4 Questions to Ask Yourself Before Starting Dialectical Behavior Therapy

Dialectical Behavior Therapy, or DBT, is a modified version of another well-known type of psychotherapy called Cognitive Behavioral Therapy (CBT). The primary goal of DBT is to help individuals struggling with certain behaviors and mental health conditions to better cope with stress, regulate their emotions, stay present in every moment, and consequently improve the health of their relationships with others. 

While DBT was initially developed to treat a specific condition - Borderline Personality Disorder (BPD) - it has since been modified to treat other conditions such as self-destructive behaviors like substance abuse, eating disorders, self-harm, emotional dysregulation, and more. DBT is even used at times for PTSD.

If you’ve heard of DBT and are wondering if this type of treatment is right for you, you’ll want to ask yourself some important questions before starting the DBT treatment protocol. 

QUESTION 1: Do intense emotions impact your day-to-day life? 

One of the main reasons an individual will seek out DBT is the impact of their emotions on their everyday reality. For many people living with borderline personality disorder (BPD), bipolar disorder, PTSD, anxiety, depression, suicidal ideation, and more, the root cause of their distress is a lack of emotional control. 

If your emotions are impacting your life in a consistent way where you feel out of control, overwhelmed, crippled, hopeless, or stuck, you can categorize yourself with the bulk of those suffering from emotional distress. When you go through these intense shifts in emotion you may find yourself participating in reckless or impulsive behaviors such as self-harm, binging or purging food, abusing alcohol or drugs, spending money, or engaging in risky sexual connection. 

Another emotion that can be indicative of the need for specialized therapy such as DBT is anger. If you explode when you are angry, or tend to act out in various ways (such as verbal attacks, breaking objects, driving recklessly, doing drugs or participating in self-harm), DBT can help.

If you’re considering DBT, examine your emotional wellbeing overall; If you experience mood swings, intense highs and lows, unpredictable changes in emotion, are sensitive, impulsive, or might say you have “anger issues,” DBT may be right for you. Stage 2 of DBT treatment actually focuses on addressing quality of life issues such as emotional regulation, distress tolerance, and more. 

QUESTION 2: Do you struggle with your identity? 

Identity is a huge part of the goal for those establishing better self-awareness through DBT. For many people exploring DBT treatment as a solution, they often feel lost, isolated, confused, or unsure of who they are. 

The Diagnostic and Statistical Manual, 5th Edition (DSM-5), describes Borderline Personality Disorder as “a chronic disorder that includes symptoms such as frantic efforts to avoid real or imagined abandonment, unstable relationships, identity disturbance, impulsive and dangerous behaviors, recurrent suicidal threats or self-mutilating behaviors, affective instability, feelings of emptiness, difficulties controlling anger, and/or stress-related paranoid thoughts or dissociation.” 

Do you find yourself feeling numb, hopeless, helpless, or lost? It can be difficult to establish a sense of self when your emotions change so frequently or dramatically on an ongoing basis. This experience can often be part of “identity disturbance,” which is a sign of BPD. 

The good news is that DBT was created specifically for BPD and other mood and identity disorders, and may drastically improve your quality of life by helping you establish a true sense of self. 

QUESTION 3: Do you often find yourself in conflict in your relationships? 

Conflicted relationships are a hallmark of group members seeking DBT. For many people, they begin to notice the emotional instability and dysregulation the most over time when their highs and lows, anger issues, and lack of sense of self erode the fabric of their relationships with others. 

If conflict with family members, friends, partners, and even coworkers is a constant part of your life, you may lose people quickly due to ongoing fallouts. Maybe many of your past relationships have been intense or damaging, ended badly, or left you feeling isolated, rejected, hurt, and abandoned. This experience with interpersonal connection creates an even greater sense of instability in your life, which can contribute to the emotional churn cycle of highs and lows. 

Chaotic relationships cause stress to everyone involved. In Stage 3 of DBT, your therapist will focus on helping you build healthier relationships through addressing self-esteem and identity problems. 

Question 4: Do you find yourself engaging in harmful or risky behaviors?

Emotional highs and lows, dysfunctional relationships, and identity crisis can result in escapist behavior or impulsively engaging in self-harm, drug abuse, overspending, and more. When you’re upset, you might have difficulty getting back to a place of reason or being in your “right mind.” 

When your emotions are overwhelming, do you struggle with solving your problems and getting back to a safe, calm place? This can lead you to make the same bad decisions over and over again, and to choose destructive habits that cause harm to your physical, mental, and emotional health as well as your relationships with others.


The initial stage of DBT treatment protocol involves identifying and targeting the most concerning or self-destructive behavior types for patience such as those described above, along with non-suicidal self-harm, suicidal ideation, and harm to others. 

If the questions above resonated with you or you can see yourself in many of the described situations, DBT may be the right choice for you.

Are you interested in trying out online DBT group therapy? Get started today.

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