Hi, I’m Robert, and I have to confess—I’m a bit of a drama queen.

But I’m learning to tame that part of me with help from a brilliant psychiatrist named Dr. Gillis. Thanks to her guidance, I’m making progress toward a happier, less theatric life, and I’m excited to share my experience with dialectical behavior therapy (DBT) with all of you.

Looking back, I can’t help but wonder, if only I had discovered dialectical behavior therapy sooner, maybe I wouldn’t have lost my closest friend during my last breakdown in 2022.

It’s too late to get her back.

But if I can help one person avoid a personal or professional disaster in their life, this post will be a worthwhile endeavor.

You’re probably here because you struggle with managing your emotions and often find yourself in dramatic situations. DBT has been a powerful tool for me, and I hope sharing my story can offer you hope and motivation.

Before I review some proven and powerful DBT techniques with you—techniques that I personally use– let’s talk a little about the practice and the science behind it.

What is DBT?

Dialectical behavior therapy is a form of therapy that aims to help people manage their emotions and build more effective coping mechanisms.

Originally developed to treat borderline personality disorder (BPD), therapists now use DBT as a treatment for a range of mental health issues, such as depression, anxiety, and substance abuse disorders.

DBT is based on the concept of dialectics, which is the idea that two opposing ideas can both be true at the same time. In therapy, DBT clinicians strive to validate their clients’ emotions and experiences while simultaneously challenging them to make positive changes in their behaviors.

What is Borderline Personality Disorder?

Since DBT was developed to treat personality disorder, it’s important for me to provide a brief definition of BPD. Borderline personality disorder is a mental illness that is characterized by erratic and intense emotions.

A few common BPD symptoms include:

1. Fear of abandonment
2. Impulsive and risky behaviors
3. Distorted self-image
4. Unstable relationships
5. Chronic feelings of emptiness
6. Difficulty regulating emotions
7. Self-harm or suicidal behavior
8. Paranoia or dissociation under stress
9. Intense anger or difficulty controlling anger

BPD affects about 1-2% of the population, with women being diagnosed more often than men.

Will Dialectical Behavior Therapy Still Work for Me if I Don’t Have BPD?

The short answer is yes—or at least probably, based on the fact that you found this blog post.

In fact, I don’t have BPD. I’m just a neurotic writer with depression, anxiety, a touch of bipolar disorder, and some theatrical tendencies. Dialectical behavior therapy helped me, and chances are, it can help you too.

Although DBT was initially developed to treat BPD, therapists have adapted and applied it to help people with other mental health conditions, like substance use disorders, eating disorders, depression, anxiety, and PTSD.

Is DBT Effective?

Since DBT was first introduced by psychologist Marsha Linehan in the late 80s, hundreds of studies have been conducted on the practice. In this next section, I’ll review a few of the most pertinent DBT studies in plain English, with no medical jargon or superfluous language beyond this point.

DBT and Suicide Prevention Study

This study included 99 participants who had recently attempted suicide. Those participants were separated into two groups, one receiving DBT and the other receiving standard care.

Key findings

• Suicidal behaviors were reduced by 50% in the DBT group.
• The DBT group had a lower rate of suicide attempts (26%) than the treatment-as-usual group (60%).
• The number of participants who engaged in self-harm decreased by 42% in the DBT group compared to the treatment-as-usual group.

DBT as a Treatment for BPD Study

This German study, conducted in 2004, examined the efficacy of dialectical behavior therapy in the treatment of borderline personality disorder. The study involved a sample of 58 patients who were randomly assigned to receive either DBT or treatment as usual (TAU) for a period of 12 months.

Key Findings

Note: All of these stats are relative to the control group.

• The DBT group had a 50% reduction in self-harm and suicide attempts.
• DBT led to a 33% improvement in emotion regulation.
• Interpersonal problems improved by 40% in the DBT group compared to the control group.

