DBT Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy that was

originally developed to help individuals with borderline personality disorder. It combines
elements of cognitive therapy with strategies for regulating emotions and improving
interpersonal relationships. DBT aims to teach individuals new skills for managing
painful emotions, reducing self-destructive behaviors, and enhancing their overall
quality of life.
Emotional regulation, within the context of Dialectical Behavior Therapy (DBT), involves
a systematic process for managing intense emotions effectively.

1. Identify the Emotion:

Therapists use various techniques and approaches to help clients identify and
understand their emotions. Here's how therapists typically identify emotions during
therapy sessions .
(a) Observation of Non-Verbal Cues:
Therapists observe the client's facial expressions, body posture, gestures, and other
non-verbal cues to gather information about their emotional state.
Non-verbal cues often provide valuable insights into underlying emotions that clients
may not express verbally.
Example 1: During a group therapy session, a participant shares a traumatic memory
from their childhood. The therapist notices the participant's hands trembling and their
shoulders hunched, indicating heightened distress and vulnerability.
Example 2: A client discusses feelings of anxiety and panic attacks triggered by social
situations. The therapist observes the client fidgeting in their seat and avoiding direct
eye contact, suggesting discomfort and unease.
Example 3: A child struggles to articulate feelings of sadness and confusion about their
parents' divorce. The therapist observes the child's slumped posture and downturned
gaze, signaling emotional distress and withdrawal.

(b) Exploration of Emotional Triggers:

Therapists help clients explore the situations, events, thoughts, or memories that
trigger emotional reactions.
By identifying and examining these triggers, clients gain insight into the underlying
causes of their emotions and how they relate to past experiences or current
circumstances.
Example 1: A client becomes tearful when recounting memories of a past trauma during
therapy. The therapist explores the specific triggers associated with the trauma, such
as certain sounds or smells, to better understand the client's emotional responses.
Example 2: A client experiences intense anger and frustration in response to perceived
rejection by a romantic partner. The therapist helps the client explore underlying
insecurities and fears of abandonment that contribute to their emotional reactions.
Example 3: A client expresses feelings of sadness and grief following the death of a
loved one. The therapist encourages the client to explore memories and shared
experiences with the deceased to process their emotions and find meaning in their loss

2. Emotion Influence / Psychoeducation

Emotion realization, also known as emotional awareness or emotional self-
awareness, is a fundamental aspect of psychological well-being and personal
growth. Here's a step-by-step guide on how to cultivate and enhance emotion
realization:

a. Understand the Importance of Emotions:

Recognize that emotions play a crucial role in our lives, influencing our thoughts,
behaviors, and overall well-being.
Understand that emotions serve as signals, providing valuable information about
our needs, desires, and reactions to the world around us.

Example 1: Recognize that emotions influence our decision-making process,

such as feeling excited about a new opportunity or anxious about a challenging
task.
Example 2: Understand that emotions impact our relationships, like feeling happy
when spending time with loved ones or frustrated during conflicts.
Example 3: Acknowledge that emotions contribute to our physical health, with
stress leading to physical tension and relaxation promoting overall well-being.
 (b) Identify and Label Emotions:
Learn to accurately identify and label your emotions. Use a wide range of
emotion words to describe your feelings (e.g., joy, sadness, anger, fear, disgust).
Pay attention to subtle variations within emotions (e.g., differentiating between
frustration and irritation).

Example 1: Recognize and label feelings of joy when receiving positive feedback
on a project at work.
Example 2: Identify and label feelings of sadness when reflecting on the loss of a
loved one.
Example 3: Distinguish between feelings of anger and frustration when facing
obstacles in achieving personal goals.

(c) Explore the Root Causes:

Reflect on the underlying reasons or triggers behind your emotions.
Consider past experiences, beliefs, values, and interpersonal dynamics that may
contribute to your emotional responses.
Journaling or talking to a therapist can help explore and understand these
underlying factors.
Example 1: Reflect on childhood experiences that may contribute to feelings of
insecurity or self-doubt in adulthood.
Example 2: Consider cultural influences that shape beliefs and attitudes towards
specific emotions, such as expressing vulnerability.
Example 3: Explore how past traumas impact current emotional responses and
interpersonal relationships.

