Dialectical Behaviour Therapy (DBT): A Complete Guide to Managing Intense Emotions & Mental Health

Life can feel overwhelming when emotions seem uncontrollable. For many people, distressing thoughts, impulsive actions, and difficulty in relationships can make day-to-day life incredibly challenging. Dialectical Behaviour Therapy (DBT) is an evidence-based approach designed to help individuals regulate emotions, manage negative thoughts, and improve mental health.

DBT is particularly effective for individuals struggling with borderline personality disorder (BPD), suicidal behaviours, eating disorders, and other mental health conditions. But how does DBT work, and what makes it so effective?

This guide explores what DBT includes, how it helps with emotion regulation, and what to expect in individual therapy and group therapy settings.

What Is Dialectical Behaviour Therapy (DBT)?

Dialectical Behaviour Therapy (DBT) is a form of cognitive and behavioural therapy that focuses on helping individuals manage intense emotions, improve relationships, and develop skills to handle distressing situations.

Originally developed by Dr. Marsha Linehan for treating borderline personality disorder (BPD), DBT has since been adapted for a wide range of mental health conditions, including:

✔ Suicidal behaviours

✔ Eating disorders (e.g., binge eating, bulimia)

✔ Self-harm and impulsive actions

✔ Anxiety and depression

✔ Substance use disorders

✔ Post-traumatic stress disorder (PTSD)

Unlike traditional talk therapy, DBT is highly structured and skill-based, teaching individuals how to manage emotions, tolerate distress, and build interpersonal effectiveness.

The Core Principles of DBT: Balancing Acceptance & Change

The word "dialectical" refers to the idea of balancing two seemingly opposite concepts—acceptance and change.

• Acceptance: Understanding and validating emotions without judgment.

• Change: Learning new DBT skills to regulate emotions and modify unhelpful behaviours.

By balancing acceptance and change, DBT helps individuals navigate intense emotions while improving quality of life.

What Does DBT Include? The Four Core Skills of DBT

DBT is built on four key skill areas that empower individuals to manage emotions and improve relationships. These skills are taught in individual therapy, group therapy, and practised in daily life.

1. Emotion Regulation: Managing Intense Emotions

People who struggle with intense emotions often feel overwhelmed by their thoughts and reactions. DBT helps regulate emotions by:

✔ Identifying and understanding emotional triggers

✔ Learning to reduce emotional vulnerability

✔ Practising strategies to respond to emotions in a healthy way

By improving emotion regulation, individuals can reduce impulsive actions and improve their overall mental health.

2. Distress Tolerance: Handling Difficult Situations Without Escalation

Life is full of stressful moments, but reacting impulsively can make things worse. DBT teaches distress tolerance skills to:

✔ Cope with crisis situations without harmful behaviours

✔ Reduce self-destructive responses like self-harm or substance use

✔ Use grounding techniques to stay present in the moment

These skills are particularly helpful for individuals dealing with suicidal behaviours or eating disorders, where distress can lead to impulsive actions.

3. Interpersonal Effectiveness: Strengthening Relationships

Maintaining healthy relationships is difficult when emotions feel out of control. DBT includes interpersonal effectiveness training to:

✔ Improve communication skills

✔ Set and maintain healthy boundaries

✔ Navigate conflict resolution in a balanced way

These skills help individuals build better connections with family, friends, and partners while reducing negative relationship patterns.

4. Mindfulness: Staying Present in the Moment

Mindfulness is a core component of DBT, helping individuals:

✔ Become more aware of thoughts and feelings without judgment

✔ Improve focus and emotional stability

✔ Reduce automatic negative thoughts and impulsive reactions

By practising mindfulness techniques, individuals gain better control over their thoughts, feelings, and behaviours.

What to Expect from DBT Therapy?

DBT is delivered in a structured format, typically involving:

1. Individual Therapy Sessions

In one-on-one therapy, individuals work with a DBT therapist to:

• Identify personal goals and challenges

• Develop strategies for emotion regulation and distress tolerance

• Review real-life situations where DBT skills can be applied

These sessions focus on tailoring DBT techniques to an individual’s unique needs and mental health conditions.

2. Group Therapy: Learning & Practising DBT Skills

In DBT group therapy, individuals participate in skills training sessions with others facing similar challenges.

✔ Groups provide a supportive environment to learn new techniques

✔ Participants practise DBT skills through structured exercises

✔ Therapists guide discussions and help individuals apply DBT in day-to-day life

Group therapy allows individuals to gain insights, improve interpersonal effectiveness, and receive peer support.

3. Homework & Diary Cards

DBT therapy includes weekly diary cards, which help individuals:

✔ Track emotions and behaviours

✔ Identify patterns of distress

✔ Practise and reinforce new DBT skills

This structured approach ensures that skills learned in therapy are applied in real-world situations.

How Effective Is DBT? The Evidence-Based Approach

DBT is an evidence-based therapy, backed by research showing significant improvements in:

✔ Emotion regulation and distress tolerance

✔ Reduction in self-harm and suicidal behaviours

✔ Improvements in quality of life

✔ Reduced symptoms of borderline personality disorder (BPD) and other conditions

Studies have shown that DBT is highly effective for people struggling with mental health conditions that involve impulsive behaviours, emotional instability, and distress intolerance.

Is DBT Right for You?

DBT may be the right approach if you struggle with:

✔ Intense emotions that feel overwhelming

✔ Difficulty managing relationships and setting boundaries

✔ Negative thoughts that affect daily life

✔ Suicidal behaviours or self-destructive actions

✔ Borderline personality disorder (BPD) or related conditions

Whether you're dealing with eating disorders, anxiety, depression, or trauma, DBT can provide the skills needed to build a more stable, fulfilling life.

Start Your DBT Journey with Matter of Health

If you’re considering DBT therapy, the right support is essential. At Matter of Health, we provide:

• Individual therapy and DBT skills training

• Therapists experienced in treating BPD, anxiety, and distress intolerance

Contact us today to learn how Dialectical Behaviour Therapy (DBT) can help you improve mental health, build emotional resilience, and create a better quality of life.