In this blog post, we will examine another Therapeutic Orientation, which is similar to our last blog post about CBT, (or Cognitive Behavioral Therapy).
In my years as a therapist, I’ve noticed a common thread that often runs through the struggles my clients face: a painful push-pull between emotional extremes. Feeling overwhelmed, acting impulsively, and getting stuck in shame or anger can create cycles that feel impossible to break. That’s where Dialectical Behavior Therapy (DBT) comes in—a transformative approach designed to help people build a life worth living, even when it feels like the emotional waves are pulling them under.
Originally developed by Dr. Marsha Linehan for individuals struggling with chronic emotion dysregulation, self-harm, and suicidality, DBT has evolved into a powerful toolkit for anyone who wants to improve emotional resilience, strengthen relationships, and create more inner peace.
At its heart, DBT rests on two seemingly opposite ideas: acceptance and change. It teaches us that we can fully accept ourselves in this moment and still strive to change behaviors that are not serving us. This balance—what DBT calls “dialectical thinking”—is a crucial antidote to the black-and-white, all-or-nothing thinking that often accompanies the above symptoms.
DBT is organized into four key skill areas:
Mindfulness: Learning to stay present without judgment, observing thoughts and feelings without being swept away by them.
Distress Tolerance: Building tools to survive crisis moments without making things worse, such as self-soothing and grounding strategies.
Emotion Regulation: Understanding and managing emotions so that one is less at the mercy of intense mood swings.
Interpersonal Effectiveness: Strengthening communication skills to get one’s needs met while maintaining self-respect and healthy relationships.
What makes DBT especially effective is its validation of real emotional pain. Rather than pathologizing emotional intensity, DBT sees it as a natural response to very real experiences—often a history of invalidation, trauma, or high sensitivity to emotional stimuli. DBT teaches that you are not broken; you are responding in the best way you know how. And now, with new skills and support, you can learn different ways to respond.
In DBT sessions—whether in individual therapy, skills groups, or coaching—clients are encouraged to practice these tools actively and with compassion for themselves. It is not about achieving perfection. It’s about building mastery little by little, moment by moment.
One of my favorite reminders from DBT is:
“You are doing the best you can. And you can do better.”
Both can be true at once.
If you’ve ever felt caught between intense emotions, overwhelmed by conflict, or stuck in cycles of self-criticism, DBT might offer the roadmap you’ve been searching for. There are therapists who are either certified in DBT, or therapists that incorporate some DBT skills into their therapeutic practice. One can even specifically search for a therapist who is certified in DBT. Remember, healing doesn’t happen overnight, but with patience, practice, and support, you can create a life that feels more stable, meaningful, and deeply connected.
Liza Linder, MSW, LCSW, is a therapist with 30 years of experience serving the LGBTQ+ and PLWHIV communities. Liza is in person only, in our Philadelphia offices. For more information about Liza, please click on the therapist’s bios.