Dialectical Behaviour Therapy (DBT) is a specific type of cognitive-behavioural psychotherapy which was developed by psychologists and empathises the psycho-social aspects of treatment.

DBT is the most recommended type of therapy for people who are diagnosed with Borderline Personality Disorder (BPD) and is seen to be the most effective.

What is DBT?

DBT is short for Dialectical Behaviour Therapy and is a type of talking therapy. DBT has roots from Cognitive Behavioural Therapy (CBT) but has been specifically adapted to help people who experience very intense emotions.

This type of talking therapy is mostly recommended for treating Borderline Personality Disorder (BPD), but it can also be adapted to treat self-destructive behaviour, eating disorders and post-traumatic stress disorder.

DBT mainly focuses on enabling you to change your unhelpful behaviours, but it also focuses on supporting you to accept who you are at the same time. The goal of DBT is to help you manage your intense emotions by supporting you to recognise, feel and accept them. As you learn to do this, you become more able to change any harmful behaviours and more motivated to do so.

DBT therapists often use two main techniques in therapy:

• Acceptance techniques: these are techniques which focus on accepting and understand who you are as a person and making sense of why you might do certain things such as misuse drugs or self-harm.
• Change techniques: these encourage you to replace harmful behaviours with more effective ways of dealing with distress and help you move forward with your life.

What is BPD?

Borderline Personality Disorder (BPD), sometimes known as Emotionally Unstable Personality Disorder (EUPD) is a type of personality disorder in which you have difficulties with how you think and feel about yourself and other people. Causes of BPD are unclear, but it is thought it’s often due to traumatic life experiences such as family instability; sexual, physical, emotional abuse or neglect; feeling invalidated as a child; and bereavement. Evidence suggests that there may also be a genetic factor as you are more likely to be given this diagnosis is someone in your close family has BPD.

Symptoms of BPD include:

• Being terrified of people abandoning you
• Having very intense emotions that can change quickly
• Having an unsure sense of who you are as a person
• Finding it difficult to keep stable relationships
• Having intense feelings of anger which is difficult to control
• Engaging in impulsive behaviours and behaviours which could harm you or others
• Often having suicidal feelings or urges to self-harm
• Experiencing paranoia or dissociation when stressed

Treatments for BPD include talking therapies such as DBT and medication such as minor tranquilisers to help you sleep and anti-depressants.

The four main strategies of DBT

DBT supports you to effectively change your behaviour using these four main strategies:

• Mindfulness – Learning how to focus on the present and live in the moment. DBT teaches you how to be more mindful by using radical acceptance, taking effective action and separating your emotions and sensations from your thoughts.
• Distress tolerance – Learning how to accept both yourself and the current situation, and learning how to tolerate crises and distress using distraction to calm down, self-soothing by relaxing and using your senses to feel more at peace, finding ways to improve the moment despite difficulty and thinking of the pros and cons of different coping strategies.
• Interpersonal effectiveness – How to keep healthy and positive relationships by learning how to express your needs. This also combines listening and social skills to help you learn how to change situations while staying true to yourself.
• Emotion regulation – How to recognise and cope with negative emotions along with learning how to reduce your emotional vulnerability by increasing positive emotional experiences.

What will the sessions be like?

DBT sessions typically last between 50 – 60 minutes per session, usually once per week. Each session will include multiple goals such as:

• Helping to keep you safe by reducing suicidal and self-harming behaviours.
• To address any issues that might interfere with therapy.
• To help you to reach your goals and improve your quality of life
• To help you to learn new skills to achieve your goals and replace unhelpful behaviours.

Some factors to consider

While some people might find DBT difficult in the beginning due to needing to accept your problems and work hard to change them, many people find the effort worthwhile. When thinking of undertaking DBT, it might be helpful to think about these questions:
 

• Am I able to put the work in? DBT can sometimes feel like hard work, especially as you will usually be asked to do some individual homework in-between sessions.
• Is DBT relevant to me? If you are mostly interested in having someone to talk to about your problems in general, and want to find out where they came from, DBT might not be the best option for you. If this is the case then you may want to consider some other talking therapies such as counselling.
• Is changing my behaviour a priority for me? The main focus for DBT is on enabling you to be able to change your problematic behaviour.
• Do I have multiple disorders? If you have any other disorders along with your BPD then DBT may not be right for you as DBT will not address issues relating to other diagnoses.

Online DBT therapy for BPD with Psychologyhelp

Thanks to the modern age, online DBT therapy for BPD has become the most convenient and efficient source of help. At Psychologyhelp, you can speak with a therapist online about your anxiety within 24 hours of sending your request. However, responses to completed forms on the website and initial emails are likely to be replied to faster than this.

We have qualified therapists and psychologists who are trained in a wide range of talking treatments and interventions, with experiences of many years. With systematic screening and due diligence work, we will always match you with a qualified therapist who specialises in the issue that you’re experiencing, and who is knowledgeable in the type of therapy you’re looking for. This is so you know that you’re receiving the best online DBT therapy for BPD.