What is Dialectical Behaviour Therapy (DBT)?

Dialectical Behaviour Therapy (DBT) was developed by Marsha Linehan while trying to find an effective treatment for suicidal and borderline personality disorder patients. She started with Cognitive Behaviour Therapy but found that it was lacking in certain areas. So she added aspects to the treatment and made changes to improve treatment results. This resulted in what is now known as DBT. Some of the changes she made were a balancing act between acceptance and change, adding validation, mindfulness, and interpersonal skills.

DBT: Building a Life Worth Living

The focus of Dialectical Behaviour Therapy is to “build a life worth living.” It is a collaborative type of therapy where the therapist and the client work together to enable the client to build a better life through collaboratively decided goals, therapy techniques, and skill-building.

Behind the DBT is biosocial theory, which believes that invalidating environments are at the root of emotional dysregulation. Emotion dysregulation involves being emotionally sensitive and emotionally reactive and having a slower return to baseline. There are several reasons for emotion dysregulation, such as biological disposition, attachment problems, loss, trauma, and invalidation. When you have frequent prolonged intense emotional reactions, it tends to create neural pathways that are sensitized to these types of reactions. These reactions can become more automatic as time goes on. The emotional reactions can become more and more intolerable as time goes on. Therefore, it can become more difficult to cope with them and choose effective behaviours to deal with them. DBT can help point clients in the right direction of choosing better behaviours to deal with intense emotions and learn how to tolerate them.

Dialectical Behaviour Therapy

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Acceptance and Change through Skill Building

Dialectical Behaviour Therapy (DBT) works by moving back and forth between acceptance and change. It validates your past experiences yet encourages you to move forward. It offers skills that you can learn to deal better with the world around you and better manage your emotions. These are often skills that people who grew up in supportive environments learned. However, people who grew up in less supportive environments did not learn these skills or have deficiencies in these skills.

The skill-building in DBT can really help people to be able to better cope with their emotions, tolerate distress, improve their relationships, and better understand how they can improve how they feel about life. This therapy can work well with people who have had emotional neglect or developmental trauma because it focuses on the skills that were neglected in their childhood. There are other modalities that work well with the actual inner wounds from childhood and other trauma, so this form of therapy works well complementing those.

Prelude to Trauma Processing

DBT and DBT skills can often be used early in therapy as the relationship between the therapist and client is being established. It can be used to help bring more skills to you so that you can tolerate the distress and intense emotions that can come with processing trauma.


DBT can be effective in helping you establish the skills to tolerate the distress and emotion dysregulation that can come from trauma and chronic pain. It can be a stepping stone to trauma processing or the healing of neuroplastic pain.

More Information on DBT: https://dialecticalbehaviortherapy.com/

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Published by Leona Westra

A Registered Clinical Counsellor (RCC) based in Surrey, BC with specialized training in Chronic Pain, Trauma, Nervous System Dysregulation, and Grief.

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