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Dialectical Behaviour Therapy (DBT) Combined with TMS for Depression

Written by Smart TMS | June 6, 2025 4:23:38 PM Z

 In this article we discuss DBT and TMS, and how the two therapies can complement each other. 

Dialectical Behaviour Therapy (DBT) emerged in the late 1980s, developed by psychologist Marsha M. Linehan. Dr. Linehan recognised the need for a specialised approach to address the unique challenges faced by individuals with borderline personality disorder (BPD). Her groundbreaking work combined elements of cognitive-behavioural therapy (CBT) with acceptance and validation strategies.  

Key Components of DBT 

DBT encompasses several interconnected components: Emotional Regulation is a breaker of DBT and focuses on helping individuals manage intense emotions effectively. Skills are taught to recognise emotional triggers, regulate emotional responses, and avoid impulsive behaviours. By understanding their emotions and learning coping strategies, individuals gain greater control over their reactions.  

Distress Tolerance is another crucial event of DBT. Coping with crises and distressing situations is a central aspect of DBT. Techniques include distraction, self-soothing, and acceptance of distress without exacerbating it. Individuals learn to tolerate emotional pain without resorting to harmful behaviours.  

Interpersonal Effectiveness is the third element of DBT and involves enhancing communication and relationship skills. DBT teaches assertiveness, active listening, and conflict resolution and by improving interpersonal interactions, individuals build healthier connections and reduce conflict.  

Mindfulness is the final element of DBT. Mindfulness involves cultivating present-moment awareness helps individuals stay grounded. Mindfulness practices reduce emotional reactivity and promote self-acceptance for people struggling with mental health difficulties. By being fully present, individuals can observe their thoughts and emotions without judgment.  

Beyond BPD: Applications of DBT 

While initially designed for BPD, DBT has proven effective in treating various conditions:  

  • Depression: DBT provides tools for managing depressive symptoms and preventing relapse. It encourages individuals to challenge negative thought patterns and engage in positive behaviours.  
  • Self-Harm and Suicide Attempts: Individuals prone to self-harm benefit from DBT's distress tolerance techniques. They learn alternative ways to cope with emotional distress.  
  • Substance Abuse: DBT helps address addictive behaviours by enhancing emotional regulation and coping skills. It targets the underlying emotional triggers that contribute to substance use.  
  • Eating Disorders: DBT assists in managing emotional triggers related to disordered eating patterns. It promotes a balanced approach to food and body image.  

TMS and DBT Combination 

Transcranial Magnetic Stimulation (TMS), a non-invasive treatment for depression, stimulates specific brain areas using an electromagnetic coil. Combining DBT with TMS holds promise as TMS focuses on the prefrontal cortex, which plays a role in mood regulation. Integrating DBT with TMS could enhance emotional regulation and reduce symptoms.  

In summary, DBT equips individuals with practical skills to navigate intense emotions, while TMS offers targeted brain stimulation. As research continues, personalised treatment choices will guide mental health care and help mental health professionals tailor treatments to individuals more effectively. 

References: 

  1. [Mind: What is dialectical behaviour therapy (DBT)?](https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/dialectical-behaviour-therapy-dbt/) 
  2. [Psychology Today: What Is DBT?(https://www.psychologytoday.com/intl/blog/hope-eating-disorder-recovery/201609/what-is-dbt)  
  3. [Harvard Health Publishing: Dialectical behaviour therapy](https://www.health.harvard.edu/blog/dialectical-behavior-therapy-what-is-it-and-who-can-it-help-202401223009)  
  4. [Simply Psychology: Dialectical Behaviour Therapy](https://www.simplypsychology.org/dialectical-behavior-therapy.html) 
  5. [NHS: Dialectical behaviour therapy (DBT)](https://www.onyourmindglos.nhs.uk/learn-more/types-of-help/dialectical-behaviour-therapy-dbt) 
  6. [BMC Psychiatry: EMDR-DBTStudy](https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02713-x) 
  7. [BrainFacts: TMS Treatment] (https://www.brainfacts.org/Diseases-and-Disorders/Therapies/2018/Cognitive-Behavioral-Therapy-Transcranial-Magnetic-Stimulation-what-are-these-therapies-020718