DBT for College Students with no History of BPD

In 2019, researchers conducted a study to evaluate the effectiveness of DBT for college students. These students were all experiencing mental health issues but did not have a BPD diagnosis. The 12-week study included 102 participants who were randomly assigned to undergo either DBT or a control treatment.

Key Findings

• Students who received DBT showed a 50% reduction in depression symptoms.
• The DBT group also had a 58% reduction in anxiety symptoms, as well as 43% reduction in suicidal ideation.

These findings suggest that DBT may be an effective treatment option for people experiencing a variety of mental health difficulties .

DBT Systematic Review (1,305 Participants)

This meta-analysis reviewed 24 controlled studies with a total of 1,305 participants. Those participants received DBT for various mental health issues, including borderline personality disorder, eating disorders, and substance use disorders.

The results of the meta-analysis showed that DBT was associated with significant reductions in suicidal and self-harm behaviors. Patients receiving DBT also reported improvements in depression, anxiety, and interpersonal functioning. The effect sizes were moderate to large.

How to Practice DBT

Voluminous books have been written about DBT, and I don’t have the time or space to tell you about every DBT technique. But here are a few of the most effective (and beginner-friendly) DBT practices.

Technique 1 – Mindfulness

Since you’re exploring dialectical behavioral therapy (DBT), you’re probably already familiar with the concept of mindfulness. It’s a cornerstone of DBT, and for a good reason.

And its core, mindfulness is the practice of being present in the moment and aware of your surroundings without judgment. It fosters emotional regulation and can enable you to stay calm in challenging situations.

Three Simple Mindfulness Exercises

1. Mindful Focus (on an object)

This was the first mindfulness exercise my therapist recommended to me.

To begin, pick an object—any object, as long as it doesn’t have words on it.

Next, stare at that object for at least three minutes—preferably five to ten minutes. Carefully examine the object—its texture, color, and anything else that jumps out at you.

During the exercise, observe your thoughts, breathing patterns, and other physical sensations without judgment.

2. Mindful Movement

Mindful movement involves paying attention to your body as you move.

Sounds simple, right?

That’s because it is simple.

You can do this with any type of movement, such as walking, yoga, or even cleaning the house.

As you move, focus on the sensations in your body—the stretch of your muscles, the rhythm of your breath, and the feeling of your feet on the ground. Notice any thoughts that come up without evaluating those thoughts, and then gently redirect your attention back to the movement.

3. Box Breathing

Box breathing is a simple breathing exercise that can help you manage stress and anxiety.

The exercise is done in four-second intervals.

To begin, from a comfortable seated position, count to four as you inhale.

Then hold your breath for four counts.

Then exhale for four counts.

And repeat.

As with all mindfulness exercises, the practice is most effective if you do it for at least five minutes.

Technique 2 – Emotion Regulation

In DBT, there’s a module called Emotion Regulation that can be really helpful for people who struggle with intense feelings and volatile moods. There are dozens of emotional regulation techniques. I’ll share a few of the ones I think are most practical and beginner-friendly.

Self-soothing

Remember the movie Happy Gilmore? If not, congratulations!

But for the rest of you, you may remember the scene where the movie’s title character, played by Adam Sandler, is advised by his mentor Chubs to find his “happy place.”

And that’s what self-soothing is about—finding your happy place.

Think about the sights, sounds, tastes, and aromas that give you pleasure.

And then go out (or stay in) and seek pleasure. But not in a hedonistic way, because that isn’t what the exercise is about.

The beauty of self-soothing techniques is that they can be practiced anywhere, from your own home to public spaces like parks and beaches. To make your surroundings more calming, you might use scented candles or diffusers with essential oils. Alternatively, you might put on relaxing music or wear noise-cancelling headphones to block out distractions.

“You’re too hard on yourself,” is something I’ve heard often in my adult life. Self-soothing practices might be useful to you if, like me, you’ve ever treated yourself like a human trampoline.

You deserve a moment of serenity every now again.

