Dialectical Behaviour Therapy (DBT): A Deeper Dive

These important therapeutic skills can be broken down into four key concepts: mindfulness; emotional regulation; distress tolerance; and interpersonal effectiveness. To understand why these make DBT so effective, it is important to take a closer look at each one.

Given the variety of therapies available, it may feel difficult to determine which one might be the right fit for you. Some therapies are inward-focused to allow us to examine ourselves, while others are based on changing overall behaviour. Dialectical Behaviour Therapy (DBT) involves both. In brief, DBT is a modified version of Cognitive Behavioral Therapy (CBT), designed to teach people how to live in the moment, apply healthy ways to cope with stress, manage their emotions, and improve relationships with others. DBT can be practiced in group and individual sessions.


Mindfulness is the ability to live in the present moment. While this may sound simple, it is something that many people struggle with. Some of us try to live in the future, imagining every possible scenario and outcome which can cause anxiety, while others find themselves stuck in the past which can lead to depression. 

With mindfulness, we can let go of the weight of the past and future and focus on the present which is ultimately the only thing that we have any control over. Mindfulness may include practicing skills like meditation or simply focusing on our breath or physical body. It can allow us to let go of distressing emotions and unreasonable expectations we may have for ourselves and others.  

Emotional Regulation

Emotional regulation is a process that helps us understand what we are feeling and why so that the emotion does not control our thoughts and behaviours. It is based on the understanding that emotions are not inherently good or bad, but just a part of life. Once we acknowledge a negative emotion and understand why we are feeling it, we can reduce our vulnerability to it, and then let go of it. 

Interpersonal Effectiveness

This is the skill of assertive communication (being able to identify and ask for what they need), and boundary setting (being able to say no when necessary) while maintaining healthy relationships and self-respect. 

We cannot assume that we know what others need or that they know what we need from them. So it is important that we actively participate in these types of conversations. We also need to be able to recognize whether the expectations that others have of us are reasonable. And if they are not, we need to define our boundaries and say no. This will help prevent burnout and feelings of guilt for not being able to do it all.

Distress Tolerance

This is the ability to cope when there is a crisis — especially a crisis that you cannot change. It is about accepting a situation as it is and not how we feel it should be. When we focus on what we think “should be” rather than what is, it can give the illusion that we have power over something that we do not. And when things don’t happen as they “should”, we can feel guilt and fear because we are responsible. Which in turn can lead to avoiding the situation altogether. 

By learning the skill of distress tolerance, we can accept a situation for what it is. This helps us to stay calm even though we may be experiencing negative emotions.

When is Dialectical Behaviour Therapy Used?

DBT was initially developed to help those with borderline personality disorder. However, because of its effectiveness, its use has been expanded to successfully treat people with depression, PTSD, bipolar disorder, and a variety of eating disorders. 

To learn more about DBT, explore these reads as resources

Eli’s Place will be a rural, residential treatment program for young adults with serious mental illness. To learn more about our mission and our proven-effective model click here.

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