3. Emotion Realization
Mindful Breathing:
(a). Find a Comfortable Position:
Sit or lie down in a comfortable position where you can relax without distractions.
 Close your eyes if it feels comfortable, or simply soften your gaze.

(b) Bring Attention to Your Breath:

Begin by bringing your awareness to your breath. Notice the sensation of air
flowing in and out of your nostrils or the rise and fall of your chest and abdomen.

(c) Focus on the Present Moment:

Gently anchor your attention to the present moment by focusing on the physical
sensations of breathing. Let go of any thoughts about the past or future, allowing
yourself to be fully present.

(d) Observe Your Breath Without Judgment:

Notice the rhythm and pace of your breath without trying to control it. Observe
any thoughts, emotions, or sensations that arise, allowing them to come and go
without judgment.
(e) Use Anchor Points:
If your mind starts to wander, gently guide your attention back to your breath as
your anchor point. You can also use anchor points such as counting breaths or
silently repeating a word or phrase with each inhale and exhale.

(f) Practice Non-Attachment:

Practice non-attachment by letting go of any attachment to specific outcomes or
experiences during the practice. Simply observe whatever arises in the present
moment with curiosity and acceptance.

Skills which can be used in DBT

1. Mindfulness Skill
2. Distress Tolerance Skill
3. Interpersonal Effectiveness Skill
(a) assertiveness skills,
 (b) boundary-setting,
(c) effective communication strategies to improve relationship satisfaction.

4. Decision making skill

5. Reverse counting
6. Cognitive reappraisal
Emotional intelligence techniques can be seamlessly integrated into DBT to enhance
its effectiveness. Here's how emotional intelligence techniques can be used in DBT:
(a) Emotion Regulation Strategies:
Emotional intelligence involves effectively regulating and managing emotions. In DBT,
clients learn practical emotion regulation skills to cope with intense emotions and
reduce emotional vulnerability.
Therapists teach clients a range of emotion regulation strategies, such as cognitive
reappraisal, distress tolerance techniques, and mindfulness-based approaches, tailored
to their individual needs and preferences.
Real-Life Example:
Meet Alex, a young adult who has been attending DBT therapy to address difficulties
with anger management. Alex often finds himself getting overwhelmed by feelings of
anger in response to minor frustrations or perceived slights from others. He recognizes
that his explosive outbursts have strained his relationships and caused problems at
work.

Applying Emotional Intelligence Techniques in DBT:

With the guidance of his DBT therapist, Alex learns to identify and label his emotions
more accurately. He realizes that his anger is often triggered by feelings of perceived
disrespect or injustice, but underneath the anger lies deeper emotions such as hurt, fear,
or insecurity.

Mindfulness of Emotions:
Alex practices mindfulness exercises focused specifically on his experience of anger.
During therapy sessions, he learns to observe the physical sensations, thoughts, and
urges associated with anger without reacting impulsively. Through mindfulness, he
becomes more aware of the early warning signs of anger, such as muscle tension or
racing thoughts.
Developing Emotion Regulation Strategies:
Using emotional intelligence techniques, Alex collaborates with his therapist to develop
personalized emotion regulation strategies tailored to his needs. Together, they explore
various techniques, including:
Cognitive reappraisal:
Alex learns to challenge and reframe his negative thoughts and interpretations that fuel
his anger. For example, instead of assuming that someone's criticism is a personal
attack, he considers alternative explanations or perspectives.
Distress tolerance skills:
Alex practices coping strategies to manage his distress when confronted with triggering
situations. He learns techniques such as deep breathing, progressive muscle relaxation,
or engaging in distracting activities to soothe himself and prevent escalation.
Mindfulness-based approaches:
Alex incorporates mindfulness practices into his daily routine to cultivate greater
emotional awareness and acceptance. He learns to observe his emotions non-
judgmentally and let them pass without reacting impulsively.
Real-Life Application:
One day, Alex encounters a frustrating situation at work where a colleague dismisses
his ideas during a team meeting. In the past, this would have triggered intense anger
and led to a heated confrontation. However, Alex now applies the emotion regulation
strategies he's learned in therapy:

Identifying the Emotion: Instead of immediately reacting, Alex takes a moment to pause
and identify his emotions. He recognizes feelings of anger and hurt arising but reminds
himself to stay calm and respond thoughtfully.

