DBT Skills: Emotion Regulation & Distress Tolerance

Learn Dialectical Behavior Therapy skills: managing intense emotions, tolerating distress, and improving relationships with practical tools.

13 min read
Reviewed October 12, 2024
Tasel Health Medical Team

Clinically Reviewed: Licensed Clinical Psychologist |Next Review: October 2025

Therapy
DBT
Skills
Emotion Regulation
Distress Tolerance

Key Takeaways

  • DBT provides practical skills for managing intense emotions and difficult situations
  • Four skill modules: Mindfulness, Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness
  • Originally developed for borderline personality disorder, now used widely for emotion dysregulation
  • Skills are learned through practice—the more you use them, the more automatic they become
  • DBT-informed therapy means using these skills without full DBT program structure

The Four DBT Skill Modules

1. Mindfulness

Being present in the moment; observing without judgment; focusing attention intentionally

2. Distress Tolerance

Getting through crisis without making it worse; skills like STOP, TIPP, distraction, self-soothing

3. Emotion Regulation

Understanding and managing emotions; reducing emotional vulnerability; opposite action

4. Interpersonal Effectiveness

Communicating needs, setting boundaries, maintaining self-respect in relationships (DEAR MAN, GIVE, FAST)

Frequently Asked Questions

What is DBT?

Dialectical Behavior Therapy is a type of cognitive-behavioral therapy that teaches skills for managing emotions, tolerating distress, and improving relationships. It was originally developed for borderline personality disorder but is now used for many conditions involving emotional intensity.

Do I need full DBT or just DBT skills?

Full DBT is a comprehensive program with individual therapy, skills group, phone coaching, and therapist consultation team. Many people benefit from 'DBT-informed therapy'—learning DBT skills in regular individual therapy without the full program structure.

What's the STOP skill?

STOP is a distress tolerance skill: Stop (freeze), Take a step back (don't react immediately), Observe (notice what's happening), Proceed mindfully (choose wise action). It creates space between impulse and action.

How do I practice emotion regulation?

DBT teaches strategies like: naming emotions accurately, understanding what triggered them, opposite action (acting opposite to emotion urge), checking the facts (are my thoughts accurate?), and self-soothing techniques. Practice these in daily life.

What's DEAR MAN?

DEAR MAN is an interpersonal effectiveness skill for making requests: Describe situation, Express feelings, Assert needs, Reinforce (explain benefits), stay Mindful, Appear confident, Negotiate. It helps you communicate clearly while maintaining relationships.

Can DBT help with anger?

Yes! DBT is excellent for anger management. Skills like distress tolerance (STOP, TIPP), emotion regulation (opposite action, check the facts), and interpersonal effectiveness (DEAR MAN) directly address anger and reactive behaviors.

Do I need DBT if I don't have borderline personality disorder?

DBT skills help anyone who struggles with emotion intensity, impulsivity, relationship conflicts, or distress tolerance. You don't need a specific diagnosis—if you feel emotions intensely or react impulsively, DBT skills can help.

How long does it take to learn DBT skills?

In full DBT programs, skills are taught over 6-12 months. In DBT-informed individual therapy, you'll learn key skills over several weeks to months. Mastery comes with practice—the more you use skills, the more natural they become.

References

  • 1. Linehan MM. (2015). "DBT Skills Training Manual." (2nd ed.) Guilford Press.
  • 2. Neacsiu AD, et al. (2010). "Dialectical behavior therapy skills use as a mediator and outcome of treatment." Behaviour Research and Therapy 48(9):832-839.

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