Dialectical behavior therapy (DBT) is form of cognitive behavioral therapy (CBT) that incorporates mindfulness, emotion regulation, and interpersonal work. DBT was developed to treat borderline personality disorder and suicidal ideation. It has since been shown to also be effective in treating substance use disorders, eating disorders, trauma, and depression.
What Is Dialectical Behavior Therapy?
Dialectical behavior therapy (DBT) helps you manage inner emotions and outward responses that are problematic. Some of the philosophy behind DBT includes:
- Emotions, actions, and behaviors all feed into each other.
- You are always experiencing change and movement (outwardly and inwardly).
- A concept or emotion (thesis) and its opposite (antithesis) integrate to form a deeper understanding (synthesis).
DBT is based on the idea of dialectics, which is that seemingly contradictory things can work together in harmony. For example, an important concept in DBT is that you should accept yourself completely. At the same time, DBT encourages and teaches methods that help you change. So, there is acceptance and change (opposites) working together in harmony to lead to greater development. DBT is also solution-based because it offers immediate tools and strategies to help you change harmful behavior or deal with overwhelming emotions. Dialectical behavior therapy draws on the following techniques:
Mindfulness
DBT teaches you practices that keep you grounded in the present moment instead of ruminating on the past or future. Mindfulness can include activities like:
- Meditation
- Breathwork
- Body scans
- Sensory work
- Visualization
Mindfulness practices like meditation can teach you to acknowledge distressing thoughts or feelings without judgment or attachment to them.
Distress Tolerance
Distress tolerance skills can help you manage uncomfortable feelings and thoughts so you don’t numb them or act on them in problematic ways. It teaches you to change your response to stress and challenges. Distress tolerance practices may include:
- Temporary distraction
- Self-soothing practices
- Intense exercise
- Cold temperatures
- Breathing exercises
- Pros and cons lists
- Sensory work
- Muscle relaxation
Interpersonal Effectiveness If you struggle with substance use and mental health issues, you may not have experienced authentic, healthy relationships in your life. A component of DBT is teaching the qualities of healthy relationships. Through processing and skill building, you’ll: Identify your relationship patterns
- Learn how to communicate your needs in relationships
- Learn how to empathize with others
- Learn to recognize and nurture healthy interactions
Emotion Regulation
Emotions are normal, but sometimes people with mental health disorders experience extreme feelings that they feel incapable of handling, or they suppress feelings viewed as “bad.” DBT teaches you how to recognize your emotions without judging them and then manage them in useful ways. While you’re learning emotion regulation skills, you’re encouraged to engage in behaviors that support overall positive well-being and make it easier to work with emotions. These follow the acronym, “PLEASE,” which stands for:
- Treat physical Illness
- Balance eating
- Avoid mood-altering substances
- Balance sleep
- Get exercise
What Is the Difference Between DBT and CBT?
Dialectical behavior therapy is a type of cognitive behavioral therapy (CBT). The two are similar in some ways, but there are differences between them.
How Is DBT Different Than CBT?
- Cognitive behavioral therapy focuses on goals and specific tools to change problematic thoughts and behaviors. Dialectical behavior therapy focuses more on roadblocks to goals, like emotional and interpersonal difficulties.
- While CBT is very behavior-oriented, DBT works on accepting yourself and your experiences, which can impact your
- Because of its focused and goal-oriented approach, CBT may involve fewer therapy sessions that DBT.
- Dialectical behavior therapy is largely driven by relationships, so group therapy is often a component of it. CBT is a common approach in individual therapy, though it can be used in groups.
- Cognitive behavioral therapy draws on logic and critical thinking to change behaviors. Mindfulness, self-acceptance, and relationships are DBT components that can influence behaviors.
How Do DBT and CBT Work Together?
- Dialectical behavior therapy is an offshoot of cognitive behavioral therapy, so there are inherent similarities between
- DBT and CBT are both concerned with the inseparable link between emotions, thoughts, and behaviors.
- CBT and DBT both target unhealthy behaviors, better alternatives to those behaviors, and self-awareness.
- Dialectical behavior therapy is often the next step after you’ve learned the practical and logical tools of CBT. DBT can bring the body and spirit into those learnings.
- A trusting, accepting relationship with a therapist is a key component of both CBT and DBT.
How Does DBT Help Addiction?
Dialectical behavior therapy can be an effective treatment for people with addictions who have a co-occurring mental health disorder like borderline personality disorder. This is also known as a dual diagnosis. Research shows that about half of people with addictions have a dual diagnosis.
DBT can help manage symptoms of mental health disorders that range from mild general anxiety disorders to severe borderline personality disorders. It can also help treat psychiatric issues like post-traumatic stress disorder (PTSD) and depression. If you struggle with a mental illness, DBT can help you recover from substance abuse because it treats the underlying causes of addiction. When you struggle with a co-occurring disorder like depression or anxiety, you may try to self-medicate your symptoms with drugs and alcohol. Not treating mental health disorders can perpetuate the addiction cycle.
Treatment for a dual diagnosis focuses on solutions. If you are dealing with unresolved trauma, then getting to the root of the problem and working through the trauma is a solution. If you have difficulty coping with emotions, interpersonal relationships, and overwhelming situations, then a dialectical behavior therapy program can help you learn the skills to manage these challenges more effectively.
DBT at Vogue Recovery Center
Dialectical behavior therapy is an approach we use in both inpatient and outpatient addiction treatment at Vogue. It is one of many therapeutic modalities in our integrative treatment program. During dialectical behavior therapy, your therapist will help you identify problem behaviors. This could include:
- Emotional outbursts
- Extreme anxiety
- Difficulty establishing boundaries with other people
- Other challenges
You’ll learn mindfulness techniques to manage these feelings and resulting behaviors. This includes specific techniques for what you can do in the moment to get through a tempting or difficult situation. As you learn to manage and regulate emotions and behaviors more effectively, you’ll find that you are changing how you respond to difficulties. Instead of having an automatic response, you’ll learn to implement DBT tools.
Ready to Get Help?
Vogue Recovery Center is a trusted and accredited addiction treatment facility. We offer an array of research-based therapies like DBT, as well as holistic approaches, so you can heal physically, mentally, and spiritually. Call us today for a free, confidential consultation.
Medically Reviewed by Kelsey Jones, MS, LPC
