Dialectical Behaviour Therapy (DBT) is a comprehensive, evidence-based approach originally developed for people experiencing intense, overwhelming emotions and self-destructive behaviours. It combines practical skills training with acceptance-based strategies to help you build a life worth living — even when emotions feel unmanageable. At London Trusted Therapy, we understand that some people experience emotions more intensely than others. If you’ve struggled with emotional overwhelm, impulsive reactions, unstable relationships, or self-harm, DBT recognises that whilst you may experience emotions more intensely, you can learn skills to manage them effectively whilst also building acceptance and self-compassion.
DBT is built on the concept of dialectics — the idea that two seemingly opposite things can both be true. You can accept yourself as you are AND work toward change. You can validate your emotions AND learn to regulate them. You can build distress tolerance AND work toward reducing suffering. This both/and thinking replaces the all-or-nothing patterns that often keep people stuck.
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Dialectical Behaviour Therapy is specifically designed for individuals who experience intense, overwhelming emotions and struggle with emotional regulation. If your emotions feel like they go from 0 to 100 in seconds or lead to impulsive actions you later regret, DBT can provide life-changing skills. You might benefit from DBT if you struggle with self-harm, suicidal thoughts, binge eating, substance use, or other impulsive behaviours used to manage overwhelming emotions.
DBT was originally developed for borderline personality disorder but is now recognised as effective for anyone struggling with emotion dysregulation, regardless of diagnosis. This approach is particularly valuable if previous therapies haven't worked or if you've been told you're "too difficult." DBT's skills-based approach provides clear tools for managing crises and tolerating distress, making therapy itself more manageable.
DBT works well for those dealing with chronic emptiness, fear of abandonment, unstable relationships, or chronic suicidal ideation. It's valuable for those who want concrete, practical skills for emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness rather than primarily exploratory therapy.
DBT for couples is particularly powerful when one or both partners experience emotional dysregulation that affects the relationship. If explosive conflicts, impulsive decisions, or emotional intensity create instability and hurt, DBT skills can help both partners regulate emotions and respond more effectively.
You might benefit from this approach if your relationship involves frequent crises, if one partner threatens to leave during conflicts, or if emotional escalation regularly damages connection and trust. DBT helps couples develop skills for managing intense emotions without letting them destroy the relationship.
This approach is valuable when past trauma or attachment difficulties create emotional vulnerability in one or both partners. Rather than trying to eliminate emotional sensitivity, DBT helps couples navigate intense emotions whilst maintaining connection and working toward shared goals.
DBT for families is especially valuable when an adolescent or young adult struggles with emotional dysregulation, self-harm, or risky behaviours. Parents learn DBT skills alongside their children and develop strategies for responding to emotional crises without inadvertently reinforcing problematic behaviours or escalating conflicts.
Families benefit from DBT when high emotional intensity creates chaos and disconnection. Perhaps family conflicts escalate quickly, with people saying things they regret, or perhaps emotional shutdown leaves family members unable to communicate. DBT provides the whole family with skills for managing emotions more effectively.
This approach helps families balance validation (accepting emotions as they are) with change (working toward more effective responses). This dialectical stance is particularly valuable for families where previous approaches either felt too harsh and invalidating or too permissive and ineffective.
Learning to be present in the moment without judgment. Mindfulness is the foundation of all other skills, helping you observe your thoughts and emotions without being controlled by them. You'll learn the "what" skills (observe, describe, participate) and "how" skills (non-judgmentally, one-mindfully, effectively).
Developing the ability to survive crises without making things worse through impulsive or self-destructive behaviours. You'll learn crisis survival strategies (STOP, TIPP, Distract, Self-Soothe), radical acceptance, and how to tolerate distress when you cannot immediately solve the problem.
Understanding your emotions, reducing emotional vulnerability, and changing unwanted emotions. You'll learn to identify and label emotions, understand what emotions do for you, reduce suffering through opposite action, and build positive experiences that create resilience.
Building and maintaining healthy relationships whilst respecting yourself. You'll learn how to ask for what you need (DEAR MAN), say no whilst maintaining relationships (GIVE), and maintain self-respect in interactions (FAST). These skills help you balance getting your needs met with keeping relationships and maintaining your values.
When in crisis: Stop, Take a step back, Observe, Proceed mindfully.
Quick ways to change your body chemistry when emotions are extreme: Temperature, Intense exercise, Paced breathing, Paired muscle relaxation.
How to ask for what you need effectively: Describe, Express, Assert, Reinforce, stay Mindful, Appear confident, Negotiate.
How to maintain relationships: be Gentle, act Interested, Validate, use an Easy manner.
How to maintain self-respect: be Fair, no Apologies (for existing), Stick to values, be Truthful.
Completely accepting reality as it is, without fighting it, when you cannot change it.
Acting opposite to your emotional urge when the emotion doesn't fit the facts or acting on it would be harmful.
The integration of emotion mind and reasonable mind — making decisions from your wisest self.
Individual and Couples Psychotherapist
Individual and Couples Psychotherapist
Individual Couples and Family Psychotherapist
Individual Couples Family Psychotherapist
Individual Couples and Family Psychotherapist
Counselling Psychologist Individual and Couples Psychotherapist EMDR
Individual Couples Family and Group Psychotherapist EMDR
Starting DBT requires commitment and courage. You’ll be asked to work hard, attend consistently, complete homework, and practise skills even when it’s uncomfortable. DBT isn’t a quick fix — it’s a comprehensive programme that requires dedication. However, for people who have struggled for years with emotional intensity, self-harm, and relationship chaos, DBT offers genuine hope for lasting change.
Many people worry they won’t be able to learn skills or that they’re “too broken” for DBT to work. DBT was specifically designed for people who’ve struggled with other treatments. You don’t need to believe it will work — you just need to commit to trying. The validation you’ll receive in DBT, often for the first time, can itself be transformative.
It's about building a life that feels worth living. It's about moving from emotional chaos to regulation, from impulsive reactions to wise responses, from unstable relationships to connections based on mutual respect and care. It's about learning that you can feel intense emotions without being controlled by them.
Your emotions, however intense, are understandable. You can learn to manage them whilst still honouring your emotional experiences. With skills, validation, support, and practice, you can build the life you want — one that includes both acceptance of yourself as you are and the changes you wish to make.
DBT offers comprehensive, evidence-based support specifically designed for emotional intensity. If you're ready to commit to building a life worth living, we're here to help.
Should you feel that your first session did not meet your expectations or that your therapist wasn’t a good fit, we will provide another session completely free of charge with a different practitioner.
We are proud to work in partnership with major UK and global insurers, as an approved mental health provider, supporting various clients in their therapy journey around the globe.
