As therapists, our goal is to choose treatment options that are best suited to you and your needs. There is no one size fits all approach to therapy, and the choices in treatment options reflect that.
Some people experience emotions that arrive at full volume, each and every time. For those individuals, one treatment option hat may make sense is known as Dialectical Behavior Therapy, or DBT. It was designed for those that experience deep emotional responses – good and bad – to events that happen in life. For example:
- Small setbacks that feel like crises.
- Minor disagreements that turn into hours of distress.
- Relationships that are always intense, cycling between love and conflict.
Dialectical Behavior Therapy, or DBT, was built specifically for this. It gives people concrete skills for managing intense emotion, tolerating distress without making things worse, and navigating relationships without the reaction taking over.
If you feel like DBT might be right for you, or you’re looking for a therapist on Long Island to help you manage your emotions, please reach out to Nassau Counseling Services, today.
The Science of DBT
DBT was developed by psychologist Marsha Linehan, originally to treat chronic suicidality and borderline personality disorder. These are both conditions where, historically, standard talk therapy alone wasn’t producing enough change. It grew out of Cognitive Behavioral Therapy, adapted specifically for people whose emotional experience is more intense and harder to regulate than standard CBT techniques were built to address.
The word “dialectical” refers to DBT’s core idea: holding two seemingly opposite things as true at the same time. A person can accept themselves exactly as they are right now, and still actively work to change. DBT treats these as complementary, not contradictory, which is part of what makes it different from therapy that leans entirely toward either acceptance or change on its own.
The Four Skill Areas
DBT organizes its skills into four connected areas:
- Mindfulness — Staying present and aware of thoughts, emotions, and sensations as they happen, rather than getting swept up in them or avoiding them entirely. This is the foundation the other three skill areas build on.
- Distress Tolerance — Getting through an intense moment or crisis without making the situation worse, using specific, practical techniques rather than relying on willpower alone.
- Emotion Regulation — Learning what drives intense emotional reactions and building the capacity to reduce their frequency and intensity over time.
- Interpersonal Effectiveness — Communicating needs, setting boundaries, and navigating conflict in a way that protects both the relationship and a person’s own self-respect.
These skills build on each other, which is why DBT tends to work best as an ongoing process rather than a handful of isolated techniques.
Who DBT Can Help Treat and Support
DBT was originally developed for borderline personality disorder and chronic suicidal behavior, and it remains one of the most well-researched treatments for both. Research since then has extended its use much further, supporting emotional intensity connected to other conditions such as:
- Depression
- Anxiety
- PTSD
- Eating Disorders
- Substance Use
When appropriate, these conditions can respond to the same underlying skill set, since the core problem in each case often involves emotions that feel too big to manage with the tools a person already has.
Many people also benefit from the same skills for managing everyday emotional intensity, conflict in relationships, or a pattern of reacting in ways they regret once things calm down.
DBT at Nassau Counseling Services
DBT skills get incorporated directly into individual therapy sessions here, built around what a specific person is actually struggling with. A session might focus on a specific distress tolerance technique after a hard week, or work through an interpersonal effectiveness skill ahead of a difficult conversation that’s coming up.
For clients also working with anxiety, depression, or eating disorders, DBT skills often get integrated alongside the specific treatment approach for that condition.
If emotions have been feeling too big to manage, or the same reactive patterns keep showing up in relationships no matter how much effort goes into changing them, DBT gives you real, practical tools to work with instead of just insight alone. Call (516) 973-1032 or reach out through our website to talk with one of our therapists about what DBT could look like for you.