Rehab Cell

Physical Medicine and Rehabilitation

What is Dialectical Behavior Therapy?

What is Dialectical Behavior Therapy?


Hey, everyone! Thanks for checking back. Now, today I’m going to talk with you about DBT therapy or Dialectical Behavioral Therapy. So, stay tuned! So, like I said, today I’m going to talk about DBT therapy (Dialectical Behavioral Therapy). Now, to give you a little history of DBT, and I’m going to try to keep this as short as I can, but if any of you want to Google it or get a workbook and check it out do that. ‘Cause there is a lot more to it than I can ever get into a Youtube video. So DBT therapy was created by Marsha Linehan and she was studying, she was a psychology researcher, I believe, at the University of Washinton at the time. What? Washington. Hey, Huskies! Okay. Anyway, she was studying there and she decided due to her own struggles with Borderline Personality Disorder, she noticed that a lot of therapists that were working with patients like this, that we were, what we call, getting “burnt out”. And when in therapy we talk about burn out, it’s like you really want to help this client, but you honestly have to refer them because you’re so exhausted. You’ve tried everything. They’re still having suicide attempts and you don’t know what else to do. You’re feeling kind of helpless. And so they recommend as a therapist that you refer them out, and so she came up with Dialectical Behavioral Therapy combining some of CBT therapy skills, which I have a video on CBT and you want to click on the link here actually if you want to check it out. And it’s combining that and also some of the Buddhist principles about being aware and mindful. She kind of squished those together and created DBT therapy. And I made some notes here. I have my laptop down here. That’s why I’m looking down, so that I don’t forget any of the contents of it because DBT therapy is something that has 2 parts. First of all, you see a therapist like me, who’s a certified DBT therapist and they’ll see you each week for an hour just like your regular therapy. But on top of that, you also are in a DBT group and you meet for 2 to 2 1/2 hours each week. That’s honestly where you get into the nitty gritty of this. You do a lot of homework. If any of you are looking for a workbook, I have one at my website KatiMorton.com in the Widget, a great DBT workbook and you can find it that way. Now, without further ado, because it can get, like I said, it’s really intensive. There are 4 modules to DBT and I’m going to go through them really quickly, so that I can keep this short. But if any of you want me to do more videos on this, give this a thumbs up and in the comments below let me know what topic you want me to talk about more. I’ve already done a video on the first one, so I’m just going to say Mindfulness is one of the first. They call it like the foundation of DBT and I have a video on that, so you can click this link for more information on Mindfulness and I’ll talk about the What skills, the How skills and all that jazz. The next portion, #2 is Distress Tolerance. Now, Distress Tolerance is what I talk about a lot when I say: “Distract yourself! Don’t do it! Don’t give into the urges!” And they talk about distracting with ACCEPTS. DBT is all about the acronyms, so get ready because you’re going to have to remember a lot of these. Now, ACCEPTS talks about Activities, like: “Hey, get out of the house. Go see a friend. Get coffee. Do some art”. I don’t know. Have an activity! Contribute; help out others in your community. Look at us, we’re so good. Comparisons, Emotions, Push Away, like: “I can’t deal with this now”. Push it to the back, right? Thoughts and Sensations; so if you looked at all the first letters of all those words, it reads ACCEPTS. Now, there are others under that, but I want to keep going ’cause you can also let me know if you like and you want me to talk about Distress Tolerance in more detail. Now, the next portion of DBT is Emotion Regulation because, like I talk about in my Borderline Personality Disorder video which you can click here to view, I talk about regulating our emotion because when we have Borderline we feel like it’s all out of whack. We worry: “Don’t leave me! Wait, no! I hate you! Agh!” We just feel really overwhelmed. And so, regulating our emotions can really be the key to us being more participative with our friends, feeling like we can really love others how others love us and we start to feel a little bit more safe. And our mood, instead of being up and down like this, it starts to kind of level out and it can really help. And this, the main part of Emotion Regulation is, I guess, the best way to say is a huge chunk of CBT therapy. They want you to realize what event has caused this, what emotion came out of it, what action you took as a result and tries to slow down the process and get us better able to regulate it without just jumping to a conclusion. Right? So I’m going to scoot down that. And there a lot of acronyms under this, so like I said, get prepared. Now, the last, the 4th portion of DBT therapy is Interpersonal Effectiveness. Now, something that we struggle with when we have BPD is having close relationships and having people that we really trust, we love. We feel like they trust and love us in return, and we’re secure in that and having that secure attachment. Right? So in this portion we talk about kind of how to assert yourself while at the same time not being aggressive. Right? So: “Hey, Sean, what you said to me really hurt my feelings and I understand you’re going through a lot right now, but I felt very misunderstood” or very unimportant or whatever it is you’re feeling and you’re able to express that without being like: “You stupid son of a gun! I hate your guts!” And bah, bah, bah! Right? And it teaches us how to better communicate. So if any of you are considering DBT or if you’ve been told or have been diagnosed with Borderline Personality Disorder I would look into it. It is amazing! It’s a lot of hard work, but it’s so worth it. You’re worth it. Check out the workbook on my website, the one that’s in my Widget because it’s amazing. And doing the homework and putting the work in will really mean a happier and healthy life down the road. And isn’t that what we’re all working for, right? So keep checking back. Like I said, let me know. Don’t forget to subscribe to my channel. And check out my other videos that I linked because it’s really helpful and it will give you a bigger picture of what this is about. We’ll keep putting one foot in front of another as we work towards a Healthy Mind and a Healthy Body. Subtitles by the Amara.org community

