Dialectical Behaviour Therapy (DBT)

What it is

Dialectical Behaviour Therapy was developed for people whose emotions come on fast, hit hard, and take a long time to settle. "Dialectical" refers to holding two things that seem to contradict each other at the same time — most centrally, accepting yourself exactly as you are while also working to change. Both are true, and DBT doesn't ask you to choose.

The heart of DBT is a set of practical skills organised into four areas. Full DBT programs typically include weekly skills groups and phone coaching; in my practice, I offer DBT-informed individual therapy, drawing on these skills and adapting them to what's going on in your life.

What a session looks like

We often start with what's been hardest recently — a blow-up, a shutdown, a moment where you did something you later regretted. Rather than going over it with blame, we look at the chain of events: what set it off, what you were feeling, what you needed, and where a different skill might have given you more room.

Then we practise. That might mean learning a technique to bring your body down from a spike of panic, or rehearsing how to ask for something you need without either swallowing it or exploding. The goal is for these skills to become things you can reach for in the moment, not just ideas you understand.

What it can be helpful for

DBT skills can be helpful if your emotions feel bigger than the situation, if you tend to react in ways you regret, if relationships feel like a cycle of closeness and conflict, or if you've experienced trauma and your nervous system is often on high alert. They can also support people with ADHD who find emotional regulation a daily challenge.