DBT skills: emotion regulation

Emotion regulation doesn’t mean never feeling angry or sad. It means having a little more choice about how long feelings last, how intense they get and what you do with them.

Emotion regulation is one of DBT’s two change-focused skill areas, alongside interpersonal effectiveness. Mindfulness and distress tolerance focus on acceptance.

• ABC: accumulate positives, build mastery, cope ahead
• Checking the facts
• Naming emotions
• Opposite action
• PLEASE: caring for your body
• Problem solving

In a 2015 trial with 99 women, DBT versions that included skills training led to bigger improvements in depression and self-harm than a version without skills training.

Fear helps keep you safe from real threats. It can also fire when there’s no real danger, like before a job interview, pushing you to avoid things that matter.

Anger gives energy to stand up for yourself. Its urge, to clench fists, lean in and lash out, can damage relationships when it doesn’t fit the situation.

Sadness helps us slow down and grieve. Its urge to hide away or dwell on the couch can deepen low mood when it goes on and on.

Guilt is about something you did; shame is about who you think you are. Both can be useful when you have truly hurt someone, and painful when they don’t fit the facts. See Self-compassion & your inner critic.

Positive emotions pull us toward people and activities that nourish us. DBT encourages you to build more of them on purpose.

• Anger: annoyed, frustrated, furious, resentful
• Fear: nervous, worried, panicky, uneasy
• Joy: content, excited, proud, relieved
• Love: caring, close, tender, warm
• Sadness: disappointed, hopeless, lonely, hurt
• Shame: embarrassed, humiliated, exposed

Anger sometimes sits on top of hurt or fear. Numbness can cover sadness. If the first name doesn’t quite fit, ask, “What’s underneath this?”

• Emotion: hurt and panic, 8/10
• Facts: I sent a message 24 hours ago. No reply yet.
• Interpretation: “She’s angry with me. She’s done with me.”
• Other explanations: busy at work, phone died, she forgot
• Fit check: some worry fits; 8/10 panic is bigger than the facts
• After checking: worry, 4/10. Plan: send a light check-in tomorrow

If you really were treated unfairly or lost something important, your emotion fits. Then the next step is problem solving or acceptance, not talking yourself out of the feeling.

Instead of clenching your fists, leaning forward and setting your jaw, loosen your hands, lean back and soften your face.

• Speak more softly than you feel like
• Think of something you understand about the other person
• Step away politely instead of attacking

When sadness tells you to hide or ruminate on the couch, do the opposite: get active, do a hobby or join a social event.

If fear tells you to avoid something that is actually safe and important, like a class or a phone call, take a small step toward it. Repeat until it gets easier.

If shame tells you to hide over something that isn’t truly wrong, do the opposite: make eye contact, keep your head up and stay in the room.

Build positive experiences into your days, and take time to enjoy them. Research describes this skill as reducing vulnerability to negative emotions.

Short term and long term

• Short term: one small pleasant thing every day, like music, a walk or a call
• Long term: steps toward a life that matches your values, like study, friendships or faith

Do something each day that helps you feel competent and confident. Aim for “a little hard, but doable”.

• Learn three words of a new language
• Fix something small
• Practise an instrument for ten minutes
• Try a new recipe

Make a skilful plan for a situation you know will be hard, like a family event or a tough meeting.

1. Describe the situation and the emotion it may bring
2. Choose the skills you’ll use
3. Imagine yourself in the situation, as vividly as you can
4. Rehearse coping well, step by step
5. Finish with a calming breath

PLEASE starts with looking after your physical health. Keep up with check-ups, and talk with your clinical provider about any health problems.

PLEASE includes balanced eating: not too much and not too little. If food is a struggle for you, see the Eating disorders guides.

PLEASE includes avoiding mood-altering substances, like alcohol and drugs. If cutting back is hard, see the Substance use guides.

Aim for balanced sleep: not too little, not too much, at fairly regular times. See Sleep & mental health for practical tips.

Regular exercise is part of PLEASE. It doesn’t need to be intense: walking, dancing or stretching all count.

• “That sounds really frustrating.”
• “Given what happened, it makes sense you feel hurt.”
• “Do you want to vent, or think through what to do?”
• “Would it help to check the facts together?”

• “You shouldn’t feel that way.”
• “It’s not a big deal.”
• “Just think positive.”
• “Here’s what you should do” before they feel heard

Saying “I’m going to take a walk and come back when I’m calmer” shows a skill in action. In DBT for teens, parents and caregivers join skills groups so the whole family learns together.

If you’re in emotional distress or thinking about suicide, call or text 988 or chat online. It is free, confidential and open 24/7. If a life is in danger, call 911.

The DBT-Linehan Board of Certification has a free search for certified clinicians and programs, including outside the U.S.

Find A Helpline lists free, confidential helplines in 175+ countries.