100 thoughts on “What is Dialectical Behavior Therapy?

  1. thank you for the video, I am learning new coping tools and this seems like a good one. I can't go to a therapist for it, but at least I got some pointers from you, so it helps.

  2. Would have been a great video, however there a lot of errors in this video.
    1. Marsha Linehan studied in Loyola University (Chicago) and did a fellowship in Stonybrook University in new york state.
    2. Your description of DBT, in general, is all kinds of questions.
    3. Marsha Linehan herself suffered from BPD and thus wanted to help others suffering as at the time BPD was not a disorder.
    4.DBT is under the umbrella of CBT.
    5. DBT was developed to help therapists tackle multiple problems at the same time (teaching new skills while dealing with chronic suicidal behavior)
    6. There are a ton more errors in your video, and it makes me worried that you claim to be "certified" as I think you lack the knowledge to be a professional therapist.

  3. Kati, please do more videos on DBT! I've watched your play list on BPD and want to learn more about treatment and therapy for this condition. Thanks!

  4. I can't gay VT class twice and I helped me a little bit but I didn't quite understand it and willing to learn again I'm struggling West family and friends right now I was wondering if you can do something on relationships I have struggles with my boyfriend cuz I have borderline personality disorder and other things but we won't go into that tell us if you have any questions please contact me

  5. I know that DBT is supposed to help people with borderline personality disorder with bipolar but does it help those with complex- PTSD too?

  6. Now, I was diagnosed with PDNOS.. but I'm somewhere in cluster B, I'm going to DBT therapy. Will it only work if I have BPD?

  7. I got referred to a DBT program, and the biggest thing that really upsets me about it is the fact that I have to see the program's therapist instead of the therapist I just started seeing, and what really bugs me about that is that I've been in "by the book" therapy off and on since I was 6, and when I started seeing this therapist, she actually seemed open minded enough to take me seriously when I said, "Hey, the by the book shit doesn't work – let's experiment with something else!" Now I feel like I'm taking a step backward and am going to wind up with, "Okay, now you're just going to have to do what we tell you" again, even though that didn't help me in the past.

  8. I go to DBT once a week for 45 minutes and then CBT once a week for 50 minutes but don’t go to group but my DBT therapist just had a baby so don’t know what I’m gonna do 😭😭😭😭

  9. More PTSD/insecure attachment. Especially in dating for males and females. Way harder for guys, we have to pursue. Homework PLEASE.

