Dialectical Behaviour Therapy

Dialectical Behaviour Therapy, or DBT for short, was originally created to better manage the extreme emotional dysregulation of borderline personality disorder. However, DBT has come to be used for any condition involving extreme emotional reactivity, especially when the client has learned to employ self-defeating behaviours to cope. DBT consists of multiple self-help strategies in four main areas:

• Mindfulness is the core skill involved, which consists of developing the ability to notice distressing emotions and negative thoughts without judging so we can step back, not become them or escalate them, but shift our attention to self-care and creating inner peace.
• Distress Tolerance is a set of skills that focus on maintaining composure and control in the face of emotional pain
• Emotional Regulation is another set of skills that develops our ability to manage emotional intensity without pushing down, blowing up, or making it worse.
• Interpersonal Effectiveness is a group of skills that develop our ability to build and maintain healthy relationships, which in turn builds confidence, expands our support system, and makes us more resilient.

Together these skills provide an excellent toolbox of self-help strategies to help us live the lives we want. It is worth noting that DBT was developed by a psychologist (Marsha Linehan) who herself had borderline personality disorder. It is also instructive that many proposals have been made over the years to rename borderline personality disorder to something like “post-traumatic personality disorder” so as to emphasize that the condition can possibly be closely related to adverse experiences in childhood (both subtle like neglect as well as more extreme forms of abuse). The development of this disorder is complex, and some experts believe that BPD develops as a result of biological, genetic, and environmental factors. This reminds us that mental health conditions are not who we are, and not just disorders we get like a cold, but are often related to our history and environment.