The core of DBT: dialectics means that opposites can be true at the same time. The client is ill AND can change. Their pain is real AND life can improve. The therapist accepts the client AND demands change. Includes work with polarized thinking through the metaphor of the pendulum, devil's advocate, extending, finding the opportunity in a crisis, and two styles of communication — warm (reciprocal) and irreverent.
Step-by-step guide
- Identify the polarity the client is stuck in ("all or nothing")
- Name both extremes without judgment
- Use a metaphor: a pendulum looking for the center
- Ask an integration question: how can both truths exist at the same time?
- If stuck — devil's advocate or extending (gently)
- Balance the warm style (reciprocal) and the irreverent
When to use
- When the client is in "either/or" mode
- When stuck in one position and unable to move
- In resistance to change
- In every session — this is not a technique but the philosophy of DBT
Key phrases
I hear that this is hard. And I notice you missed three sessions. Both are true: it really is hard for you, AND you need help. How can we both be right?
Follow-up questions
You say "never" — then why are you here? [extending, gently]
Why change at all? Maybe better to leave it as it is? [devil's advocate]
This is awful. AND there is something here you do not yet see
Alternative phrasings
You either fully trust or you do not trust at all. What is between?
Both are true: you are suffering AND you are capable of change
Warnings
- ⚠️ Irreverent requires established trust — without it, it sounds like harshness
- ⚠️ It can be misheard as mockery
- ⚠️ It requires sincerity and good contact with the client
Source: Linehan, M. M. (1993, 2015). Based on dialectical philosophy (Hegel)
Materials are informational and educational and summarize publicly available scientific sources. They are not medical or psychological advice, are not intended for self-diagnosis or self-treatment, and do not replace consultation with a qualified professional.