Doctrine is a tool for object-relational mapping in PHP. It sits on top of PDO and is itself divided into two main layers, the DBAL and the ORM. The picture below shows how the layers of Doctrine work together.

The DBAL (Database Abstraction Layer) completes and extends the basic database abstraction/independence that is already provided by PDO. The DBAL library can be used standalone, if all you want is a powerful database abstraction layer on top of PDO. The ORM layer depends on the DBAL and therefore, when you load the ORM package the DBAL is already included.