DBT Skills – TRANSCENDENT MENTAL HEALTH

Part 2 of a Five-Part Series on Dialectical Behavior Therapy

Mindfulness is the foundation of Dialectical Behavior Therapy (DBT). Although DBT includes skills for managing emotions, tolerating distress, and navigating relationships, those skills depend on something more basic: being able to notice what is happening before deciding how to respond.

In DBT, mindfulness means intentionally focusing your awareness on the present moment without judgment. That sounds simple, but our minds rarely stay in the present for long. We replay conversations, worry about tomorrow, criticize ourselves, imagine what other people are thinking, or become swept up in whatever emotion we are experiencing.

Mindfulness teaches us to notice these processes rather than automatically following wherever they lead.

This is also why mindfulness in DBT isn’t simply a relaxation technique. Relaxation can certainly happen while practicing mindfulness, but it isn’t the primary goal. You can be mindful while anxious, angry, sad, excited, or physically uncomfortable. The goal is to develop greater control over where you place your attention and how you respond to your internal experiences.

Put another way, mindfulness helps you control your mind rather than allowing your thoughts, emotions, and impulses to control you.

The Three States of Mind

DBT describes three different states of mind: Emotion Mind, Reasonable Mind, and Wise Mind. We move among these states throughout the day.

In Emotion Mind, feelings are in charge. When we’re frightened, everything may seem dangerous. When we’re angry, we may feel absolutely certain that someone deserves an angry response. When we’re deeply discouraged, our problems can seem permanent and hopeless. Emotion Mind isn’t inherently bad—emotions contain important information—but intense emotions can make it difficult to see the whole picture.

Reasonable Mind operates primarily through logic, facts, planning, and analysis. This state is extremely useful when balancing a budget, following instructions, or solving a practical problem. But Reasonable Mind can also become problematic when we dismiss legitimate feelings because they seem inconvenient or irrational. Human beings aren’t machines, and sometimes feelings tell us something that a spreadsheet can’t.

Wise Mind is the integration of the two. It takes both facts and feelings seriously.

Wise Mind doesn’t mean splitting the difference between emotion and logic. Instead, it means considering everything we know—including our emotional experience, intuition, values, and objective facts—and responding thoughtfully.

Imagine receiving a frustrating email from someone you care about. Emotion Mind might say, Send an angry response right now. Reasonable Mind might say, This shouldn’t bother me, so I’ll ignore how I feel. Wise Mind might say, I’m genuinely upset, and responding while I’m this angry probably won’t help. I’ll wait until tonight and decide what I want to say.

The “What” Skills

DBT divides its basic mindfulness practices into “What” skills and “How” skills. The What skills describe what we actually do when practicing mindfulness:

Observe: Notice thoughts, emotions, physical sensations, and events without immediately trying to change them.
Describe: Put words to what you observe. “I’m noticing tension in my shoulders.” “I’m having the thought that she’ll reject me.” “I’m feeling angry.”
Participate: Become fully engaged in what you’re doing instead of standing outside the experience analyzing yourself.

These skills can be practiced almost anywhere. While walking, you might notice the sensation of your feet contacting the ground, the temperature of the air, and the sounds around you. During a difficult conversation, you might notice your heart beating faster and recognize the urge to interrupt.

That tiny moment of awareness can create space between an emotion and an action.

The “How” Skills

The How skills describe the attitude we bring to mindfulness: nonjudgmentally, one-mindfully, and effectively.

Being nonjudgmental means noticing what is happening without immediately labeling it good, bad, stupid, unfair, or unacceptable. This doesn’t mean abandoning your values or pretending harmful behavior is okay. It means separating observable facts from the judgments we add to them.

Instead of “I’m an idiot for forgetting that appointment,” we might say, “I forgot the appointment, and I’m embarrassed about it.” The second statement gives us useful information without turning one mistake into a verdict about who we are.

Being one-mindful means doing one thing at a time and bringing our attention back when it wanders. If you’re talking with someone, talk with them. If you’re eating dinner, eat dinner. If you’re worrying about something while trying to work, notice the worry and gently return your attention to the task.

Finally, being effective means focusing on what actually works. We sometimes become so concerned with proving that we’re right, showing that something is unfair, or wishing reality were different that we lose sight of our goals. Effectiveness asks, Given the situation as it actually exists, what response is most likely to help me get where I want to go?

Mindfulness Is a Practice

Nobody remains in Wise Mind all the time. Nobody maintains perfect attention. A wandering mind doesn’t mean you’ve failed at mindfulness.

In fact, noticing that your attention has wandered is mindfulness.

The practice is noticing where your mind has gone and bringing it back—again and again. Over time, that practice can make it easier to recognize emotions without immediately acting on them, notice thoughts without automatically believing them, and make deliberate choices instead of simply reacting.

Mindfulness doesn’t eliminate life’s difficult moments. It helps us become more present for them—and gives us a better chance of choosing what happens next.