As you construct your happy place, consider all five senses and think about what sights, sounds, scents, tastes, and textures bring you joy and comfort. Whether it’s a cozy nook with soft blankets and candles, a quiet hike in the woods, or simply listening to your favorite music, find what works for you and make self-care a priority.

The Rest Formula

If I’d have known about the REST formula prior to my 2022 breakdown, I don’t think I would’ve lost my best friend. Basically, it’s just a way to slow down and act more rationally when  you’re feeling overwhelmed by a situation or emotion.

Rest stands for Relax, Evaluate, Set an intention, and Take action.

First, relax your muscles.

When we’re stressed or anxious, our bodies often tense up, and our muscles become tight. By intentionally relaxing your muscles through deep breathing, progressive muscle relaxation, or basic mindfulness practices, you can calm your body’s stress response and think more clearly.

Next, evaluate your options.

It’s easy to get stuck in all-or-nothing thinking when you’re feeling overwhelmed. The “evaluate your options” step encourages you to step back and consider multiple possible courses of action. This helps you identify solutions that you may not have otherwise considered.

The third step is to set an intention.

Once you’ve evaluated your options, you set an intention for how you want to proceed. What outcome do you want to achieve? What values do you want to uphold? By setting a clear intention, you focus your energy and efforts in a specific direction.

Finally, take action.

This step is all about putting your intention into action. What steps can you take to move toward your goal? By taking action, you’ll regain a sense of control and agency in a situation that may have felt overwhelming before.

Overall, the REST formula can be a powerful tool to help you navigate moments of distress and make more intentional choices. By intentionally relaxing your muscles, evaluating your options, setting an intention, and taking action, you can approach difficult situations with a greater sense of calm and clarity.

Check the Facts

Have you ever found yourself making assumptions or jumping to conclusions without all the facts? I know I have, and it often leads to unnecessary stress and emotional turmoil. That’s where Check the Facts comes in. The process involves five steps:

1. Observe the situation: Notice what’s happening around you and what triggered your emotional reaction.
2. Describe your emotions: Identify and label the emotions you’re feeling without judgment.
3. Gather evidence: examine what happened in an objective way. Look for evidence that supports or contradicts your thoughts.
4. Evaluate the facts: Are you interpreting the situation accurately, or are you jumping to conclusions? Could there have been a misunderstanding?
5. Choose an effective response: Based on the facts, decide on an effective response that aligns with your values and goals.

For example, if you’re feeling angry because your friend canceled plans with you, you could check the facts by asking yourself if there’s a valid reason for the cancellation. If your friend canceled because of a family emergency, your anger may not be warranted.

Checking the facts will help you avoid overreacting or making assumptions, leading to more effective and rational decision-making.

Technique #3 – Radical Acceptance

So many therapeutic devices sound about as intriguing as a DMV manual. Radical Acceptance, on the other hand, has a lovely ring to it.

The practice incorporates elements of mindfulness, emotional regulation, and other techniques.

If you can practice radical acceptance, you’ve effectively earned a black belt in DBT. So that’s not going to happen for you in the next few days or weeks (just being honest). But because radical acceptance is such a beautiful concept, I feel obliged to tell you a little about it.

Embracing the present moment, even if it’s not what you hoped for or expected, is at the heart of radical acceptance. It means letting go of resistance, judgment, and denial, and instead choosing to respond in a way that’s mindful, compassionate, and empowering.

If you’re interested in eventually earning your black belt in DBT mastering the art of radical acceptance, here are a few tips to get you started.

