An approach created by Marsha Linehan for working with severe emotional instability. Teaching concrete skills instead of talking about feelings.
Some people’s emotions arise faster, reach greater intensity and subside more slowly than most. This is not a choice and not manipulation — it is a feature of emotional regulation.
The problem is that at such intensity the usual advice (“think differently”, “wait it out”) is useless: by the time thinking would be possible, the emotion is already governing behaviour. Hence impulsive acts, self-harm, damaged relationships — and then shame, which sets off the next round.
DBT was created for exactly this.
The name contains the approach’s central idea: to accept yourself as you are now and at the same time work on change. Not “first I will fix myself, then I will accept myself”, but both together. Trying to change without acceptance turns into self-punishment; acceptance without change leaves everything as it is.
Mindfulness. The ability to notice what is happening inside without merging with it. The foundation for everything else: until an emotion is noticed there is nothing to work with.
Distress tolerance. What to do when things are so bad that “just waiting” is impossible and the habitual reaction is destructive. A set of concrete techniques — from working with temperature and breathing to methods of distraction — that let you get through the peak without doing anything you will regret.
Emotion regulation. How to recognise emotions, understand their function, reduce vulnerability to strong reactions and act opposite to the urge where the urge is harmful.
Interpersonal effectiveness. How to ask for what you need and how to refuse while preserving the relationship and your self-respect. For people with emotional instability this is a separate and very practical block.
DBT in its full format is individual therapy plus a skills training group. In our practice elements of DBT are built into individual work: the specialist teaches the skills, you apply them between sessions and bring your observations back.
A lot of attention goes to diaries: tracking emotions, urges and the skills you used is not bureaucracy but a tool that makes change visible.
This is not a short method. Standard protocols are designed for a year or more. Individual skills, however, start working straight away — often within the first weeks.
If you are a practitioner and want to add this method to your work, the centre runs programmes where it is taught.
Systematic training in cognitive behavioural therapy: 13 modules that take you from methodology and assessment through to independent case work under supervision.
Write to us — a coordinator will clarify what you need and suggest a therapist who works in this approach.
