As a psychologist certified in Dialectical Behavior Therapy (DBT), I see the approach as much more than a treatment. It’s the lens through which I view life. I’ve been saying this for a while, and I’m recognizing how misleading that statement might seem.
DBT is a framework that I practice in my therapy office with individuals who meet criteria for a psychological diagnosis (often more than one). So when people outside of the psychology world hear that I view life through DBT, they probably wonder how the clinical manual for borderline personality disorder applies to my worldview. Or maybe they just think I’m crazy (which is their judgment to tolerate, not mine).
I’ve been thinking more about what seeing life through a DBT perspective means. It’s not the treatment per se that I find applicable; rather, it’s the underlying philosophy, principles, and behavioral skills.
The approach is grounded in dialectical philosophy, which assumes that reality is composed of seemingly opposing forces and that wisdom emerges from their integration. It proposes that human thinking moves forward by recognizing these contradictions and synthesizing them into something new. This conviction underlies all of DBT; hence, the word ‘dialectic’ in the title.
The central dialectic in DBT integrates the tension between acceptance and change. Integrating acceptance of reality with effective change anchors the entire framework.
Synthesis runs throughout, pulling together ideas that otherwise appear contradictory. This is evident in DBT’s integration of Zen Buddhism with behavioral psychology, making the framework both contemplatively informed and scientifically grounded. The Buddhist concepts of mindfulness, radical acceptance, nonattachment, the middle path, and compassion are interwoven with the behavioral principles of contingency management, shaping, exposure, and reinforcement.
Dialectically speaking, the synthesis of these divergent schools of thought expands beyond psychotherapy.
Understanding and synthesizing dialectics serve the ultimate goal of DBT: helping people build a life worth living. Change skills move clients toward more effective living, while acceptance skills cultivate understanding that pain is inevitable.
When reality isn’t accepted, suffering emerges through behaviors like rumination, catastrophizing, and judgment. A life worth living isn’t void of pain; it’s one that acknowledges pain as unavoidable and chooses to accept facts as a means to decrease suffering. It’s experiencing life as worth living amid pain, which makes it more tolerable.
When I start working with anyone, one of the most important conversations involves exploring their definition of a life worth living: what gives their life meaning, where they hope to go, and what they value. Not what their parents, their spouse, their friends, or their boss value – what they value. What they feel internally passionate about, regardless of what others might think or feel. What they experience as innately inspiring, especially when no one else is around.
Naming values offers guidance toward a destination people find motivating. Identifying current behavior and evaluating the space between that behavior and their values reveals areas of misalignment that often increase suffering. When habitual behaviors are inconsistent with someone’s vision of a meaningful life, people get stuck.
The behavioral skills in DBT help people close the gap. They offer strategies to move toward living a life that is values-aligned – one experienced as worth living. A satisfying and meaningful life, defined by whoever lives it.
My top values include adventure and connection, and I’m lucky to travel often with people I love. I’ve had a slew of less-than-ideal travel experiences recently. Within the past year, I’ve taken two international trips where my luggage was lost (one for most of the trip). On a road trip (or what was supposed to be one), my fully packed car was broken into, and everything inside was stolen.
The moment each of these occurred, I was tempted to throw a massive tantrum. While the urge was understandable, I asked myself: how will that help me live the life I want? The answer: not at all. It only moves me farther from it.
Now, that doesn’t mean I didn’t shed a few tears (I actually shed much more than a few); however, I didn’t let my distress take over. I validated my emotions (it made complete sense that I was upset) and accepted the brutal facts: my belongings were no longer with me. Throwing a tantrum wasn’t going to change that. It wasn’t going to bring back my favorite outfits. It was only going to interfere with fully enjoying each location and staying present with my favorite people.
Acceptance of the situation paved the way to effective problem-solving. And more importantly, it allowed me to stay aligned with my values of adventure and connection. Hyper-focusing on a situation that I couldn’t change would only detract from them.
My passion for my career comes from living what I teach. I find myself engaging with life more effectively every year I practice the skills (recent travel situations say hello). I credit much of my emotion regulation, cognitive flexibility, and interpersonal effectiveness to actively using DBT strategies in my own life.
Most people are well aware of my love for DBT (yes, my birthday celebration this year involved dialectics). A close friend and colleague recently said, “when I think DBT, I think Courtney; and when I think Courtney, I think DBT.”
I want the world to know DBT, love DBT, practice DBT, and live a DBT-informed life. What I love most isn’t DBT as a treatment model. It’s the broader philosophy underneath – and the behavioral skills that emerge as a result – that are too valuable to remain confined to the therapy office.
Dialectical Living translates that philosophy into a secular, non-clinical framework for everyday life. It’s a way of embracing reality as it is – full of complexity and hardship – and still finding value in the day-to-day.
The purpose is to experience life as worth living.
It’s skillfully engaging with life by accepting what feels intolerable, regulating emotions that feel uncomfortable, separating thoughts from facts, and interacting effectively with others.
Dialectical Living starts with accurately observing reality. It’s using that awareness to change what’s in your control and accept what’s not. It’s practicing self-regulation and relational finesse when the difference is uncertain. And it’s tolerating that ambiguity long enough for deeper understanding to emerge.
A diagnosis is not necessary for this framework. Neither is a therapist.
What’s necessary is deciding to accept reality, pursue change, and navigate the messy space in between — over and over — to build a life you feel is worth living.