Last updated May 27, 2020 by Dr. Sheri Jacobson

Dialectical Behaviour Therapy (DBT) in London

What is DBT?

Dialectical behaviour therapy is a type of therapy that combines standard cognitive behavioural techniques with concepts derived from Buddhist meditative practice. DBT was developed to treat people with borderline personality disorder and indeed, is the first therapy that has been demonstrated to be effective for treating this disorder.

DBT emphasises the following four skills:

Core mindfulness
Interpersonal effectiveness
Emotion modulation
Distress tolerance.

The aim of DBT is to create a practical way to help those who otherwise may remain resistant to treatment. DBT is a hybrid approach consisting of elements such as cognitive behavioural therapy (with the emphasis on the here and now), dialectical thinking (emphasising the limitations of linear ideas), Zen Buddhism (with the key concept of mindfulness) and metaphorical thinking (with the goal of viewing the situations practically).

What does DBT look like in practice?

DBT accepts and works with the fact that some people, due to environment and/or biology, react abnormally to emotional stimulation. Their levels of arousal rise very quickly and peak at a higher level than the average individual, because due to their past experiences they do not have a method of coping with these intense and often sudden surges of emotion. DBT targets behaviours in a descending hierarchy in the following order:

Decreasing high-risk suicidal behaviours
Decreasing responses or behaviours that interfere with therapy
Decreasing behaviours that interfere with quality of life
Decreasing and dealing with post traumatic stress responses
Enhancing respect for self
Acquisition of the behavioural skills in group therapy (four shown above)
Additional goals set by patient.

By following this structure, therapy sessions are less likely to be disrupted by patient behaviours and concerns.

What can DBT help with?

DBT is effective in treating patients with borderline personality disorder. It is also effective in treating people who suffer with ‘spectrum mood disorders’, including self-harm. Recent research also suggests its effective use in treating people with chemical dependencies and sexual abuse survivors.

Dialectical behaviour therapy is one of the types offered by therapists at Harley Therapy in addition to cognitive behavioural therapy (CBT). It is often recommended for borderline personality disorder, self-harm, addictions and sexual abuse issues.