Dialectical Behaviour Therapy



DBT is closely related to CBT, and was initially developed by Marsha Linehan for individuals with Borderline Personality Disorder who cope with distressing emotions and situations by using self-destructive behaviours such as self-harm, substance abuse and eating disorders.  DBT is now being used for treating other mental health conditions.

Individuals learn more helpful coping skills to deal with distressing emotions and situations, and to improve their relationships.

Dialectics is the theory that opposites can co-exist.  In therapy, different points of view are discussed, and clients are then helped to select appropriate skills to either change or accept situations.

Skills taught include:




'Wise Mind'                                                                  Wise Mind Worksheet

DBT uses the theory of Wise Mind (Linehan 1993) - the part of our mind where 'Emotional Mind' (thoughts based on our feelings) and 'Reasonable Mind' (rational thinking part) merge together. 

Emotion Mind Wise Mind Reasonable Mind

Thinking and behaviour controlled by emotional state

Thoughts are unhelpful and distressing

Difficult to think logically and rationally

Facts are distorted to fit with current distress


Strong emotions drive strong behaviour

What I want to do


Integrates Emotion Mind and Reasonable Mind

Adds intuitive knowing to emotional distress and logical analysis

The calm that follows a storm

Sees or knows something directly and clearly

Grasps the bigger picture, rather than just parts

Ensures needs of both Emotion Mind and Reasonable Mind are met:  Reasonable Mind is right, but Emotion Mind needs to be soothed

What's the most appropriate and effective skills that I could use for this situation?

Intellectual, scientific

Logical and rational thinking

Factual thinking, based on evidence

Able to plan how to respond

Focuses attention

Cool in approaching problems

What I should do


When we feel upset or distressed, we normally react automatically, without thinking about the consequences.  And we can often get into the habit of using unhelpful and often self-destructive behaviours to help us cope.  These may include:

  • Self-harm including cutting or taking ‘overdoses’
  • Manipulating others (we’re often unaware of doing this)
  • Under or over-eating
  • Using or relying on drugs and alcohol
  • Depending on physical exercise
  • Sleeping too much, or opting to sleep rather than address problems
  • Focusing on illness and physical pain rather than the ‘real’ issues


When we use these self-destructive coping behaviours, we often then get caught up in thinking we’re bad for doing them, which makes us feel even worse, and may make us more likely to keep on doing them.  A vicious cycle. 


 In order to break that cycle, we can learn to do doings differently, including learning new healthy coping skills which will help us feel better about ourselves and others, and learning to understand and see our thoughts differently.



This website suggests introductions to alternative, healthier ways of coping, but like with anything else in real life, it’s not easy or a quick fix – it has to be worked consistently hard at, and the only certainty is that it takes a lot of practice, practice, practice! 

MP3 guided imagery/relaxation downloads, including Wise Mind meditation



More information:


DBT Self Help Books





MP3 guided imagery/relaxation downloads






Self Help Books

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Carol Vivyan