In Part 2 of the Fellowman guide to different types of therapy, we’re looking at another one that I’ve been up close and personal with and that’s DBT aka Dialectical Behavioral Therapy.
DBT is a structured, skills-based type of therapy designed to help people manage intense emotions, improve relationships, and develop healthier ways to cope with life’s challenges.
I had my own unplanned introduction to DBT this past summer, when as a result of my own mental health spiralling downwards I undertook an intensive 8 week outpatient program (which i’ll dig into in more detail in a future post) that was heavily focused on the use of DBT to manage depression and anxiety.
What is Dialectical Behavioral Therapy (DBT)?
DBT is a practical, hands-on approach to therapy that teaches you how to handle emotions and difficult situations without feeling overwhelmed or losing control. Think of it as mental strength training—just like you’d work out to build physical fitness, DBT helps you build emotional and mental resilience. It’s especially helpful if you find yourself dealing with intense emotions, reacting impulsively, or struggling to maintain balance in your relationships.
The “dialectical” part of DBT means balancing two key ideas: acceptance and change. It’s about learning to accept yourself as you are while also working to make positive changes in your life. This balance helps you move forward without feeling judged or stuck.
If, like me, you’re curious about where a therapy like this comes from, it's worth reading the autobiography of the creator of DBT, Marsha Linehan. She’s maybe the ultimate in wounded healers going from institutionalized borderline personality in-patient to world renowned mental health expert and creator of DBT.
How Does DBT Work?
DBT focuses on four main skill areas, and within each of these 4 you’ll find countless worksheets, tools and techniques.
Mindfulness: Learning to stay present in the moment without getting overwhelmed by stress, regret, or worry. This helps you focus on what’s happening right now and make decisions with a clear head.
Distress Tolerance: Building the ability to cope with tough situations without making them worse. You’ll learn techniques to manage pain, frustration, or crisis moments without turning to unhealthy coping mechanisms, like anger, avoidance, or substance use.
Emotion Regulation: Understanding your emotions and learning how to respond to them in healthier ways. Instead of feeling like your emotions control you, DBT helps you gain control over them.
Interpersonal Effectiveness: Improving communication and relationship skills so you can set boundaries, express your needs, and resolve conflicts more effectively.
These skills are taught in a clear, step-by-step way. It’s not just about talking through your feelings; it’s about learning practical tools you can use in everyday life.
Why DBT Might Be a Good Fit
If you’re someone who feels like emotions can spiral out of control or that you often regret how you react in certain situations, DBT gives you a roadmap for handling those moments better. It’s straightforward and structured, so it doesn’t feel vague or abstract. Many men find that the focus on skill-building and problem-solving aligns with their preference for action-oriented approaches.
DBT is also great for anyone who struggles with black-and-white thinking (e.g., “I’m either a total success or a complete failure”). The “dialectical” nature of the therapy helps you see the gray areas and find balance in your thoughts and actions.
How did DBT it work for me?
Personally I found DBT really interesting to learn, and the focus on skills, tools and worksheets is really good if you like that type of structure. I did find my outpatient program a little frustrating at times in that it was so focused on DBT and found myself wanting a little more variety. As i’ve done a lot of therapy and understood my own issues in more detail I think i’ve learned that for me I don’t necessarily need tools to regulate my emotions in the moment, and prefer more abstract approaches like psychodynamic therapy that look at some of the root causes rather than what might seem like a band aid over the problem.
In hindsight, I think the one really valuable thing I learned from DBT was that I was using alcohol to self medicate when my anxiety peaked, so this alone was a huge win to start to recognise when it happened and consider alternative coping strategies.
That’s not to discount DBT at all, it’s got some really valuable tools, so take the time to consider if this is right for you and talk to potential therapists who can explain how their approach can help address your specific issues.
Image credit: https://concept.paloaltou.edu/resources/business-of-practice-blog/what-is-dbt-how-does-it-work