Dialectical Behavior Therapy, or DBT, is a widely used therapeutic model that is helpful for a wide variety of mental disorders and symptoms. The basis of DBT can be understood by looking at the definition of dialectical: “concerned with or acting through opposing forces.” Therapy following this modality focuses largely on combating negative emotions by acting in opposition to them and bringing upon more desirable, pleasant feelings. DBT has four main areas of focus: interpersonal effectiveness, mindfulness, distress tolerance, and emotional regulation. For each of these components, DBT provides skills and techniques that can be used to improve daily functioning and overall mental health.
The emotional regulation side of this therapy modality teaches tools that people can use to manage and cope with unwanted intense emotions. Oftentimes, when experiencing strong emotions, we end up behaving in ways that we end up regretting. In fact, it often feels like we don’t have control over our actions at all in these moments. However, in therapy we often talk about differentiating between things that you can and cannot control, and how we respond to our feelings is one of the things that is within our realm of control. For this reason, it is helpful to learn and practice these skills so that you are ready to use them next time uncomfortable feelings arise. Keep reading for an introduction to some of my favorite DBT emotional regulation techniques.
DBT uses many acronyms, one of which being STOP, which stands for stop, take a step back, observe, and proceed mindfully. This skill teaches us to pause before reacting when experiencing heightened emotions, take some time to calm down and think about how to respond, pay attention to what is happening around us and in our head, and prepare to deal with the situation effectively before moving forward. Stopping before acting is challenging at first, however, utilizing this skill will help you acknowledge how your emotions are affecting your behaviors before you act out and do or say something that you don’t mean.
Another acronym commonly taught by DBT therapists is ABC PLEASE, which encourages us to take care of ourselves when dealing with intense emotions. A stands for accumulating positive emotions by doing something that is pleasant, B means building mastery by doing something you enjoy, and C stands for coping ahead, or practicing coping skills ahead of time so you feel prepared to manage strong emotions. This skill attempts to increase our overall well being and decrease the frequency of intense negative emotions. It is important to remember that uncomfortable emotions are not entirely avoidable, but there are things we can do to promote more positive feelings.
The opposite action skill is somewhat self-explanatory, it just means doing the opposite of what our emotions are naturally trying to get us to do. For example, when experiencing sadness and depression it is natural to want to isolate and shut down. This coping technique encourages us to do the opposite, so for this example it may look like being active and doing something you enjoy. By doing this, we are increasing positive emotions and behaviors and paying less attention to the unwanted ones. This builds upon ABC PLEASE by encouraging beneficial activities, no matter what your underlying mood is at that moment. Think of it as “faking it ‘till you make it”, because by continuing to practice opposite action, those positive emotions will come more naturally.
Checking the Facts
Finally, we have checking the facts. When experiencing intense emotions it is easy to misinterpret situations or react more strongly than what is appropriate. Using this skill allows us to examine the situation in the moment before reacting. It is helpful to ask yourself the following questions: What is triggering this emotion? What assumption am I making about the event? Are my emotions and intended response congruent with the intensity of the situation? Oftentimes asking yourself these questions will help you realize that the way your extreme emotions are leading you to want to respond in a way that does not actually make sense for the moment.
If you think that any of these skills would be helpful for you, start practicing them! The more we practice skills during calm periods of regulation, the easier it will be to utilize them during moments of intense emotions. Using these emotion regulation techniques will allow you to realistically assess and address whatever situation is affecting your thoughts and feelings, rather than reacting solely based on what your unwanted emotions are telling you to do. If you feel like you need support in challenging negative thoughts and emotions, any of our therapists can help you learn and implement these DBT skills.
Alyssa Meixelsperger, LSW