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What Is Dialectical Behavior Therapy?

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As one of the offerings of Fair Oaks Recovery Center, dialectical behavior therapy, or DBT, is a type of therapy that deals with emotional regulation and stress management.

DBT offers individuals skill sets that allow them to more effectively deal with painful emotions and decrease conflict in relationships.

Originally developed to treat borderline personality disorder, DBT has been shown to have a positive impact for people in substance abuse recovery. One of the goals of DBT is to help increase a person’s skill sets without him or her feeling criticized, which can have a negative effect in people in need of treatment.

There are four key principles of therapeutic skills involved in DBT.

1. Mindfulness
2. Emotional Regulation
3. Distress Tolerance
4. Interpersonal Effectiveness


Mindfulness is a practice which focuses on bringing one’s awareness to the present moment while calmly acknowledging thoughts, feelings, and bodily sensations. According to a 2015 Psychology Today article, mindfulness is one of the leading, most-effective mental health practices that has emerged since the millennium.

Rooted in thousand-year-old Buddhist tradition, mindfulness gained popularity though its use in helping people manage chronic pain. Rather than seeking methods for escaping the pain, mindfulness approaches were used as a way to relieve discomfort and promote overall well-being. Surpassing just cognitive behaviorists, mindfulness was further examined in relation to neurology, primarily in attachment patterns.

The primary concept of mindfulness deals with enhancing inner awareness and acceptance.

Emotional Regulation

Emotional regulation deals primarily with managing negative emotions such as anxiety, anger, or frustration. In order to best manage emotions, it’s helpful to think of emotional management as the driver in a car. Because life is inevitably full of challenges, finding a method for dealing with the overflow of emotions is less about figuring out how to decrease them, and more about learning how to respond when negative emotions arrive.

The idea is that when a negative situation arises, rather than succumbing to the knee-jerk reaction, emotional regulation would allow a person to more appropriately adjust their reaction in relation to considering the outcome of their response. In other words, they will become more resilient.

Consider a situation in which a person might feel frustrated, such as when a newly sober person encounters an old friend he used to drink alcohol with. Initially, that person may get excitable and see the friend’s appearance as an invitation to go drink. But because he has learned emotional regulation skills, he will stall before jumping off the bandwagon. This is because he will think about the outcome of this decision and realize that down-regulating frustration can be facilitated in a healthier manner and does not require him to throw away his progress in recovery.

Distress Tolerance

The idea of distress tolerance, an emerging construct in psychology, is to learn how to apply a radical level of acceptance in situations of extreme distress. Four key principles of practicing acceptance include:

  • Distracting
  • Self-soothing
  • Improving the moments
  • Focusing on pros and cons

Through learning these methods, an individual will better respond to distressing situations, which allows a level of control and empowerment rather than a person feeling victim to, or attempting to escape, his impulses or emotions.

Interpersonal Effectiveness

The idea behind interpersonal effectiveness is for individuals to develop better skills in reducing negative feelings toward other people. THINK is an acronym used in needed situations to reduce interpersonal distress.

  • Think: Think about the other person’s perspective.
  • Have Empathy: Put yourself in the other person’s shoes. How would you feel in that situation?
  • Interpretations: Consider why a person might respond the way they do.
  • Notice: Notice if the other person is scared or reaching out. Notice if they smile or seem to be trying. Notice the little things. No need to do anything just yet. Just take notice of the small kind gestures that might otherwise be drown in emotion.
  • Kindness: Practice kindness in your response. This doesn’t mean that you are forgiving and forgetting. It just means that you choose a route of kindness in communicating your feelings rather than name-calling or character bashing.

In addition to substance abuse and borderline personality disorder, DBT has proven effective to treat people experiencing depression, bulimia, binge eating, bipolar disorder, and post-traumatic stress disorder.

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For more information about programs offered at Fair Oaks Recovery Center, Sacramento outpatient treatment for addiction, please call us today at (888) 989-9690.