In Part 3, we’ll explore Emotion Regulation, the DBT skills designed to help us understand our emotions, reduce emotional vulnerability, and respond to powerful feelings more effectively.

If you live in Washington State, and would like to set up an appointment with Susan Reimers, LICSW at Transcendent Mental Health, please click here.

Part 1 of a Five-Part Series on DBT Skills

Dialectical Behavior Therapy, usually called DBT, is a form of therapy designed to help people manage difficult emotions, navigate relationships, cope with painful situations, and build lives that feel more meaningful and manageable.

Psychologist Marsha Linehan originally developed DBT to treat people experiencing chronic suicidal thoughts and borderline personality disorder. Over time, however, DBT and DBT-informed approaches have been used much more broadly. Its skills can be helpful for people struggling with anxiety, depression, trauma-related difficulties, impulsive behavior, relationship problems, anger, and overwhelming emotions. Many of its principles can also be useful to people who simply want better tools for dealing with the ordinary stresses of life.

At its heart, DBT asks an interesting question: How can we accept ourselves and our lives as they are while also working to change them?

What Does “Dialectical” Mean?

The word dialectical refers to the idea that two things that seem contradictory can both contain truth.

For example:

I am doing the best I can, and I need to do better.

Those statements may initially seem incompatible. If I am already doing my best, why should I need to do better? DBT asks us to consider that both can be true. Given your history, circumstances, knowledge, emotional state, and skills, you may genuinely be doing the best you can right now. At the same time, what you are doing may not be working. You may need to learn new skills, make different choices, or change your circumstances.

This balance between acceptance and change runs throughout DBT. Acceptance without change can leave us stuck. Change without acceptance can turn into constant self-criticism. DBT tries to hold both.

The Assumptions of DBT

DBT is built around several assumptions about people and behavior. Among the most important are:

People are doing the best they can.
People want to improve.
People need to do better, try harder, and become more motivated to change.
People may not have caused all of their problems, but they still have to solve them.
New behaviors have to be learned and practiced in the situations where they are needed.
People cannot fail at DBT. When treatment isn’t working, the task is to understand what isn’t working and make adjustments.

These assumptions reflect the dialectical nature of the treatment. DBT does not require us to decide whether someone is responsible or blameless, strong or weak, trying or not trying. Human behavior is usually more complicated than that.

You may not have chosen the circumstances that caused your pain. You may nevertheless be the person who has to figure out what to do about it.

What Is the Goal of DBT?

The broad goal of DBT is sometimes described as building a life worth living.

That will mean different things to different people. For one person, it might mean maintaining relationships without constantly fearing abandonment. For another, it might mean getting through intense emotions without using substances or self-destructive behaviors. Someone else might want to communicate more effectively, manage anger, tolerate uncertainty, or stop allowing anxiety to dictate everyday decisions.

DBT therefore isn’t simply about making unpleasant feelings disappear. Sometimes feelings provide useful information. Sometimes distress is an understandable response to genuinely difficult circumstances. And sometimes a painful situation cannot immediately be changed.

Instead, DBT teaches us to respond more effectively to whatever situation we are actually facing.

Four Ways to Respond to a Problem

One particularly useful DBT idea is that there are essentially four ways we can respond to a problem.

We can solve the problem—or leave the situation. If something can be changed, we can identify the problem and take practical steps to address it. Sometimes the solution is changing or leaving the situation itself.

We can feel better about the problem. A situation may remain the same while our emotional response to it changes. We can examine our interpretations, regulate emotions, practice acceptance, or find a different way of relating to what happened.

We can tolerate the problem. Some problems cannot be fixed right now. DBT teaches distress-tolerance skills for getting through painful situations without making them worse.

Or we can do nothing and stay miserable.

That last option may sound harsh, but it reflects an important point: doing nothing is still a choice. Sometimes we cannot control what happened to us, what another person does, or what life has placed in our path. We can still work on choosing our response.

The Four DBT Skill Groups

DBT organizes many of its practical tools into four major skill areas.

Mindfulness teaches us to pay attention to what is happening in the present moment without immediately judging it or reacting to it. It forms the foundation for many other DBT skills.

Emotion regulation helps us understand emotions, reduce emotional vulnerability, and respond to feelings in ways that fit the situation rather than simply acting on emotional impulses.

Distress tolerance focuses on surviving painful moments that we cannot immediately change. The goal isn’t to pretend that distress feels good. It is to get through it without turning a difficult situation into an even more difficult one.

Interpersonal effectiveness focuses on relationships: asking for what we need, saying no, setting boundaries, managing conflict, maintaining self-respect, and balancing our own needs with those of other people.

Together, these skills provide something like a toolbox. DBT isn’t about using every tool in every situation. It is about recognizing what kind of problem you’re facing and learning which tool is most likely to help.

In the next four parts of this series, we’ll look more closely at each of these skill areas, beginning with mindfulness—the foundation on which the rest of DBT is built.