What is DBT?

Dialectical Behavior Therapy (DBT) is an evidenced-based treatment, which was developed by Marsha Linehan in the early nineties.  It was originally created to help individuals who were struggling with life-threatening and self-injurious behaviors.  Since then, DBT has been a promising treatment for other clinical as well as non-clinical populations.

DIALECTICS is a philosophy that informs DBT.

In a nutshell, dialectics is the synthesis of opposing perspectives.  In other words, two perspectives that seem to contradict each other, can harmonize to illuminate a higher truth; just as the process of fitting together individual pieces of a puzzle gradually reveals a bigger and more complete picture.

The core dialectic in DBT is that between acceptance and change. The following assumptions are balanced throughout the therapeutic process:

We are doing the best we know how in any given moment (acceptance),


We are going to need to work harder and find more effective ways of managing life’s stressors, to have the life we really want (change).

Imagine someone has just treated you in a disrespectful way. This is not the first time this person has treated you this way, and you are feeling strongly about finally “dishing it back” to them. You might even think if you don’t respond in this way right now, you might look weak and the disrespect will just continue. However, you may not be considering some of the consequences. With your therapist, you will learn (and practice) how to have your justified anger and urge to “dish it back”, while at the same time responding in a way that is direct, respectful and does not compromise what is important to you – whether that may be your job, housing/other services, relationship, or even your own self-respect. It is not as easy as it sounds!

Dialectics, in the context of the therapeutic relationship, is also the idea that “truth” is constructed between the therapist and the client.  Both are experts, and both need each other to see what the other may be missing.  The therapist relies on the client to understand the history and unique circumstances contributing to one’s problems and distress, and the therapist assists the client in balancing acceptance with change and change with acceptance.

BEHAVIOR is anything we do.

The behavioral component of DBT is the notion that we are probably doing or not doing some things that are contributing to our current situation, despite other factors that may be out of our control.  While we may not have control over people and events in our lives, nor our initial reactions, we do have control when it comes to how we respond to them.

THERAPY comes from the Greek word “therapeia,” which literally means healing.

Life can hurt and harden us in various ways.  DBT places us in the driver’s seat of our own healing process, working with a therapist who assists us to navigate on our journey towards a “life that is worth living.”

  • Suicidal ideation / frequent hospitalizations
  • Self-harming behaviors
  • Substance misuse
  • Lashing out verbally or physically in the heat of the moment
  • Food restriction, binge eating, purging and other nutrition and body-image concerns
  • Shutting down when overwhelmed
  • Skipping work/school
  • Constantly worrying about the future
  • Ruminating on painful events from the past
  • Shopping
  • Gambling
  • Risky sex
  • Isolating from others
  • Hopeless thinking
  • Self-loathing
  • Perfectionism
  • Mindlessly engaging with technology (scrolling social media “Binge watching” Netflix, video games)