What is Dialectical Behavior Therapy (DBT)?

Life can feel overwhelming sometimes—especially when emotions seem too intense or relationships become complicated. For those who struggle with big feelings, impulsive behaviors, or frequent conflicts, traditional talk therapy may not always feel like enough. This is where Dialectical Behavior Therapy (DBT) comes in.

DBT is an evidence-based form of therapy that was originally developed to help people who experience intense emotional distress, but over time, it has been shown to benefit a wide range of individuals. It combines practical skills training with strategies to help you better understand, accept, and manage your emotions.

At Wellness Solutions, we often recommend DBT because it’s structured, actionable, and focused on helping you build a life that feels more balanced and manageable. Here’s what you need to know about DBT and how it works.

The Basics of DBT

DBT was created by psychologist Dr. Marsha Linehan in the late 1980s. The word “dialectical” means bringing together two seemingly opposite ideas—in this case:

• Acceptance (understanding yourself as you are)

• Change (working toward healthier patterns and goals)

  
  

DBT is about finding the balance between accepting yourself in this moment and taking steps toward meaningful change. This dual focus is what sets DBT apart from many other therapies.

The Four Core Skills of DBT (Plus Additional Skills)

DBT focuses on teaching practical skills that you can use every day to manage emotions, reduce stress, and build better relationships. These skills are grouped into four main areas, with additional strategies like pleasurable activities and radical acceptance to deepen the work.

1. Mindfulness Skills

Mindfulness is the foundation of DBT. It teaches you how to stay present in the moment and observe your thoughts, emotions, and sensations without judgment. This practice helps you break free from automatic, reactive patterns and develop more control over your responses.

Key mindfulness skills include:

• Observing: Simply noticing your surroundings or feelings without trying to change them.

• Describing: Putting words to what you notice (“I feel anxious in my chest” rather than “I’m falling apart”).

• Participating: Fully engaging in the current activity—whether it’s eating, walking, or talking—without distraction.

Mindfulness also emphasizes “Wise Mind,” which is the balance between your logical mind and emotional mind. Instead of reacting impulsively or overthinking, you learn to make decisions from a calmer, clearer place.

2. Distress Tolerance Skills

Distress tolerance skills help you survive crises and painful moments without making things worse. They’re especially useful during situations you cannot immediately change.

Examples include:

• Self-soothing: Using comforting senses (sight, sound, touch, taste, smell) to calm yourself, such as wrapping in a soft blanket or listening to soothing music.

• Grounding: Focusing on simple, present sensations like touching a cold object or counting objects around you.

• “TIPP” Skills: Quick body-based strategies (Temperature change, Intense exercise, Paced breathing, Progressive muscle relaxation) to reduce emotional arousal.

  
  

Distress tolerance also includes “Radical Acceptance” (explained below in detail), which helps you come to terms with reality so you can move forward without unnecessary suffering.

3. Emotion Regulation Skills

Emotion regulation skills teach you how to better understand and manage your emotional experiences. Instead of feeling ruled by your moods, you learn how to reduce emotional vulnerability and increase emotional stability.

These skills include:

• Identifying Emotions: Naming emotions accurately helps reduce their power. For example, labeling something as “disappointment” rather than “anger” changes how you respond.

• Reducing Vulnerability (“ABC Please”): This involves maintaining physical health, balanced sleep, nutrition, exercise, and avoiding mood-altering substances, all of which impact emotional resilience.

• Opposite Action: Acting opposite to the urge your emotion gives you. For instance, if you feel like isolating when sad, you intentionally reach out to a friend.

  
  

A vital part of emotion regulation is engaging in pleasurable activities—deliberately adding enjoyable, soothing, or rewarding experiences to your day. Simple activities like taking a walk in nature, enjoying a favorite hobby, or watching a comforting movie can help rebalance your emotional state and build a sense of well-being.

4. Interpersonal Effectiveness Skills

These skills teach you how to navigate relationships in a healthy way—assertively and respectfully—while maintaining self-respect.

Key strategies include:

• DEAR MAN: A structured way to make requests or set boundaries (Describe, Express, Assert, Reinforce, Mindful, Appear confident, Negotiate).

• GIVE Skills: (Gentle, Interested, Validate, Easy manner) for maintaining relationships during difficult conversations.

• FAST Skills: (Fair, Apologies kept brief, Stick to your values, Truthful) for preserving self-respect.

  
  

These skills help reduce conflict, improve communication, and make it easier to maintain relationships that feel supportive instead of draining.

5. Radical Acceptance Skills (Detailed)

Radical acceptance is one of DBT’s most transformative tools. It means fully accepting reality as it is—even when it’s painful or unfair—without fighting it, denying it, or wishing it were different. This doesn’t mean you approve of what’s happened; it means you acknowledge it so you can stop adding layers of suffering on top of the original pain.

Why Radical Acceptance Matters

Much of our suffering comes from resisting reality. For example:

• “This shouldn’t have happened!”

• “It’s not fair.”

• “I can’t stand this!”

These thoughts keep us stuck, fueling anger, sadness, or hopelessness. Radical acceptance is about saying, “This is the situation. I may not like it, but it’s real. What can I do next?”

By accepting what’s true, you free yourself to take meaningful action rather than staying trapped in emotional resistance.

What Radical Acceptance Is (and Isn’t):

• It IS: A conscious choice to stop fighting reality, so you can reduce suffering and focus on coping.

• It IS NOT: Approval, resignation, or giving up. You’re not saying the event was okay—you’re saying you accept that it happened.

How to Practice Radical Acceptance

1. Acknowledge reality fully. Notice your resistance (“I don’t want this to be happening”) and shift to recognition (“This is happening right now”).

2. Name the facts. Stick to objective statements (“I lost my job” vs. “I’m a failure”).

3. Let go of “shoulds.” Replace “This shouldn’t be” with “This is what is.”

4. Use mindfulness. Focus on observing without judgment, returning to the present moment instead of replaying the past or imagining “what ifs.”

5. Practice self-compassion. Talk to yourself kindly: “This is hard, but I can handle it.”

6. Engage in coping actions. Once you accept the situation, you can choose your next steps: seeking support, problem-solving, or simply getting through the moment.

Example of Radical Acceptance in Action

Imagine a painful breakup. Without radical acceptance, you might replay arguments, blame yourself, or cling to hopes of reconciliation. With radical acceptance, you acknowledge: “The relationship has ended. It hurts deeply, but it’s reality. I don’t have to like it, but I can accept it and focus on my healing.”

This shift reduces emotional suffering and allows space for growth, new opportunities, and healthier coping.

Final Thoughts

Dialectical Behavior Therapy offers practical tools for real-life challenges. Skills like mindfulness, distress tolerance, emotional regulation, interpersonal effectiveness, pleasurable activities, and radical acceptance help you navigate emotions, relationships, and life’s ups and downs with greater balance.

DBT isn’t about eliminating emotions—it’s about learning to experience them without being controlled by them. If you’ve been feeling overwhelmed or stuck, DBT can provide both structure and hope for real change.

At Wellness Solutions, our clinicians are trained to guide you through DBT and help you develop these skills at your own pace. With support, practice, and patience, you can build a more stable, meaningful, and fulfilling life.