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DBT Therapist Corner: What Are Dialectics and How Do They Show Up in Mental Health Disorders?

Writer: Holly PriscuHolly Priscu

Updated: Feb 6


Dialectics involve the idea that two opposing things can be true at the same time.

Dialectics can be a challenging concept to grasp at first, but it’s essential in understanding certain mental health disorders and how they are treated. In essence, dialectics involve the idea that two opposing things can be true at the same time. This notion comes up frequently in everyday life and especially in therapy, where individuals often struggle with seemingly contradictory thoughts and emotions.


Dialectics are at the heart of Dialectical Behavior Therapy (DBT), a treatment model that helps people, particularly those with Borderline Personality Disorder (BPD), to navigate and reconcile these contradictions in their thoughts, behaviors, and feelings.


Dialectics in Mental Health Disorders


People with Borderline Personality Disorder often experience intense, rapidly shifting emotions and beliefs about themselves and others. One moment they may feel immense love and affection, and the next, overwhelming anger or disappointment. This extreme emotional variability is sometimes referred to as "splitting" or "black-and-white thinking."


Instead of viewing emotions or situations as all good or all bad, dialectics encourage the acceptance of both positive and negative aspects at the same time.

Dialectics help to frame these seemingly opposing thoughts in a way that allows for balance. Instead of viewing emotions or situations as all good or all bad, dialectics encourage the acceptance of both positive and negative aspects at the same time. This can be life-changing for people with BPD and other disorders where emotional intensity creates distress and confusion.


How Dialectics Became DBT


Dialectical Behavior Therapy (DBT) was created by Dr. Marsha Linehan to treat individuals with BPD, who often struggled with traditional talk therapy. Linehan saw the need for a therapy model that would both validate a person’s emotional experience and encourage change.


As Linehan put it, “The problem with a purely accepting, validating stance is that it can reinforce maladaptive behavior. The problem with a purely change-oriented stance is that it can invalidate the client’s current experience.” DBT, through its dialectical framework, balances acceptance and change, teaching individuals to accept where they are while simultaneously working toward transformation.


DBT is rooted in cognitive-behavioral therapy (CBT) but integrates dialectical thinking to help clients navigate complex emotional landscapes. It emphasizes mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness—all tools to manage the contradictions that can make life feel overwhelming.


DBT is designed to teach you how to navigate emotional extremes and bring balance to your life.

Examples of Dialectics


Here are some common dialectics that may arise in mental health:


- "I am doing the best I can, and I need to do better."

- "I want to be alone, but I crave connection."

- "I feel hurt by you, and I still love you."


For people with BPD, these kinds of conflicting feelings and thoughts often feel like an emotional roller coaster. Learning to hold both truths in balance, rather than seeing life in extremes, is an essential skill.


Activities to Notice Dialectics


If you're curious about how to recognize dialectics in your life, here are some simple activities to try:


- Mindfulness practice: Pay attention to how often you think in "either/or" terms. Whenever you notice this, ask yourself, “Could both be true?”

- Journaling: Write about a time when you felt conflicted—when two opposing feelings or thoughts were present at the same time. Reflect on how both could hold some truth.

- Opposite Action: When you notice a strong emotional response (e.g., anger), try acting in the opposite way to challenge your habitual response. This can help you recognize the dialectic of “I feel this way, and I can choose a different action.”


How DBT Can Help You Find Balance


DBT is designed to teach you how to navigate emotional extremes and bring balance to your life. If you're struggling with intense emotions, difficulty in relationships, or a mental health disorder like BPD, DBT can help you learn to hold two opposing truths in a way that leads to more emotional regulation and less distress.


**Ready to learn more?**

If you're interested in how DBT can help you or a loved one, schedule a free consultation with a DBT therapist today. We offer online therapy across Colorado, Montana, and Nevada, making it easier than ever to access the support you need.


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