  10. Thank you, thank you, thank you for putting out these videos for all of us out here in need of a bit of assistance and don't really feel we can afford therapy. I am thinking that this bit of information is going to help me so much when I am feeling so overwhelmed and then I respond with such emotions of tears and heavy crying. I don't want to get to that point again in front of my adult children and friends. I am hoping this is going to be something that I can do to help me in the future. I would love to have the therapy because I know that I have to have some issues coming out of a home with a mother that had bipolar disorder and maybe she also had BPD. I am so sorry that I never learned for certain what my mother suffered from, but I am now 59 years old and I really know that the family of siblings is suffering and has been for years. It appears that I am the only one that has really been able to admit this and I removed myself from the family off and on all my life. I just knew that it wasn't healthy for me and it was also very painful to neglect my family at the same time. I struggled quietly all my life and now worry that I too, have passed this down to my own children that are all grown now and successful wonderful people. I often had so much pushed down pain and allowed abuse from my sibling for years on and off because I didn't allow myself to become fully aware of my part in the abuse by accepting it. I just tried to stay away with a constant pull at my heart of wanting to have a family and maybe it would be possible and then I would try again and end up with the same results. Not able to have a family. No contact now for good if I am strong enough to do it. So very sad to me, but I must work on myself and try to do better now for myself and my own family. Healing needs to take place. Thank you so much for being a positive face on the internet reaching out to so many of us. It is so appreciated.

  11. Was just diagnosed with BPD and will be starting DBT in the next 3-4 weeks. Thank you for explaining it so people can know what to expect 🙂

  12. I was seeing a therapist every tuesday morning last year and she had me to go DBT group therapy tuesday afternoons for two hours. Though, after watching this video, I'm not sure why she referred me. I don't believe I was putting her at withsend nor do I have BPD.

  13. Thank you for the vid. Also, excellent "linkage" to CBT in the emotional regulation pillar of DBT. You seem to be a good instructor. I love doing group therapy as well as individual. My steps are to do about 3 to 4 weeks didactic, teaching the group members about the topic, lets say 'shame and guilt' as well as the therapeutic modality(s) we are all going to use. Then switch to a process type group where we utilize what we learned about the topic using the modality we also learned. It is during the process that I would incorporate individual sessions as well. I am only 13 years in recovery and 10 years working in this field. Is there a better way to go about the group process than the one that I exampled? Again, thank you for the information and the video.

  14. I feel like if I was in a dbt group, I’d just be judging non stop and then judging myself because I must be as messed up as the people I’m judging if I’m in that group. It would be a horrible viscous cycle.

  15. When you give examples in a voice similar to a 5 year old it makes it hard to listen to/take seriously the point you're trying to make.

  16. I know this is an old video but I found out i have borderline and your video shave been really helpful. My therapist doesn’t even know how to treat borderline which is kinda disappointing and i mentioned this type of therapy to her and she said she would look into

  17. It's great to see that your videos have inspired and informed so many people. And your compassionate attitude helps reduce the stigma.

  18. Love your work, Kati!
    I personally found both CBT and DBT to to completely ridiculous (and I worked with a highly respected, very expensive practitioner).
    Basically the idea is to help you see how your thoughts aren't really an accurate representation of reality. Well, DUH! I already know that when I feel like nobody cares about me, it's not exactly the truth. People have told me this for years; I didn't need somebody to prove it to me.

    It's just a systematic version of the well-meaning friend who says, "cheer up, you've got a great life!". If that worked, depression would not be the major societal issue it is.

    They claim that negative feelings are the result of irrational thoughts. I don't think that's always the case for me, and when it is, I know that my thoughts are exaggerated, but they still make me upset! I knew the theory going in, but somehow I thought there must be more to it. Nope, that was just hope borne of desperation.

  19. Do you have anything to say about DBT therapy in recovery from addiction? Particularly early recovery

  20. Just hearing your calm voice makes me feel hopeful that one day I will have a long lasting relationship one day. It's all I want in this lifetime. Wish I could have heard you in my teens and twenties especially. Many suicide attempts. Mosty overdoses. The internal tsunami has been reduced to a tornado. I understand I need to pursue and complete this DBT. It makes sense. Those skills would really improve my life. Thank you for doing these videos.

  21. Do you have a video where you explain what CBT (Cognitive Behavioral Therapy) is?

    Is only DBT beneficial for people with Borderline or is CBT also helpful?

    I'm not sure if aspects of CBT is a part of DBT or not.

    I have had DBT over the years and it's not essy finding someone with BPD, especially due to the stigma of mental illness, and more specifically, geared towards BPD.

    Thanks for reading this and hope you or anyone else can help!

