Understanding Dialectical Behaviour Therapy (DBT): A Path to Emotion Regulation Skills

Dialectical Behaviour Therapy (DBT) has emerged as a powerful and evidence-based approach for individuals struggling with emotional dysregulation and various mental health challenges. Developed in the late 1980s by psychologist Dr. Marsha Linehan, DBT was originally designed to support people living with Borderline Personality Disorder (BPD). Today, its principles are widely applied to help individuals facing difficulties such as eating disorders, addiction, trauma, and overwhelming emotions.

This blog post aims to provide an introduction to DBT, explore its core principles, and highlight how it differs from other therapeutic approaches.

What is Dialectical Behaviour Therapy (DBT)?

DBT is a form of cognitive-behavioural treatment that blends acceptance and change. The word dialectical refers to the synthesis of opposites, and this balance underpins every part of DBT. It teaches you to accept yourself and your current situation while also making meaningful changes in how you respond to life’s challenges. At its core, DBT involves harnessing emotion regulation skills.

A scale of justice set against a backdrop of yin and yang imagery, symbolising the balance between acceptance and change in the pursuit of harmony.

DBT treatment is structured around four essential components:

• Individual therapy: Weekly one-to-one sessions focused on your personal goals.

• Group skills training: Learning and practising DBT skills in a supportive group setting.

• Phone coaching: Real-time support to help apply skills during crises.

• Therapist consultation teams: Ensuring therapists receive support to deliver DBT effectively.

  
  

Core Principles of DBT

Understanding the core principles of DBT can empower you on your journey. Here are the key concepts:

1. Acceptance of Duality: The foundation of DBT is recognising that two seemingly opposite truths can exist at once. For example, you may be doing your best while also learning new ways of coping.

   
   

2. Validation of Feelings: Many individuals with emotional struggles have experienced invalidation. DBT therapists create space for your feelings as real and understandable, fostering trust and reducing shame.

   
   

3. Behavioural Analysis: DBT uses behavioural analysis to identify what leads to unhelpful behaviours and what follows them. This process paves the way for healthier responses.

   
   

4. Daily Skills Training: DBT teaches skills you can use daily. These modules include:

   1. Mindfulness: The cornerstone of DBT, helping you stay present without judgment.

   2. Distress Tolerance: Coping with crises safely and effectively.

   3. Emotion Regulation: Reducing vulnerability to intense emotions and building resilience.

   4. Interpersonal Effectiveness: Improving communication, boundaries, and relationships.

      
      

5. Structured Therapy: Therapy follows a clear structure, addressing issues with skills development in this order:

   1. Life-threatening behaviours

   2. Therapy-interfering behaviours

   3. Quality-of-life issues

      
      

6. Motivation and Change: Both therapist and client regularly revisit motivation, recognising that change is difficult but possible with persistence.

   
   

7. Supportive Relationship: The relationship in DBT is supportive, validating, and honest. It combines empathy with gentle challenge, helping you grow in a safe environment.

   
   

8. Practical Application: Progress happens through weekly therapy, group learning, and between-session support. This balance makes DBT practical and applicable in daily life.

   
   

9. Therapist Support: DBT therapists work within consultation teams to remain effective and aligned with the model. This prevents burnout and ensures high-quality treatment.

   
   

10. Assumptions of DBT: DBT assumes that:

    1. Clients are doing their best.

    2. Clients want to improve.

    3. Clients need to learn new skills.

    4. There is no such thing as failure, only opportunities to learn.

How DBT Differs From Other Therapies

Many therapies aim to reduce distress, but DBT stands out because of its balance of acceptance and change. Here’s how it compares to other therapeutic approaches:

• Cognitive Behavioural Therapy (CBT): CBT focuses on challenging unhelpful thoughts and behaviours. DBT builds on this foundation but adds mindfulness and acceptance, making it particularly effective for intense emotions.

  
  

• Psychodynamic Therapy: Psychodynamic approaches explore unconscious processes and past experiences. While this can bring insight, DBT offers practical tools to manage distress in the present.

  
  

• Acceptance and Commitment Therapy (ACT): ACT also values acceptance but emphasises aligning with personal values. DBT provides more structured skills training for regulating emotions and relationships.

  
  

The Role of a DBT Therapist

A DBT therapist does more than listen. They teach skills, offer support, and help you apply what you learn in everyday situations. They are trained to understand the challenges of emotional dysregulation and work actively with you to build stability and resilience.

Group skills training also plays a key role. These sessions provide a space to practise skills, share experiences, and learn from others, often creating a valuable sense of community and belonging.

Online DBT Therapy

With the rise of online therapy, DBT is now accessible online. This allows individuals to participate in therapy from the comfort of home, making it easier for those with busy schedules or mobility challenges. Online DBT follows the same principles and structure as in-person therapy, ensuring consistent and comprehensive support.

The Benefits of DBT and Emotion Regulation Skills

Research has shown that DBT can help individuals:

• Manage emotions without feeling overwhelmed.

• Reduce harmful or impulsive behaviours.

• Improve communication and relationships.

• Build long-term coping strategies and resilience.

  
  

Who Can Benefit From DBT?

DBT can be especially helpful for individuals experiencing:

• Borderline Personality Disorder (BPD).

• Emotional dysregulation and trauma.

• Eating disorders.

• Substance misuse and addiction.

• Cycles of intense emotions and relationship difficulties.

  
  

Is DBT Right for You?

If you often feel stuck in cycles of strong emotions, harmful behaviours, or relationship difficulties, DBT may be a powerful option for support. With its mix of acceptance, skills training, and compassionate guidance, it can help you build a more balanced and fulfilling life.

Finding DBT Therapy in Central London, Fitzrovia, or Online

As a qualified DBT practitioner, I split my time between working at Priory, facilitating Dialectical Behaviour Therapy with clients, and my private practice.

In both settings, I combine the structure of DBT with an integrative, trauma-informed approach. My aim is to provide a safe and supportive space where you can learn skills, gain insight, and move toward meaningful change.

If you’d like to explore whether DBT is right for you, please feel free to get in touch to arrange a confidential consultation.

Click here to arrange a free and confidential consultation