What is Dialectical Behavioral Therapy?

Picture of Sam Grimaldo, LMFT, LPC

Sam Grimaldo, LMFT, LPC

Sam is a Licensed Marriage and Family Therapist and Professional Counselor in San Antonio. He specializes in working with couples to recover from disconnection caused by trauma or addiction.

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Dealing with intense emotions can be a challenging task, especially when your coping mechanisms seem to fail you. Dialectical Behavior Therapy (DBT) is a therapeutic approach that can help address such difficulties, making it a highly sought after psychotherapy technique. DBT was initially designed to assist individuals diagnosed with borderline personality disorder, but today, it’s widely used to treat a wide range of mental health issues.

What is Dialectical Behavioral Therapy (DBT)?

Dialectical Behavioral Therapy (DBT) is a therapeutic approach that combines standard cognitive-behavioral techniques with mindfulness practices. Originating from psychology, this approach encourages patients to accept their feelings and thoughts without judgement, all the while striving to change negative behaviors.

DBT can be a valuable and effective therapy for individuals seeking help in regulating their emotions, interpersonal relationships, and overall mental health. The four core skills Mindfulness, Emotion Regulation, Interpersonal Effectiveness, and Distress Tolerance, provide a roadmap to help individuals navigate intense emotions and challenging situations. If you’re seeking guidance in coping with life’s challenges, DBT can help.

4 Core Skills of DBT


1) Mindfulness:

The first core skill of DBT, mindfulness, emphasizes a non-judgmental and focused techniques used to help individuals stay focused on the present moment. The fundamental principle of mindfulness is being fully aware of our thoughts, feelings, bodily sensations, and surrounding environment without any judgment. It’s about finding a balance between being engaged in your experiences while also having an objective perspective.

There are several core mindfulness skills that can be developed with practice. These include observing, describing, and participating. Observing involves paying attention to the present moment and noticing what is happening both internally and externally. Describing is about putting words to the observations, articulating what you perceive in a non-judgmental way. Participating involves actively engaging in the current activity, immersing yourself completely in the experience without self-consciousness. Regular practice of these skills can help to reduce stress, increase mental clarity, improve emotional regulation, and enhance overall well-being. Mindfulness is not only a tool for mental health but also a way of living that can transform our relationship with ourselves and the world around us.

In other words, mindfulness helps individuals concentrate on the present, instead of dwelling on past events or future scenarios. It enriches one’s mind by increasing awareness and acceptance of one’s thoughts, actions, and feelings, enabling self-reflection.


2) Emotion Regulation:

The second core skill of DBT, emotion regulation, helps individuals learn and adopt effective coping mechanisms for their emotions. Emotion regulation skills are essential tools that help individuals manage and respond to their emotions in a healthy way. These skills are particularly important because emotions can significantly impact our thoughts, behaviors, and overall well-being. Emotion regulation isn’t about suppressing or ignoring our feelings, but rather understanding them, acknowledging their presence, and choosing an appropriate response.

There are several key emotion regulation skills that can be developed and practiced. These include self-awareness, which is the ability to recognize and name our own emotions; self-soothing techniques, such as deep breathing or meditation, which can help calm intense emotional reactions; and cognitive reappraisal, which involves changing our interpretation of a situation to alter its emotional impact. Another important skill is distress tolerance, which is the ability to withstand negative emotions without resorting to harmful behaviors. By developing these emotion regulation skills, we can better navigate life’s ups and downs, build stronger relationships, and improve our overall mental health.


3) Interpersonal Effectiveness:

Interpersonal effectiveness, the third core skill of DBT, concentrates on enhancing communication and relationship building to enhance one’s social skills. Interpersonal effectiveness is a key component of Dialectical Behavior Therapy. It involves teaching skills that enhance the ability to interact effectively with others. Interpersonal effectiveness is not just about communicating effectively; it’s also about maintaining self-respect and building and maintaining positive relationships.

In DBT, interpersonal effectiveness is taught through a variety of strategies and skills. These include learning to assert oneself in a non-confrontational manner, negotiating solutions to problems, setting boundaries, and saying no when necessary. The goal is to improve the person’s ability to communicate their needs and wants clearly, to listen and understand others, and to manage conflict and interpersonal stress. These skills can be particularly beneficial for individuals who struggle with intense emotions, as they provide tools for managing these emotions within the context of relationships. By improving interpersonal effectiveness, individuals can strengthen their relationships, reduce interpersonal conflicts, and ultimately, improve their overall quality of life.


4) Distress Tolerance:

The final core skill of DBT, distress tolerance, helps individuals be more resilient and tolerant in distressing situations. Distress tolerance skills are psychological tools and techniques designed to help individuals cope effectively with painful events, circumstances, or emotions. These are particularly beneficial for those who have a heightened sensitivity to emotional pain and tend to react impulsively or use self-destructive behaviors to alleviate such distress. The core idea behind distress tolerance skills is not to avoid or negate the distressing situation, but rather to bear and survive it without resorting to harmful behaviors.