  22. My therapist suggested a day program focused on DBT today. Does that mean she doesn't want to deal with me anymore? Is she burnt out on me? I don't know if I can open up to another person like I have with her. 🙁

  23. I was in a DBT program about five years ago or so. I "graduated" and as I like to put it, my Borderline went into remission. Lately, I've been having a difficult time, so I enrolled in a DBT program again. It has helped me immensely. Seriously people, I would look into DBT. If you stick with it, I really think you'll find healing

  24. I hope dbt can help because I’m destroying my own life. I’m trying my hardest but it’s so so hard. I’m hurting people I love and the guilt just kills me. I feel like a prisoner in my own mind. Bpd sucks

  25. I'm confused. I have just started my journey with DBT and I already like it. But I'm not diagnosed with BPD from what I know. I'm missing something here, right?

  26. I was diagnosed with borderline personality disorder today.. they gave me meds and want me to go into dbt.. I have a really bad experience with counseling so I'm really nervous and fearful it's not going to work.. Thank you so much for posting this video (even if it was long ago) I really needed it

  27. I'm actually in therapy 2x a week one for individual therapy and DBT group therapy I've had so many suicide attempts and hospitalizations so therapy has been a life saver for me

  28. Hey Kati, you cheered for the Huskies? Are you from washington?? I saw your practice is California based. I only ask because if you had other therapist friends in WA i'd love a referral. ^_^

  29. Your videos are very informative and I really like watching them. I would point out at something that soothes me a lot while watching you speaking which is you always use the pronoun "we" which I find so compassionate and accepting as if you are so close to us in a way that you really understand what we go through. Thank you so much for those videos and keep up the good work.

  30. I just wanted to say that DBT is not for everybody and that's okay.

    I was in an intensive outpatient program for 3 months, got through Marsha Linehan's entire workbook, and worked really hard inside and outside group, and it still didn't help at all. I was eventually discharged because they could see I got all I could out of the program even though I didn't make any progress. I did see DBT help a lot of groupmates though, so it's definitely worth a try. Good luck!

  31. 8 mouths iv been doing this iv bought books everthing iv tryed so hard still dont get any of it its i feel a right let down iv still got my child hood going around in my head 24 hours a day
    iv had this bullshit from 11 years old im 44 im so tired of this fight taken me 30 years just to get help im just feeling at my end of it all nothing ever worked

  32. CBT plus 'mindfulness' or double dose of nonsense for double the cost. Just Say no, free yourselves from your therapy addiction and make the dealers get a proper job.

  33. Hello Kati ! I know this video is very old but I have a question. So my therapist wants to start DBT treatment with me, but I haven’t had any formal diagnosis yet, and idk I don’t wanna asume I have bpd, even tho I do consider it. Should I ask my therapist first for a diagnosis before starting DBT??

  34. I've been thinking that it seems to me that one of the main culprits we face nowadays is a direct result of a lack of emotional education.
    Unless we are somehow impaired or have an illness that specifically affects reaction, we can control our actions. Yes, we might feel enraged, but we need not react with anger. Yes, we might feel disappointed, hurt, betrayed, but we need not react with violence.

    I believe that if more people (and DEFINITELY men in particular) would be aware of their emotional needs and their regulation, we would see less abuse, violence and harrassment.
    Yeah, I'm not perfect and have not always reacted to the best of my abilities, but I am very aware now of the power to change your outcomes with a shift in thoughts.
    One of the most valuable things I've learned through DBT therapy is that thoughts aren't facts. When we react to thoughts and assume them as facts, we often engage in a mind-*#@ng cycle that is deeply hurtful.
    I wish everyone could receive emotional education, regardless of their age, gender or any other factor often used to diminish responsibility.

    I'll be happy to share what I've learned with anyone that is interested. If you have been someone to shout at wait staff, exert violence in any way towards others, blame and pass responsibility, justify your actions with emotional overwhelming, know that nothing justifies it. It is ON YOU.
    You can have a better life. It's worked for me because I worked it! Yes it sounds familiar right? Try it if you can.

  35. Can anyone please point out which DBT self help book she’s referring to? I can’t find any widget on the website. Thanks

  36. Kati, please keep uploading videos on the 4 modules of DBT (I know this one's a lil old). Especially, distress tolerance. Thanks!

Leave comment

Your email address will not be published. Required fields are marked with *.