Dialectical Behavior Therapy (DBT) has helped countless people build healthier, more balanced lives—but misconceptions still surround it. Some believe it’s the same as CBT, while others think it’s just about suppressing emotions. These misunderstandings not only misrepresent what DBT truly offers but can also prevent people from discovering a therapy that has transformed lives worldwide.
Originally developed by Dr. Marsha Linehan for Borderline Personality Disorder (BPD), DBT has grown into a powerful tool for treating anxiety, depression, PTSD, eating disorders, and more. It blends cognitive-behavioral techniques with mindfulness and acceptance strategies, offering practical skills for emotional regulation, distress tolerance, and building stronger, healthier relationships.
Here's what many don't realize: DBT isn’t just for those in crisis. It’s for anyone who wants to handle emotions more effectively, improve relationships, and navigate life’s challenges with greater ease. In this article, we’ll debunk the biggest myths about DBT and explore why so many people rely on it. Whether you're new to DBT or a longtime advocate, get ready to separate fact from fiction—you might just find that DBT is exactly what you've been looking for!
Myth #1: DBT Is Only for Borderline Personality Disorder
The Misconception
Many people assume that Dialectical Behavior Therapy (DBT) is designed exclusively for individuals with Borderline Personality Disorder (BPD). Because DBT was originally developed by Dr. Marsha Linehan to help people with BPD manage intense emotions and self-destructive behaviors, this misconception is understandable. However, it overlooks how DBT has evolved and the wide range of people who benefit from it today.
The Truth
DBT’s origins trace back to the late 1980s, when psychologist Dr. Marsha Linehan set out to find a more effective way to treat individuals who struggled with extreme emotional distress, self-harm, and suicidal thoughts. Her mission wasn’t just professional—it was personal. As a young woman, Linehan herself had spent years in psychiatric hospitals, battling her own mental health struggles. She understood firsthand what it felt like to be overwhelmed by emotions and dismissed as “untreatable.”
Determined to change the system, she combined cognitive-behavioral therapy (CBT) with mindfulness and radical acceptance techniques. She recognized that traditional therapy often pushed people to change without acknowledging their emotional pain. DBT was her answer: a therapy that balanced acceptance with change, giving people the skills to navigate intense emotions without judgment.
The Evidence
A growing body of research supports DBT’s effectiveness across multiple conditions. Studies have found that DBT reduces suicidal ideation, improves emotional regulation, and enhances overall well-being in people with depression, PTSD, and eating disorders—not just those with BPD. Research also shows DBT's effectiveness for substance use disorders, bipolar disorder, and even some neurodevelopmental conditions. Mental health professionals worldwide now use DBT in individual therapy, group therapy, and even inpatient settings.
The Takeaway
DBT isn’t just for one diagnosis or one type of person—it’s a skill-based therapy that teaches practical, life-changing tools for anyone struggling with emotional dysregulation, distress, or interpersonal conflicts. Whether you're dealing with a specific mental health condition or simply want to improve emotional resilience, DBT offers strategies that can make a profound difference.
Myth #2: DBT Is Just About Controlling Emotions
The Misconception
Many people believe that Dialectical Behavior Therapy (DBT) is all about forcing emotions into submission—bottling them up, suppressing feelings, or trying to "stay positive" no matter what. This couldn’t be further from the truth. DBT doesn’t teach people to control emotions like a strict, unyielding traffic cop. Instead, it helps them understand, accept, and navigate their emotions in a way that leads to healthier, more balanced reactions.
The Truth
Think of emotions like ocean waves. Some days, the waves are small and manageable. Other times, they crash over you, leaving you gasping for air. DBT doesn’t teach you to stop the waves—because that’s impossible—but rather how to surf them. Instead of getting swept away or fighting against the tide, DBT helps people ride the waves with greater confidence and skill.
DBT isn’t about suppressing emotions; it’s about working with them. Through the skills it teaches, DBT gives people the tools to sit with their feelings, understand where they come from, and choose how to respond—rather than reacting impulsively or feeling completely overwhelmed.
Real-World Application
Imagine it’s late Friday afternoon, and you're rushing to get everything ready for Shabbos. The house is chaotic, the challah still isn’t braided, and your kids are fighting in the next room. Suddenly, a family member makes an unhelpful comment—maybe about how stressed you look or how they “never understand why Erev Shabbos is so hectic.”
Without emotional regulation skills, you might snap back in frustration, stew in resentment, or withdraw completely. But with DBT techniques, you can pause, acknowledge your emotions without judgment, and choose a response that aligns with your values—whether that’s taking a deep breath, using humor, or calmly responding back. DBT doesn’t aim to erase emotions—it empowers you to work with them, transforming overwhelm into mindful, intentional action.
The Takeaway
Emotions aren’t the enemy! DBT teaches that emotions serve a purpose and provide valuable information, but they don’t have to dictate every action. Instead of suppressing feelings, DBT helps people make peace with them, respond thoughtfully, and regain control over their lives.
Myth #3: DBT Is the Same as CBT
The Misconception
If you’ve ever heard someone say, “DBT? Isn’t that just another version of CBT?”—you’re not alone. Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are often lumped together. But, while they share some similarities, they are far from identical.
The Truth
It’s true that DBT grew out of CBT. In fact, Dr. Marsha Linehan originally developed DBT as a form of CBT for individuals struggling with extreme emotional dysregulation. But she quickly realized that traditional CBT—focused on changing negative thoughts and behaviors—wasn’t always enough for people experiencing intense emotions. Many of her patients felt invalidated when therapy focused solely on “fixing” their thoughts without acknowledging the depth of their emotional pain.