Applying Emotion Regulation Techniques:

Alex employs his coping skills, taking deep breaths to calm himself down and using
cognitive reappraisal to reframe the situation. He reminds himself that everyone is
entitled to their opinions, and his worth isn't determined by others' approval.
Choosing an Adaptive Response:
Instead of lashing out or withdrawing, Alex decides to address the issue calmly and
assertively. After the meeting, he approaches his colleague privately, expressing his
perspective calmly and advocating for his ideas without hostility.

Through consistent practice and application of emotional intelligence techniques within

the framework of DBT, Alex gradually learns to manage his anger more effectively. He
experiences fewer outbursts, cultivates healthier coping mechanisms, and improves his
interpersonal relationships both at work and in his personal life.
(b) Empathy and Compassion:
Emotional intelligence includes the ability to understand and empathize with others'
emotions. In DBT, clients develop interpersonal effectiveness skills, including
assertiveness, active listening, and validation.
Therapists model empathy and compassion in their interactions with clients, validating
their emotional experiences and fostering a supportive therapeutic relationship built on
trust and understanding.
(c) Interpersonal Effectiveness:
Emotional intelligence skills are crucial for navigating interpersonal relationships
effectively. In DBT, clients learn assertiveness skills, boundary-setting, and effective
communication strategies to improve relationship satisfaction.
Therapists role-play interpersonal scenarios with clients, helping them apply emotional
intelligence techniques in real-life situations and navigate challenging interpersonal
dynamics with confidence and skill.
(d) Problem-Solving and Decision-Making:
Emotional intelligence includes the ability to identify and solve problems effectively,
even in emotionally charged situations. In DBT, clients learn problem-solving skills and
decision-making strategies to address life challenges.
Therapists assist clients in applying emotional intelligence techniques such as
perspective-taking, considering consequences, and weighing options when making
decisions or solving problems, promoting adaptive functioning and resilience.
(e) Normalize Your Emotions:

Understand that it's entirely normal to have the emotions you're experiencing. Emotions are a
natural part of the human experience, and there's no right or wrong way to feel in a given
situation.
(f) Avoid Self-Judgment:

Refrain from being overly critical of yourself for feeling a certain way. It's common to have self-
doubt or self-criticism when dealing with challenging emotions, but try to remind yourself that
it's okay to feel what you feel. In case of academic failure, mostly student criticize himself that I
failed, I am very dull student, how can I face my family members and friends with failure.

(g) Self-Compassion:

Treat yourself with the same kindness and understanding that you would offer to a friend who's
going through a difficult time. Imagine what you might say to a friend in your situation and say
those words to yourself.

(h)Journaling:

Writing down your emotions and thoughts in a journal can be a helpful way to validate your
feelings. Describe how you're feeling and why you think you're feeling that way. Define positive
and negative emotions and try minimize negative emotions according to advised.

(i) Seek Support:

Talk to a trusted friend, family member, or therapist about your emotions. Sharing your feelings
with someone who listens and understands can provide validation.

(j) Positive Self-Talk:

Process: Remind yourself of your strengths and capabilities. Offer yourself words of
encouragement and reassurance.

(k) Problem-Solve: If there are practical issues contributing to your grief, such as unresolved
matters with the person who passed away, engage in problem-solving to address these
concerns.

Or there is problems in relationship then use problem solving technique.

1. Root cease of problems why problems occurs. Example ; relationship failure may due to
not contribute enough time with each other or may our contributed time not in rich
quality .

Academic failure due to not follow teachers guidelines etc.

2. Divide the problems in small parts like relationship problems can be divide, verbal
aggression towards partner, devalue partner etc.

3. Options : both partner share minimum 10 options to resolve the problems .may there is
3, 4 options same which play strong role. In others option can be discus to make more
flexible for each other.

4. Achievement : Count each achievement which makes by both partner , realize and
appreciate to each other.

5. Celebrate each achievement. Celebration is one of important factor for motivating

himself or your partner.