Are You a Highly Sensitive Person?

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DBT helps HSPs manage emotions, set boundaries, and accept life.

DBT helps break a cycle of emotional overwhelm by combining validation with practical skills for change.

DBT emphasizes self-compassion, validating HSPs' emotional experiences.

As I emerged from therapy into the bustling chaos of Manhattan’s East Village, cheeks wet with tears, I thought to myself, “How will things ever change?” Arriving 20 minutes late, I’d spent the too-short session lamenting my lack of control, how my life didn’t feel like mine. How I was trapped in a disordered, emotional eating cycle. How I had recently drank way too much at a friend’s birthday party, stayed up till 3 a.m. bingeing on TV to try and reset, and then slept through my classes... I was exhausted, overwhelmed, and constantly crying. The simplest tasks filled me with dread.

The therapist helped some, but I still left disheartened and directionless. My behaviors were reinforcing a cycle of misery. I had no idea what to do, what to change, how to escape. I needed something different if I wanted different results. I mustered the strength to type an email to a new therapist. From the moment I hit send, everything changed.

The reason? Dialectical behavior therapy. DBT taught me that my reaction makes sense, and then it provided me with a series of new skills. The skills I needed to change my life.

Highly Sensitive People (HSPs) like myself are often challenged by feeling like they are “too much” or that something is “wrong” with them. We are frequently overstimulated and may struggle to manage big feelings. Lacking the tools to address these feelings, we may feel overwhelmed by our emotions or completely disconnected from them.

The solution to help me navigate my sensitivity was DBT. I was such a fan of DBT that I went to school to become a psychologist so I could teach other HSPs this modality. I have been described as a “DBT-head” before.

If you are unfamiliar with this form of therapy, here are a few things to know.

DBT is an evidence-based form of psychotherapy that supports clients in regulating their emotions and improving their relationships. This modality is considered a “third wave” therapeutic approach that teaches practical methods to manage intense emotions, set boundaries in relationships, and radically accept the realities of life as an HSP.

Dialectical behavior therapy (DBT) was created for managing intense emotions

In the late 1970s, American psychologist Marsha Linehan had been providing cognitive behavior therapy (CBT) to clients diagnosed with borderline personality disorder (BPD) who struggled with self-harm and suicidal thoughts. Linehan found that her clients frequently dropped out, claiming feelings of invalidation. CBT protocol dictated that she consistently ask them to change their thoughts and behaviors. These clients, many of whom were HSPs, were understandably frustrated. Their therapeutic experience was echoing what they were already hearing outside: Be less impacted by your emotions, stop engaging in emotional behavior, be different than you are.

How many times has someone told you to “just change” your thoughts and your feelings? Do you find yourself lamenting, “I want to, but I just can’t!”

Linehan understood this exasperation and designed a new modality specifically for people like us, emotionally sensitive folks who need to be met with compassion, validation, and acceptance. This approach became what we now know as DBT.

While DBT was initially developed for the treatment of individuals with a diagnosis of BPD, over time, it evolved into a transdiagnostic approach proven effective across wider populations. Research has shown DBT to benefit individuals diagnosed with everything from mood disorders (including depression and bipolar disorder) to post-traumatic stress disorder (PTSD), anxiety, eating disorders, and substance abuse issues. Research consistently demonstrates DBT's versatility and efficacy across the whole spectrum of psychological disorders.

Are You a Highly Sensitive Person?

Take our Highly Sensitive Person Test

Find an HSP therapist near me

DBT clearly helps many people, and, in my experience working with HSPs, I have found it to be extra beneficial for individuals who identify as sensitive because it validates their experience and then teaches the therapy and coping skills that make living life easier (and more fulfilling).

DBT’s biosocial theory validates the HSP experience

Marsha Linehan created DBT for individuals who have a history of feeling invalidated, of being told (either verbally or nonverbally) that their emotions are not appropriate, legitimate, or understandable. The antidote to invalidation? Self-validation and compassion.

Many sensitive people—myself included—are often made to feel alone in their experience. We experience emotional misattunement, a form of invalidation where our emotions are not acknowledged or understood by our caregivers, partners, or close relationships. Have you ever left an interaction with a parent, lover, or friend feeling off, kinda yucky, but unable to pinpoint why? Oftentimes, this invalidation can be subtle, and we do not even perceive it on a conscious level.

If you have dealt with chronic emotional misattunement in your past, you may struggle with feelings of shame and be quick to self-invalidate your emotions. You believe you "shouldn't" feel the way you are feeling. You start judging yourself for your natural response, which makes you feel even worse, and takes a toll on your self-esteem.

DBT’s biosocial theory explains this circular phenomenon. The interplay between high sensitivity and an invalidating environment leads to maladaptive coping skills, low self-esteem, and emotional dysregulation, which in turn lead to even higher sensitivity and more external invalidation.

This framework reminds us that our experiences of the world growing up were not wrong; they were just misunderstood. But I want to be clear, I am not saying, "Blame your parents" or "It's all your ex's fault." DBT is not about condemning the past. It’s about having compassion for where you are now.

If you are an HSP, DBT can remind you that your feelings are important (even if you do not like them or if other people try to tell you they are wrong). DBT helps you to be tender with the parts of yourself that have been hurt, and to validate your own experience. In DBT, self-compassion is key.

Jones, B.D.M., Umer, M., Kittur, M.E. et al. (2023). A systematic review on the effectiveness of dialectical behavior therapy for improving mood symptoms in bipolar disorders. International Journal of Bipolar Disorders, 11(1), 6. https://doi.org/10.1186/s40345-023-00288-6

Kliem, S., Kröger, C., & Kosfelder, J. (2010). Dialectical behavior therapy for borderline personality disorder: A meta-analysis using mixed-effects modeling. Journal of Consulting and Clinical Psychology, 78(6), 936–951. https://doi.org/10.1037/a0021015

Kothgassner, O. D., Prillinger, K., Goreis, A., Macura, S., Hajek Gross, C., Lozar, A., Fanninger, S., … & Kothgassner, O. D. (2024). A systematic review and meta-analysis on the efficacy of dialectical behavior therapy variants for the treatment of post-traumatic stress disorder. European Journal of Psychotraumatology, 15(1). https://doi.org/10.1080/20008066.2024.2406662

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.

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