Stress has a way of creeping into every corner of our lives. For the highly sensitive and intelligent individuals I work with—professionals in high-stakes fields like law, tech, and healthcare, as well as students navigating the pressures of academia—stress isn’t just an occasional visitor; it often feels like a permanent resident.
I’m Dr. Matthew G. Mandelbaum, a licensed psychologist with over 20 years of experience in the human services and mental health industry. In my practice, I can work with clients across 43 states through PSYPACT. I see firsthand how modern life amplifies emotional intensity. The constant connectivity, the drive for perfection, and the sheer volume of information we process daily make stress feel more unrelenting than ever before.
But here is the good news: while we cannot eliminate stress, we can change how we respond to it. Dialectical Behavior Therapy (DBT) offers a powerful, evidence-based framework for doing exactly that. It provides practical tools for managing intense emotions in daily life, helping you move from a state of overwhelmed reactivity to one of clarity and purpose.
What Is Dialectical Behavior Therapy (DBT)?
Before diving into the techniques, it is helpful to understand the foundation. Dialectical Behavior Therapy (DBT) is a comprehensive cognitive behavioral treatment developed by Dr. Marsha Linehan. While it was originally designed to treat borderline personality disorder, research has shown it is incredibly effective for a wide range of mental health conditions, including anxiety, depression, PTSD, and substance abuse.
DBT Dialectical Behavior Therapy Explained
The term “dialectical” refers to a synthesis of opposites. In DBT dialectical behavior therapy, the central dialectic is the balance between acceptance and change. We work on accepting our experiences and emotions exactly as they are in the present moment, while simultaneously working to change the behaviors and patterns that cause us suffering. This balance is crucial for anyone seeking an emotionally balanced life.
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The Core Skills of DBT Therapy
DBT skills training is structured around four core modules. Whether you are in individual therapy, group therapy, or a dedicated DBT program, these are the pillars we focus on:
- Mindfulness skills: Focusing on the present moment.
- Emotion regulation skills: reducing vulnerability to negative emotions.
- Distress tolerance skills: Surviving crises without making them worse.
- Interpersonal effectiveness skills: Navigating relationships and maintaining self-respect.
Below, I have outlined 15 specific DBT techniques across these four categories that can serve as a valuable tool for your mental well-being.
Photo by Pawel Czerwinski on Unsplash
Mindfulness Techniques (Present Moment Awareness)
Mindfulness is the foundation of all DBT skills. It allows us to slow down the rush of intense emotions and observe our internal world without getting swept away by it.
1. Observing Without Judgment
This technique involves stepping back to watch your thoughts and feelings as if they were clouds passing in the sky. You notice “I am feeling anxious right now” without attaching a judgment like “I shouldn’t be anxious” or “This is weak.” By simply observing, you reduce the emotional distress that comes from fighting your own experience.
2. Describing Emotions Accurately
We often say “I feel bad,” but that is vague. DBT therapy encourages putting precise words to your experience. Are you frustrated? Disappointed? Lonely? When you describe the facts of an event and your internal reaction to it, you engage your frontal cortex, which helps regulate the emotional centers of your brain.
3. Participating Fully in the Present Moment
Anxiety lives in the future; regret lives in the past. To reduce stress, throw yourself completely into what you are doing right now. If you are washing dishes, just wash dishes. Feel the water, smell the soap. Practicing mindfulness in this way anchors you in the present moment, giving your mind a break from worrying.
Emotion Regulation Skills for Intense Emotions
Emotion regulation skills are designed to help you understand the function of your emotions and modify intense emotional responses.
4. Identifying and Naming Emotions
You cannot tame what you cannot name. This skill involves understanding what an emotion is telling you. Anger often signals a blocked goal; fear signals a threat. By identifying the specific emotion, you can decide if the response fits the facts of the situation.
5. Reducing Vulnerability to Negative Emotions (PLEASE Master)
This acronym reminds us to take care of our physical health to support our mental health.
- PhysicaL illness (Treat it)
- Eating (Balance your diet)
- Avoid mood-altering substances
- Sleep (Get 7-9 hours)
- Exercise (Intense exercise can be particularly helpful for releasing stress)
6. Increasing Positive Emotions Intentionally
We often wait for happiness to happen to us. In DBT therapy techniques, we actively schedule pleasant events. Whether it is reading a book, walking in nature, or calling a friend, accumulating positive emotions builds a buffer against stress.
