Dialectical behavioral therapy (DBT) is a type of cognitive behavioral therapy (CBT) that was originally developed to treat borderline personality disorder (BPD). BPD is a mental health condition marked by persistent mood swings, poor self-image, and impulsive behaviors.
DBT for BPD works by helping you develop new skills to better manage emotional dysregulation (ED) and more effectively cope with the intense, strong emotions that are common with borderline personality disorder.
Read on to learn more about specific DBT therapy techniques used to treat BPD and see what research tells us about dialectical behavioral therapy’s efficacy.
How Does DBT Help with Borderline Personality Disorder?
Although it’s no longer the only treatment for borderline personality disorder, DBT treatment was the first therapy developed to address the BPD symptoms. It’s still the first-line treatment and has been proven effective in helping to reduce anger issues, suicidal behavior, substance abuse, psychiatric hospitalization, and interpersonal issues.
Why does DBT work so well for BPD?
Borderline personality disorder dialectical behavior therapy considers the biological risk factors, childhood stability, and other factors that contribute to BPD symptoms.
DBT focuses on decreasing impulsive actions that cause problems in your life and relationships. This effective type of individual therapy teaches you how to anticipate and recognize episodes of intense emotions, like anger, hatred, and depression, before they take hold of you.
“Dialectical behavior therapy (DBT) has been one of the most effective treatments for individuals with borderline personality disorder. The main struggle for BPD is emotion dysregulation, so treatment revolves around learning to decrease and manage emotion dysregulation. This includes working on improving unhealthy coping skills.”Talkspace therapist Minkyung Chung, MS, LMHC
4 DBT Techniques for BPD
DBT for borderline personality disorder uses a variety of different therapeutic techniques. These typically include one-on-one talk therapy or online therapy, telephone and email coaching, and group skills training. Let’s look closer at four of the main dialectical behavioral therapy techniques used to treat BPD.
Mindfulness meditation teaches you how to focus on the present moment. Paying attention to your breath, thoughts, and feelings helps you remain in control of them. Mindfulness meditation helps you observe, analyze, describe, and be a part of every experience without judgment. Ultimately, it teaches you how to be aware.
When anybody, whether they have borderline personality disorder or not, pays attention to how they’re thinking and what they’re feeling in the present moment, they’ll be naturally more relaxed, calm, and in control of their emotions and behaviors.
Mindfulness meditation allows you to step back and observe your reality before you express yourself inappropriately. Anyone can see the benefits of mindfulness meditation as a powerful tool for improvement and personal growth. Meditation is free, can be done anywhere, and delivers strong and often instant results.
A DBT therapist works with those who have borderline personality disorder to enhance their interpersonal effectiveness. This approach is especially useful for maintaining healthy relationships, balancing priorities, setting boundaries, increasing self-respect, improving self-confidence, and accepting others without bias.
This module of dialectical behavioral therapy involves teaching you new ways to tolerate stressful situations without engaging in destructive behaviors. It puts an emphasis on helping you be able to stop and think before you react.
People with borderline personality disorder are often faced with strong, intense emotions. They may act out impulsively, engaging in risky behaviors to distract themselves from what feels intolerable. These behaviors can include substance abuse or violence.
Distress tolerance teaches you to better manage strong emotions so you can begin to respond in healthy, effective, and appropriate ways to improve your quality of life. You’ll learn to remain in emotive control and react more calmly and appropriately instead of returning to the destructive behaviors you once impulsively turned to.
Emotion regulation skills
DBT for BPD also typically involves learning to proactively recognize and cope with your emotional reactions. This aspect of dialectical behavioral therapy helps you practice effectively responding to emotional stimuli in a positive way.
When people living with borderline personality disorder understand their thoughts and emotions better, they become empowered to manage and express them in healthy, constructive ways.
Emotion regulation skills help you accept your feelings without letting them take over. You can learn to adopt new behaviors that will ultimately improve stressful situations. You’ll learn to create new methods for radical acceptance and calmly dealing with your thoughts and feelings. This alone can be very liberating and powerful.
Effectiveness of DBT on BPD
Borderline personality disorder dialectical behavior therapy is an effective, evidence-based treatment that many people with BPD say has improved their quality of life.
If you live with BPD, it’s important to seek treatment from a trained therapist or psychologist. The techniques they use should be backed with solid clinical evidence. Receiving treatment from untrained mental health professionals can do more damage than good.
According to 2020 research, DBT is indeed extremely effective and helpful in treating symptoms of BPD. The positive outcomes of this style of treatment can include:
- Decreased inappropriate anger
- Reduced actions of self-harm
- Improved general functioning
How long is DBT for borderline personality disorder?
Many people find DBT for borderline personality disorder works quickly to help them regain control over their emotions and live happier lives. However, there’s no golden standard for how long it takes this type of individual therapy to produce positive results. Like any type of treatment, for any mental or physical health condition, results can vary from person to person and will depend on several things including motivation, severity of symptoms, and type of treatment.
“As with a majority of therapy techniques, there’s no set ‘duration’ or expected length of time for effectiveness. Factors like consistency in therapy, follow-through with skill building, and insight building are important. One of the most important factors to successful treatment is willingness to make those changes.”Talkspace therapist Minkyung Chung, MS, LMHC
The National Institute of Mental Health (NIMH) reports that people who receive adequate DBT for borderline personality disorder are more likely to:
- Avoid developing additional comorbid chronic mental or physical health conditions
- Make healthier lifestyle choices about exercise, diet, and mindfulness
- Develop better self-control over strong emotions like anger and depression
If you’re living with borderline personality disorder and want to learn new skills that can help you live a more contented, rewarding life, reach out to a licensed mental health professional who specializes in dialectical behavioral therapy. Also consider speaking to a licensed mental health professional if you’re interested in learning about DBT for Post Traumatic Stress Disorder or other disorders. Many people with BPD find this to be a life-changing decision that they wish they had made much sooner.