That’s where DBT takes a different path. Unlike CBT, which prioritizes changing thought patterns, DBT emphasizes balancing acceptance and change. Instead of pushing people to simply “think differently,” DBT teaches them how to accept their emotions while also developing tools to manage them.
The Takeaway
While CBT is a valuable therapy that focuses primarily on changing thought patterns and behaviors, DBT adds the crucial element of acceptance alongside change. By blending cognitive and behavioral strategies with mindfulness, distress tolerance, and emotional acceptance, DBT creates a more nuanced and comprehensive approach to mental well-being.
Myth #4: DBT Is Just Skills
The Misconception
There is a critical distinction between comprehensive DBT treatment and DBT skills training. Many people confuse these two aspects or believe they are interchangeable.
Comprehensive DBT is a structured, intensive treatment protocol designed for individuals with complex symptom presentations, such as those with Borderline Personality Disorder or severe emotional dysregulation. In contrast, DBT skills training—which focuses on mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness—is just one component of full DBT treatment, and can often be used as a complement to one’s existing treatment (including other non-CBT/DBT modalities).
The Truth
DBT is a multifaceted treatment approach with several distinct components. People often confuse the entire treatment with just one of its parts. Comprehensive DBT treatment includes:
Individual therapy sessions
Skills training groups
Phone coaching
Therapist consultation team
This comprehensive approach is specifically designed for individuals who struggle with emotion dysregulation as their main presenting problem, sometimes presenting with a history of trauma, interpersonal difficulties, and other difficulties like anxiety, depression, or eating disorders.
DBT skills training alone, however, teaches specific coping techniques that can benefit anyone. These skills include mindfulness practices, distress tolerance strategies, emotion regulation techniques, and interpersonal effectiveness tools. Skills training can be delivered in group settings and is often used to complement other forms of therapy.
The analogy is apt: DBT is like learning to swim. Some need it because they're drowning (comprehensive treatment), while others can benefit from the skills to improve technique or simply enjoy the water more (skills training).
Practical Example
Meet Elisheva, a 32-year-old mother of three and a second-grade morah. She often feels overwhelmed by the constant demands of her day—juggling her students’ needs, managing her home, and trying to be present for her family. By the time bedtime rolls around, she’s exhausted, and when her kids push back, she sometimes snaps—only to feel guilty afterward.
Elisheva doesn’t necessarily need comprehensive DBT treatment, but she finds that incorporating DBT skills into her life helps her manage stress more effectively. Through mindfulness, she learns to stay present rather than getting caught up in anxious thoughts about everything still on her to-do list. With distress tolerance, she finds healthier ways to cope with frustration, like stepping away for a moment to breathe instead of reacting impulsively. Over time, she feels more in control of her emotions, her reactions, and her overall well-being.
The Takeaway
The distinction is important: comprehensive DBT is a structured, intensive treatment approach for those with significant emotional and psychological challenges, while DBT skills can benefit virtually anyone.
Full DBT treatment follows a specific protocol and hierarchy designed for people with severe emotional dysregulation, suicidal behaviors, or self-harm. It requires specially trained therapists and a significant time commitment.
DBT skills, however, are versatile tools that can be incorporated into daily life or other therapeutic approaches. They offer practical strategies for emotional resilience, effective communication, and stress management that can help anyone navigate life's challenges with greater self-awareness and balance.
Myth #5: DBT Is Too Rigid and Structured
The Misconception
Some people hesitate to try DBT because they’ve heard it follows a structured curriculum, leading them to believe it’s a rigid, one-size-fits-all approach. They might worry that the therapy won’t accommodate their unique struggles or that they’ll be expected to follow a strict set of rules without flexibility. This concern is understandable—after all, mental health treatment should feel personal, not like a checklist.
The Truth
While DBT follows a structured format, it’s far from rigid. In fact, one of its core principles is dialectics, which is all about balance and flexibility. DBT teaches that two seemingly opposite things can be true at the same time—for example, you can accept yourself as you are while still working toward change. That same philosophy applies to the therapy itself.
Real-World Flexibility
Therapists adapt DBT techniques to fit each person’s needs, adjusting the focus, pace, and application of skills based on what works best for the individual. Some clients might benefit most from focusing on interpersonal effectiveness skills if relationship conflicts are their primary challenge. Others may need to prioritize distress tolerance if they're struggling with impulsive behaviors during emotional crises.The beauty of DBT is that it's a framework—not a rigid set of rules—and it can be tailored to suit the client’s unique challenges and goals.
DBT has also been successfully adapted for different age groups (children, teens, and adults, children), cultural contexts, and specific populations—further evidence of its inherent flexibility.
Final Thoughts
Dialectical Behavior Therapy isn’t just a treatment—it’s a transformation. It’s about reclaiming control over your emotions, strengthening your relationships, and developing the resilience to face life’s challenges with clarity and confidence.
Imagine a life where emotions no longer dictate your actions, where stress doesn’t spiral into frustration, and where challenges become opportunities for growth instead of barriers to happiness. That’s what DBT offers—a roadmap to emotional freedom and a toolkit for navigating life with wisdom and grace.
If you're seeking comprehensive treatment for complex emotional challenges or simply looking to enhance your coping skills for everyday life, DBT offers something valuable. Its blend of acceptance and change, mindfulness and action, provides a balanced approach to emotional well-being that few other therapies can match.