Dialectical Behavior Therapy
DBT, or Dialectical Behavior Therapy, is a therapy model that was developed by psychologist Marsha Linehan in the late 1980s as an offshoot of Cognitive Behavioral Therapy, but with an increased focus on mindfulness, accepting pain as a part of life, and learning to regulate emotions rather than change them. DBT focuses on providing specific coping mechanisms and skills for improving life functioning in four domains: Distress Tolerance, Mindfulness, Emotion Regulation, and Interpersonal Effectiveness.
Initially researched to be effective at treating individuals with suicidal ideation and Borderline Personality Disorder, DBT is now also used to treat individuals with Bulimia Nervosa, Binge Eating Disorder, disordered eating and urges, ADHD, Bipolar Disorder, Depression, Anxiety, self-harm, PTSD, and general emotion dysregulation and stress management. DBT can help children, teens, and adults, and it has shown to be effective cross-culturally as well (1).
So...what is it?
The “D” in DBT stands for Dialectical, or the synthesis of two opposites. DBT operates on the assumption that living in the extremes can be a major contributor to stress, therefore, we must learn to accept that two things can be true at once, to be willing to learn to “live in the gray." DBT promotes the idea that we must both learn to accept our difficult circumstances without judgement, to reduce suffering, while also working on personal change in order to improve our coping.
DBT can teach you how to improve your relationships with others
DBT can teach you mindfulness skills to help you live a more intentional life
How does DBT help?
As mentioned, DBT supports clients in four different domains. In Mindfulness, the client learns to increase awareness without judgment and live more fully in the moment rather than the past or future. In Distress Tolerance, clients learn how to manage emotional experiences that have reached a breaking point through radical acceptance and crisis survival skills. Emotion Regulation teaches clients to recognize emotions and respond to them effectively rather impulsively. And finally, in Interpersonal Effectiveness, clients learn how to set limits, ask for needs, maintain self-respect, and take care of their relationships. (2)
How can it help me if I struggle with food and body image?
Clients of all eating disorder diagnoses have benefited from DBT. First, Mindfulness encourages one to become more aware of themselves, their feelings, their body, and their present experience. Mindfulness is a major tool when working through disordered eating and trying to build intuitive eating skills. Interpersonal Effectiveness skills help guide folks with eating disorders, and those in relationships with individuals with eating disorders, in improving their communication and building healthier relationship patterns, which can be healing for folks facing disordered eating struggles. Emotion Regulation skills can be incredibly helpful too, as clients with eating struggles often find that improving their awareness of and language for their emotions can help them gain insight on how their emotions impact eating. Distress Tolerance is helpful with urges of all kinds, so clients who are working to overcome restriction, binging, purging, over-exercising, and other compulsive disordered eating behaviors often find those skills to be very useful in managing urges and impulses.
(2) The Dialectical Behavior Therapy Skills Workbook