?

  • It depends on where you start and your own definition of having learned something. Many of the skills taught through DBT are lessons that could be read in book or gained during childhood, but were never effectively role-modeled for you. Meaning, everyone wanting to learn DBT will come in at a different level based on life experiences. Reading through the skills is one thing, but practicing, applying, and talking about skill use is where the real learning happens. You will probably find that you are already using many of the skills, but did not have a way to identify your choices and actions. When you are more aware, you will recognize more opportunities to replicate effectiveness.

How will I know it is working?

  • Once you accept the process and are ready to understand, PRACTICE, and apply the skills you will begin to notice the difference and eventually use skills without much planning or thought. They become your way of thinking and doing. DBT skills will come to replace the ineffective thoughts and behaviors that were keeping you stuck.

Why is this not taught in Middle School?

  • After hearing about DBT and learning the skills, the most common question becomes, “Why is DBT not taught to everyone in middle school?” My response, “Good question!” I believe DBT could be such a benefit at early agaes. Learning these skills, with peers in a structured environment, could set children up with greater resources for success throughout their life.

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- Nikki Gorman, MA, LPCC