Short answer: dialectical behavior therapy (DBT) teaches four skill sets (mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness) for people who feel emotions intensely. Originally developed for borderline personality disorder and self-harm, DBT-informed skills now help teens and adults with many conditions.
The four skill areas
- Mindfulness: noticing thoughts and feelings without immediately acting on them.
- Distress tolerance: getting through a crisis without making it worse, using techniques like paced breathing or intense exercise to bring arousal down.
- Emotion regulation: understanding emotions, reducing vulnerability (sleep, food, exercise) and building positive experiences.
- Interpersonal effectiveness: asking for what you need and saying no while keeping self-respect and relationships.
Who may benefit
- People with intense mood swings or anger
- Teens and adults who self-harm or have frequent crises
- People with emotional dysregulation alongside ADHD, depression or PTSD
- Families wanting better ways to handle conflict
How DBT fits with psychiatric care
A psychiatrist can treat underlying conditions such as depression, bipolar disorder or ADHD with medication, while DBT-informed therapy builds skills. At Psych Boston, our clinicians integrate DBT-informed approaches into care where helpful, and can refer to comprehensive DBT programs.
A skill to try now
When an emotion feels overwhelming, try “opposite action”: if fear says avoid, take one small step toward the situation; if anger says attack, step away and soften your voice. Practice when calm so it is available in hard moments.
The PLEASE skill
DBT’s emotion regulation module emphasizes reducing vulnerability through daily habits, summarized as PLEASE: treat physical illness, balance eating, avoid mood-altering substances, balance sleep, and get exercise. When these basics slip, emotions become harder to manage, so small improvements here pay off.
Distress tolerance in a crisis
When emotions spike to a level where you might act impulsively, distress tolerance skills help you ride the wave. Examples include intense brief exercise, paced breathing with longer exhales, holding something cool, or distracting with an absorbing activity until the peak passes. The goal is not to fix the problem immediately, but to avoid making it worse.
Interpersonal effectiveness
The DEAR MAN skill gives a structure for asking for what you need: describe the situation, express feelings, assert your request, reinforce why it matters, stay mindful, appear confident and negotiate. Practicing it in low-stakes situations builds confidence for harder conversations.
Frequently asked questions
Is DBT only for borderline personality disorder?
No. Its skills help many people who struggle with intense emotions.
Are there DBT programs for teens?
Yes, adolescent DBT often includes parents in skills groups.
Meet our clinicians on the team page or request an appointment with Psych Boston.
Related reading: Generalized Anxiety Disorder: Symptoms, Causes and Treatment · Grief or Depression? How to Tell the Difference
This article is general information, not medical advice. If you are in crisis, call or text 988 or call 911. Psych Boston is an outpatient psychiatry practice at 35 Bedford St #17, Lexington, MA781-218-9550).