7. Changing Emotional Responses Through Problem Solving
If an emotion is justified by the situation (e.g., fear because a deadline is approaching), the best way to regulate that emotion is to solve the problem. Break the task down, create a plan, and take the first step. Action reduces anxiety.
Distress Tolerance Skills for Stressful Situations
Sometimes, we cannot solve the problem immediately. Distress tolerance is about getting through stressful situations without resorting to impulsive behaviors, self-harm, or substance abuse.
8. Radical Acceptance
This is one of the most challenging but liberating core skills. Radical acceptance means completely accepting reality as it is, without throwing a tantrum or wishing it were different. It doesn’t mean you approve of the situation; it means you stop fighting the reality of it, which reduces suffering and frees up energy for change.
9. Self-Soothing Using Five Senses
When emotional distress is high, ground yourself physically.
- Vision: Look at a beautiful photo.
- Hearing: Listen to soothing music.
- Smell: Light a scented candle.
- Taste: Eat a piece of chocolate mindfully.
- Touch: Wrap yourself in a soft blanket.
10. Distracting Without Avoiding (ACCEPTS)
Distraction is a valid coping strategy when used intentionally.
- Activities (Hobbies)
- Contributing (Helping others)
- Comparisons (Putting your situation in perspective)
- Emotions (Watching a funny movie to generate a different feeling)
- Pushing away ( mentally shelving the problem for an hour)
- Thoughts (Puzzles or counting)
- Sensations (Holding ice)
11. Coping Ahead for Stressful Situations
If you know a difficult event is coming, rehearse your coping plan in your mind. Visualize yourself handling the situation effectively using your DBT skills. This prepares your brain to respond skillfully rather than reactively.
Interpersonal Effectiveness Skills for Healthy Relationships
Stress often stems from our interactions with others. Interpersonal effectiveness skills help you ask for what you need and set boundaries while maintaining healthy relationships.
12. Assertive Communication (DEAR MAN)
This script helps you get your objective met:
- Describe the situation facts.
- Express your feelings (“I feel…”).
- Assert your wishes clearly.
- Reinforce (Explain why this benefits the other person too).
- Mindful (Stay focused on the goal).
- Appear confident.
- Negotiate.
13. Setting Boundaries While Maintaining Self Respect (FAST)
This skill protects your self-respect:
- Fair (Be fair to yourself and others).
- Apologies (No over-apologizing).
- Stick to values.
- Truthful (Don’t lie or exaggerate).
14. Asking for What You Need Effectively
Many highly intelligent people struggle to ask for help because they feel they “should” handle everything alone. Learning to ask effectively is a key aspect of preventing burnout.
15. Navigating Conflict in Interpersonal Relationships (GIVE)
This skill focuses on the relationship itself:
- Gentle (Be courteous).
- Interested (Listen).
- Validate (Acknowledge the other person’s feelings).
- Easy manner (Smile, use humor).
Who Can Benefit from DBT Therapy Techniques?
While DBT for borderline personality disorder is well-known, its application is far broader. I use these techniques to help clients with attention deficit hyperactivity disorder (ADHD) manage impulsivity, clients with post-traumatic stress disorder navigate triggers, and high-functioning professionals manage burnout. It is also effective for eating disorders and preventing harmful behaviors.
The psychological benefits are profound. DBT patients typically see an increase in emotional resilience, better communication skills, and a greater sense of control over their daily life.
What DBT Therapy Looks Like in Practice
In my practice, DBT sessions are collaborative. As a trained therapist, I don’t just listen; I actively teach. We review your week, look at where skills could have been used, and practice new ones. Skills practice between sessions is crucial. It is like learning a language—you have to speak it daily to become fluent.
For many, combining individual therapy with skills training creates the most robust change. DBT therapists act as coaches, helping you apply these tools to your unique challenges, whether that is a high-pressure board meeting or a difficult conversation with a partner.
Turning Stress Into Skillful Action
Stress is unavoidable, but suffering does not have to be. These DBT techniques are not magic wands, but they are incredibly effective levers for shifting your reality. They help reduce stress without minimizing the real pain or challenges you are facing.
If you find yourself struggling with intense emotions or feeling stuck in reactive patterns, know that you don’t have to navigate it alone. Seeking DBT therapy with a professional can help you build a life that feels not just manageable, but truly fulfilling.