There are several key distress tolerance skills, including distraction, self-soothing, improving the moment, and acceptance-based skills. Distraction involves redirecting attention away from the distressing situation or thought, while self-soothing includes using sensory-based activities to calm oneself. Improving the moment refers to making one’s environment or mindset more positive, and acceptance-based skills involve acknowledging and accepting the situation without judgement. These skills, when practiced regularly, can significantly improve an individual’s ability to handle distress in a healthy manner.


How DBT Can Help Treat Trauma

DBT has been observed to be particularly effective in trauma counseling. It provides tools to manage distress, regulate emotions and improve interpersonal relationships. Through DBT, those suffering from trauma can learn to face their painful memories and symptoms in a safe and supportive setting.

DBT’s approach for those struggling with trauma goes beyond symptom management. It empowers individuals to understand and alter thought patterns that lead to destructive behaviors. The therapy’s mindfulness aspect encourages patients to remain present and fully inhabit their experiences, whether pleasant or painful. This practice reduces their tendency to avoid or repress trauma-related thoughts, which often exacerbates distress.

The emotional regulation component of DBT helps individuals identify and label their emotions accurately, reducing the unpredictability often associated with post-traumatic emotional reactions. Furthermore, the ‘distress tolerance’ part of DBT equips individuals with skills to endure and manage intense emotions without resorting to harmful coping behaviors. With such comprehensive tools, DBT offers a lifeline to those grappling with the aftermath of trauma, providing them with the means to reclaim control of their lives and their emotional well-being.

Finally, DBT is not a one-size-fits-all approach to trauma counseling. Its individualized nature allows practitioners to tailor the therapy based on their clients’ specific needs and experiences. By acknowledging that no two people are alike, DBT has proven particularly effective in helping those struggling with trauma find relief and hope.


How DBT Can Help With  Addiction and Substance Abuse

Additionally, DBT has demonstrated remarkable benefits in addiction counseling. It helps individuals struggling with substance abuse to develop coping strategies, thereby reducing the reliance on drugs or alcohol as a means of escape. DBT also teaches skills like distress tolerance and emotional regulation which are crucial in breaking the cycle of addiction.

At the heart of DBT lie two core beliefs – acceptance and change. Acceptance involves acknowledging one’s experiences, emotions, and behaviors as they are, while change emphasizes the need to alter those behaviors and thoughts that are causing harm or distress. When practiced together, these two beliefs provide a comprehensive understanding of addiction and the recovery process.

The DBT approach stresses that addiction is an illness; therefore, it requires effective treatment. Treatment involves replacing negative coping mechanisms with positive ones, which can be accomplished through building coping skills such as distress tolerance and emotion regulation. In addition to this, individuals learn acceptance strategies for situations that cannot be changed and interpersonal effectiveness techniques for building strong, supportive relationships.

Dialectical Behavioral Therapy (DBT) has shown promise in addressing the multifaceted complexities of addiction. It’s not just about abstaining from drugs or alcohol; it’s about equipping individuals with the necessary skills to manage the difficulties of life without turning to substances as a crutch. DBT’s holistic, skills-based approach to addiction counseling cultivates self-acceptance, personal growth, and resilience, offering hope for a substance-free life.


Benefits of DBT Therapy

DBT therapy is an evidence-based treatment that has been shown to help individuals with a variety of mental health issues. It can help with reducing the symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), borderline personality disorder (BPD) and other mental health disorders.

Research has demonstrated that DBT can be beneficial for increasing self-esteem and enhancing overall mental wellbeing. DBT has also been found to improve physical health, reduce substance use, enhance social functioning, and increase quality of life.

Ultimately, DBT is designed to help individuals reach their full potential in a healthy way that allows them to live a more meaningful life. By learning how to cope with difficult emotions without resorting to destructive behaviors, individuals are able to build more fulfilling relationships and foster greater life satisfaction.



In conclusion, Dialectical Behavior Therapy (DBT) has proven to be a highly effective therapeutic approach for addressing trauma, addiction, and relationship issues. It provides individuals with practical skills such as mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness that can help navigate the complexities of these challenges. For those struggling with trauma, DBT offers tools to manage intense emotions and reduce self-destructive behaviors. In the realm of addiction, it aids in fostering awareness, acceptance, and change, supporting the journey towards recovery. When it comes to relationships, DBT helps improve communication, set healthy boundaries, and enhance relationship satisfaction. Thus, DBT is not just a therapy – it’s a comprehensive approach to improving mental health, enhancing quality of life, and nurturing healthier relationships.


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