Dialectical Behaviour Therapy
DBT was built for people who feel things intensely — and it gives them one of the most practical, skills-based toolkits in all of psychotherapy.
DBT is organised around four core areas, each with practical, learnable skills.
Mindfulness is the foundation — the ability to observe your own experience without immediately reacting to it. It sounds simple and is genuinely difficult. Most of us spend very little time actually noticing what's happening inside us; we just respond. Mindfulness creates a pause.
Distress tolerance is about getting through a crisis without making it worse. These are the skills for the moments when emotions are at their peak and the urge to do something destructive is loudest. The goal isn't to fix the situation — it's to survive it without adding new problems.
Emotion regulation is a set of tools for understanding, naming, and working with emotional experiences — reducing vulnerability to intense emotions and building positive experiences that create resilience.
Interpersonal effectiveness is about how to navigate relationships — how to ask for what you need, say no, maintain your self-respect, and keep relationships that matter to you healthy.
Try this: TIPP, for when emotions are overwhelming
Temperature (splash cold water on your face — this triggers the dive reflex and physiologically slows your heart rate). Intense exercise (even 60 seconds of jumping jacks). Paced breathing (breathe out longer than you breathe in — try 4 counts in, 8 counts out). Progressive muscle relaxation (tense and release each muscle group). These are not coping platitudes — they are physiological interventions with real effects on the nervous system.
DBT doesn't ask you to stop feeling so much. It teaches you to feel without being swept away, and to act from your values rather than your emotional state.
Who DBT is for
DBT was originally developed for borderline personality disorder, but its evidence base now extends to depression, anxiety, eating disorders, PTSD, and anyone who struggles with emotional intensity, impulsivity, self-harm, or the feeling that their inner life is running them rather than the other way around. It is practical, teachable, and deeply respectful of how hard it is to be human.
