Dialectal behavior therapy (DBT) is based on the importance of having balance in one’s life. It is about realizing that not everything is black and white and finding a balance between changing and maintaining behavior.

DBT primarily helps people with borderline personality disorder (BPD) who experience a lot of anxiety. Those with BPD tend to feel like they cannot tolerate the anxiety and need to get rid of it, instead of thinking “yes, I am feeling this, but it is going to be okay.” They do not realize that they can feel what they are feeling and do something different to tolerate it better.

DBT is based on four different areas: mindfulness

Mindfulness

Mindfulness is all about being able to focus on the present rather than the past and the future. While thinking about the past and future is not inherently wrong, problems arise when people allow difficulties they experienced in the past or worries they have regarding the future to influence the present negatively.

For example, I had a patient with a great deal of anger, stemming from betrayal from his family early in his life. As a result, he now thinks that if he gets close to someone, they will eventually betray him. In his current relationships, he only lets people get close to a certain extent. When he senses they are getting too close, he pushes back or becomes angry.

To combat this line of thinking and behavior, we focus on realizing that the betrayal happened in the past. Relationships are different, and you can not put everyone into the same category. Even if you have been betrayed in the past, it is not guaranteed someone will betray you in the future.