Dialectical Behavior Therapy

Linehan’s (1993) Dialectical Behavior Therapy (DBT) has been enormously influential in creating interest in mindfulness-based techniques. Like Mindfulness-Based Stress Reduction, DBT is rooted in Buddhist thought. DBT employs mindfulness practice without traditional sitting meditation, although DBT providers are encouraged to practice meditation. It was developed for people who may be too emotionally dysregulated and chaotic to maintain formal practice, which they may find too intense. Having taken a year’s sabbatical to train in Zen monasteries in California and Germany (Butler, 2001), Linehan incorporated skills in DBT that emphasize remaining attentive to the present moment but which do not necessarily involve formal meditation. For example, DBT participants practice observing their thoughts and emotions, observing a specific aspect of their external world, and other related skills. DBT has been demonstrated to be effective in clients with borderline personality disorder, particularly in reducing self-harming behaviors and suicide attempts behaviors and keeping clients in treatment (Linehan, Cochran, & Kehrer, 2001).