How I came to love DBT

Updated: Feb 15

When I was a graduate student intern in an intensive outpatient program for adults with significant mental health challenges, I was assigned to teach Dialectical Behavior Therapy (DBT) skills to an evening therapy group. I found the teaching manual baffling and the worksheets and handouts complicated. With the emphasis on borderline personality disorder, I could not understand the relevance to other clients who did not struggle with this affliction. We were teaching the skills on an 8-week rotation, so every two months, the skills were repeated. This was meant to ensure that clients received the full set of skills before they left the program for regular outpatient therapy. For me, it meant many exposures to these principles and little by little, understanding grew.

While Marsha Linehan developed DBT specifically for reducing self-harm behaviors and suicide attempts in clients with borderline personality disorder (see: Linehan (1993) Cognitive-Behavioral Treatment of Borderline Personality Disorder), over time the skills, as well as the Biosocial Theory that underpins them, has been shown to be beneficial for treatment of anxiety disorders, mood disorders, and trauma, amongst others.

As I worked to understand DBT skills and theory so I could teach them, I began to see changes in my own life. I became less irritable, more patient, more forgiving (of myself, as well as others), and more resilient to the vicissitudes of life.

DBT is not the only theory that informs my psychotherapy practice, but the biosocial theory and specific skills taught are eminently practical for lowering anxiety, building resilience, and improving interpersonal effectiveness.