DBT or Dialectical Behaviour Therapy

Dialectical Behaviour Therapy, or DBT, was originally developed by psychologist Dr. Marsha Linehan in order to help people struggling with intense emotions, self-harm and suicidal thoughts, – difficulties commonly seen in the experience of individuals living with Borderline Personality Disorder. DBT, however, is not limited to this diagnosis. In fact, when we look at the diagnostic system, most of the clinical diagnoses show an element of emotional dysregulation, making DBT a suitable therapeutic modality for a variety of mental health challenges.

DBT is widely studied and has strong scientific support for its effectiveness. It has been shown to be particularly helpful for people struggling with emotional dysregulation, impulsivity and relationship difficulties. It can also benefit those dealing with trauma, substance abuse and eating disorders.

DBT is a highly practical approach, as it focuses on building tools and skills that help people cope more effectively with life’s challenges. By practicing the skills learned in DBT, people often find they are better able to manage stress, improve their relationships, and feel more balanced and in control of their lives. The skills learned through DBT are useful beyond therapy and can contribute to lifelong personal development and a deeper sense of meaning.

An essential part of DBT is learning balance and acceptance. The term dialectical refers to the reconciliation of opposites—for example, accepting yourself as you are while also working to change patterns that no longer serve you. DBT acknowledges that life is full of contradictions, and by learning to navigate them, we can live a more meaningful and balanced life. Teaching practical skills is therefore central to the DBT approach.

The Four Core DBT Skills

Mindfulness: Learning and practising mindfulness means that you learn to stay present in the moment – to observe your thoughts and feelings without labelling them; not as good, not as bad. This will support your ability to respond, not react to the challenges you encounter.

Distress Tolerance: In this skillset, the goal is to learn how to cope with painful emotions in healthy ways without spiralling into self- destructive behaviours.

 Emotion Regulation: These skills help clients understand and manage intense emotions, and to reduce vulnerability to mood swings.

 Interpersonal Effectiveness: This skillset focuses on how to build and maintain healthy relationships, how to set boundaries and to communicate needs assertively.

DBT is typically offered in individual counselling, and in group-based skills training. It is also possible to engage in self-study as there are online resources and self-help books available, although many people prefer the personalised support a therapist can provide.

DBT Mindfulness Exercises You Can Try

Observe & Describe (5 minutes)

• Sit comfortably and focus on your breath.

• Notice what you can observe (sensations, sounds, thoughts).

• Then describe them silently: “tightness in chest,” “thought about work,” “sound of traffic.”

• No judging—just noticing.

Purpose: Builds awareness and reduces reactivity.

One-Mindfully

• Choose one activity (drinking tea, walking, washing hands).

• Do it with full attention, gently bringing your mind back when it wanders.

Purpose: Trains presence and reduces overwhelm.