"A dialectical world view emphasizes wholeness, inter-relatedness and process (change) as fundamental characteristics of reality" (Linehan & Kehrer, 1993, p.400). The fundamental value of the dialectical view is never to accept an absolute truth or an indisputable fact (Linehan & Kehrer,1993). For example, an individual with BPD may only be able to see things in black or white, or from one extreme to another. The dialectical view does not search for either extreme, but takes the middle road of balance. Thus, there is no search in absolute truth, for there are many truths and different perspectives. The therapist and client must constantly ask themselves "what is being left out of [their] understanding" to help them clarify the dialectical dilemmas that exist within the client (Linehan & Kehrer, 1993, p. 401).

The dialectical view assumes that clients' problems are caused by these dialectical failures. In dialectics, reality is seen as comprised of internal opposing forces (thesis and antithesis) out of whose synthesis evolves change. Dichotomous and extreme thinking, behavior, and emotions, which are characteristic symptoms of BPD, are considered to be dialectical failures (Linehan, 1993b). The borderline individual becomes stuck in polarities (opposite extremes) and is unable to move to synthesis. For instance, the individual with BPD may not be able to see a solution to a problem, such as feeling isolated, and therefore may react with impulsive behavior such as binge drinking. The individual needs to find a balance between accepting her feeling of isolation and finding a more adaptive way to cope with it. The therapist must help the client move towards a workable synthesis by balancing the need for the client to accept herself as she is in the moment and the need for her to change. The change process is conceptualized by the borderline individual being able to "radically accept" her present situation in the moment, and being willing to change it to better her life (Linehan, 1993b). The therapist supports the client by validating her views and difficulties, and uses dialectics to focus the client's attention on the opposing polarities and help her find ways out of them. Through the therapeutic opposition of contradictory positions, the client and therapist can both "arrive at new meanings within old meanings and move closer to the essence of the subject under consideration" (Linehan & Kehrer, p.401).