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What is Dialectical Behavior Therapy? A Comprehensive Guide
Mental Health

What is Dialectical Behavior Therapy? A Comprehensive Guide

Learn more about dialectical behavior therapy to discover if it's the right fit for your mental health needs.

Finding the right kind of therapy for you is key for being able to properly take care of your mental health. Before making an appointment with a therapist, it’s important to understand the different kinds of therapies available to determine which one you’ll get the most out of. 

Dialectical behavior therapy, a type of cognitive behavioral therapy, can be beneficial for people working through a number of different issues as it helps you establish new ways of thinking and create helpful habits for recovery. Here’s what you should know about this type of therapy and what skills you can expect to learn from it. 

Defining dialectical behavior therapy

Dialectical behavior therapy focuses on helping people change their patterns of thinking from a black and white, all-or-nothing mentality to more of a spectrum of possibilities. This kind of therapy also helps people improve their relationships, which can be strained due to these rigid thought patterns.  

The word dialectic is defined as ​​”the art of investigating or discussing the truth of opinions” and “inquiry into metaphysical contradictions and their solutions.” Being able to hold two different views in your mind, or searching for the truth while welcoming conflicting opinions are examples of dialectic thinking. Instead of having an either-or outlook, dialectic thinking is more of a both-and.

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In dialectical behavior therapy, a few different therapeutic methods, or settings, are combined. There’s individual therapy where you would work one-on-one with a therapist to discuss behavioral skills and challenges. This happens in tandem with group therapy where you can talk about behavioral skills and work on them with other people. This kind of therapy often utilizes phone coaching in between sessions so that your therapist can help you with difficult situations as they arise. 

Who Dialectical Behavior Therapy Is For

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This therapy was developed in the 1980s by Marsha Linehan, Ph.D. for the purpose of treating people with borderline personality disorder. Borderline personality disorder is characterized by intense negative emotions, which can thus negatively affect the relationships people have with those closest to them.

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However, dialectical behavior therapy is now used to treat a number of mental health issues that make it hard to regulate emotions or cause people to engage in self destructive behaviors. Some of these include: 

  • Eating disorders like anorexia and bulimia
  • Depression and anxiety
  • Obsessive compulsive disorder
  • Post-traumatic stress disorder
  • Substance abuse
  • Suicidal behavior or self injury
  • Attention deficit disorder

If you have harmful internal thought patterns or can’t seem to stop yourself from engaging in damaging external behaviors, dialectical behavior therapy can encourage you to build new habits, replacing the destructive ones with healthier ones. 

The Four Main Skills of Dialectical Behavior Therapy

woman meditates on the beach on a beautiful day
(Photo by Chelsea Gates on Unsplash)

In dialectical behavior therapy, there are four key skills that you will work on with your therapist and with your group. These skills help you break old, destructive patterns and work toward building new, healthier habits that will benefit you and your relationships. These four skills are:


Mindfulness is the ability to be fully present in the current moment. It means that you can be here, now, as well as accept the circumstances of the present without being overwhelmed, reactive or stressed out. Mindfulness helps you cultivate a healthy perspective on your life by encouraging you to live in the now. 

Distress tolerance

When something difficult in your life arises, distress tolerance refers to your ability to handle the situation without trying to run away from it or become reactive as a result of it. Being able to manage stress and discomfort enables you to problem solve and come back to your center after getting thrown off course. 

Emotional regulation

Emotional regulation is the skill of being able to manage and accept your emotions in a way that allows you to bounce back from them, rather than allowing these emotions to take over your life.

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The idea is to learn how to change your thinking about a situation or circumstance that caused the emotion by reframing it rather than trying to suppress it, which can typically make things worse. 

Interpersonal effectiveness 

The last skill of dialectical behavior therapy is interpersonal effectiveness, which helps your communication skills within your relationships. The purpose of interpersonal effectiveness is to help you communicate your needs and feelings in a way that shows both self-respect and respect to others. To achieve this skill, you’ll work on collaborating with others, showing people comfort, learning how to give constructive feedback, managing moments of conflict, harnessing empathy toward others and developing self awareness. 

Benefits of Dialectical Behavior Therapy

young people having a chat by the lake on sunny day
(Photo by Aarón Blanco Tejedor on Unsplash)

After working with your therapist and your group, you can expect a number of positive changes, especially as the skills you’re practicing start turning into habits. Here are just a few of the concrete benefits you should see:

Recognition of your positive traits

As you do the work, you’ll start being able to pick up on your particular strengths and see which skills you’re able to really grasp the quickest. As you develop and use these new attributes, you’ll develop new confidence. 

Less anger and explosivity 

For many people, the reason to start dialectical behavior therapy is to make concrete behavior changes. This can lead to you becoming less reactive, allowing you to understand which of your behaviors are self-destructive or harming your relationships and being able to replace these with healthier choices. 

Improved communication skills

In working with your therapist and group, you’ll practice how to talk about your feelings, empathize with others and communicate effectively, which will have a large impact on your relationships. 

Openness toward acceptance and change

As you learn how to make positive behavioral changes and become more mindful of your reactions, you can build toward better accepting your feelings and the situations that arise in your life.

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You can make peace with what you can’t change and feel confident that you’re growing  into a better version of yourself. 

More likely to continue therapy

According to the American Psychiatric Association, people who start dialectical behavior therapy are more likely to continue treatment. The therapy you’ll actually stick with is the best therapy for you. So the fact that this type of therapy has a high rate of continuation is an important consideration.  

Is Dialectical Behavior Therapy Right for You?

young man figures out his life
(Photo by Ben Warren on Unsplash)

You know yourself best. After reading over the various skills you can learn and the benefits of this type of therapy, ask yourself: Does this sound like the right fit for your mental health needs? If you’re looking to break destructive behavioral patterns and repair your relationships, it may be worth finding community with others who are seeking help so you can work on yourself and your interpersonal skills. Therapy is a journey so just take it one step at a time. 

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