Dialectical Behavior Therapy 
(DBT) Explained

Created by Marsha Linehan in the 1970s, Dialectical Behavior Therapy (DBT) was originally designed for people who were chronically suicidal. Today it is one of the best-researched treatments we have, and it helps with a much wider range of problems: borderline personality disorder, substance use disorders, depression, anxiety, PTSD, eating disorders, and the everyday struggle of feeling emotions more intensely than other people seem to.

 

DBT focuses on building practical coping skills so that strong emotions stop running your life. A unique aspect of DBT is its use of dialectics, which means holding two seemingly opposite ideas at once, most importantly acceptance and change. When you're anxious, for example, you can accept the feeling ("I have anxiety, and that's okay") while also doing something to reduce it, like paced breathing or going for a walk. Acceptance without change leaves you stuck; change without acceptance turns into self-criticism. DBT teaches you to do both.

 

The Four DBT Skill Modules

 

Mindfulness. Noticing what is happening inside you and around you, right now, without judging it. Mindfulness is the foundation for every other skill because you can't change a reaction you haven't noticed yet.

 

Distress tolerance. Getting through a crisis without making it worse. These are the skills for the moment when you want to drink, text the ex, quit the job, or hurt yourself: ways to ride out the urge until it passes, and ways to accept painful situations you can't change right now.

 

Emotion regulation. Understanding what emotions do for you, reducing how vulnerable you are to them (sleep, food, exercise, and avoiding mood-altering substances all matter here), and changing emotions you don't want by acting opposite to what they tell you to do.

 

Interpersonal effectiveness. Asking for what you need, saying no, and handling conflict in a way that keeps your self-respect and the relationship intact.

 

Who DBT Helps

 

DBT is a good fit if you recognize yourself in any of these: emotions that go from zero to one hundred fast and take a long time to come down; impulsive decisions you regret (spending, substances, relationships); relationships that feel intense and unstable; a harsh inner critic; or feeling empty or numb. It is also an excellent complement to individual therapy for anxiety, depression, trauma and addiction, because it gives you tools to use between sessions.

 

How DBT Works at Brain Repair

 

Our 12-week DBT Skills Group meets in person at our San Clemente office. Each week we teach one skill, practice it together, and give you a small homework assignment so the skill shows up in real life, not just in the room. Admission is rolling, so you can start whenever you're ready, and you don't need to be seeing one of our clinicians for individual therapy to join. Many people do both: group to learn the skills, individual sessions to tailor them to what's actually going on in their lives.

 

Family members are welcome to learn the skills too. When the people around you understand what you're practicing, they can support you and hold you accountable. Call or text (949) 415-4204 for the current group schedule, or meet our clinicians.