1. Notice when you’re resisting reality: Pay attention to the thoughts, emotions, and physical sensations that arise when you encounter a difficult situation. Are you trying to push it away or deny it? Are you judging yourself or others? When you notice resistance, take a deep breath and acknowledge what’s happening.
2. Practice self-compassion: Radical acceptance involves being kind and gentle with yourself, even when things are hard. Treat yourself as you would treat a good friend who’s struggling.
3. Use mindfulness techniques: Mindfulness helps you stay present and grounded, even when you’re facing difficult emotions. Try focusing on your breath or body sensations, or use a mindfulness app to guide you through a meditation.
4. Take empowered action: Radical acceptance isn’t about giving up or resigning yourself to a bad situation. It’s about recognizing reality and choosing to respond in a way that’s mindful, compassionate, and empowering. Once you’ve accepted a situation, ask yourself what actions you can take to improve it or make the best of it.

10 Benefits of DBT

In case you’ve been skimming the article rather than carefully examining each section, here’s a brief recap of the benefits of DBT.

1. Emotional regulation: DBT can help you identify and manage intense emotions like anger, sadness, and anxiety.
2. Mindfulness: Practicing mindfulness enables you to be more present in the moment and less reactive to stressors.
3. Self-awareness: You’ll gain a better understanding of your thoughts, feelings, and behaviors.
4. Acceptance: DBT emphasizes accepting yourself and your situation as they are, rather than fighting against reality.
5. Interpersonal effectiveness: DBT helps you improve your communication skills and develop healthier relationships.
6. Self-compassion: Instead of being hard on yourself for mistakes or setbacks, you’ll learn how to treat yourself as you would treat someone you care about, with support and encouragement.
7. Distress Tolerance: DBT offers you a roadmap to overcoming adversity and developing resilience.
8. Enhanced creativity: By learning to regulate your emotions and improve your focus, DBT can help you unlock your creativity and better express yourself.
9. Increased sense of purpose: With DBT, you’ll develop a greater sense of meaning and purpose in your life.
10. Improved overall well-being: By working on these skills, you may find that your overall sense of well-being improves, leading to a happier and more fulfilling life.

Dialectical Behavior Therapy – Summary

1. DBT is a therapy that helps people manage their emotions and build effective coping mechanisms.
2. Originally developed to treat borderline personality disorder, DBT has also demonstrated effectiveness as a treatment for a range of mental health issues, such as depression, anxiety, and substance abuse disorders.
3. DBT is based on the concept of dialectics–the idea that two opposing ideas can both be true at the same time. In clinical settings, practitioners work with clients to accept and validate their experiences and emotions while also challenging them to make positive changes in their behavior.
4. DBT techniques include mindfulness, emotional regulation, and radical acceptance.
5. Mindfulness helps you be present and aware of your thoughts, feelings, and sensations in the moment.
6. Three beginner-friendly mindfulness exercises include mindful focus, movement, and breathing.
7. Emotional regulation allows you to communicate more effectively with people and manage your emotions when you feel stressed or overwhelmed.
8. Three beginner-friendly emotion regulation techniques include self-soothing, checking the facts, and the REST formula (Relax, Evaluate, Set an Intention, Take Action).

Further Reading

DBT Skills Training Handouts and Worksheets 

Written by Marsha M. Linehan, who created DBT in the late 80s, this book is a comprehensive guide to DBT skills, including mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance.

It provides handouts and worksheets that can be used for individual therapy, group therapy, and self-help. This book has a 4.8/5 rating on Amazon with over 4,500 reviews.

The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation & Distress Tolerance

I purchased this book after my breakdown in 2022, mentioned earlier. It also includes exercises and worksheets to help readers apply the skills in their daily lives. I’ve personally completed many of those exercises. This book has a 4.6/5 rating on Amazon with over 3,000 reviews.

Dialectical Behavior Therapy – Conclusion

With a focus on mindfulness, emotion regulation, and interpersonal effectiveness, DBT offers practical tools and techniques that can help you manage difficult emotions and build healthier relationships.

Dozens of randomized and controlled studies have demonstrated the efficacy of DBT, particularly for individuals with borderline personality disorder, but also for those with depression, anxiety, substance abuse, and other conditions.

If you or a loved one is struggling with a mental health issue, consider speaking with a qualified mental health professional about whether DBT may be a possible solution.