Struggling with Anxiety? Discover These DBT Skills That Really Work!

If you’ve been battling anxiety, you’ve likely tried a variety of approaches to calm your mind. But when the usual methods—like distracting yourself or relying on sheer willpower—fall short, you might feel stuck in a never-ending cycle of worry. This is where Dialectical Behavior Therapy (DBT) steps in as a game-changer. DBT isn’t just another therapy; it’s a structured, research-backed framework that provides practical tools to handle emotions and stress more effectively.

What is DBT?

Dialectical Behavior Therapy was originally developed in the 1980s by Dr. Marsha Linehan to treat borderline personality disorder (BPD), but its application has since broadened. Today, DBT is widely used to help people with various challenges, including anxiety, depression, and emotion regulation difficulties. At its core, DBT is a skills-based therapy that combines cognitive-behavioral strategies with mindfulness techniques, empowering individuals to navigate life’s challenges with greater resilience and calm.

DBT is built around four key modules:

1. Mindfulness: Learning to stay present in the moment without judgment.
   
   
2. Distress Tolerance: Managing crises and intense emotions without resorting to harmful coping mechanisms.
   
   
3. Emotion Regulation: Understanding, naming, and effectively managing emotions.
   
   
4. Interpersonal Effectiveness: Navigating relationships with assertiveness and empathy.

These modules are designed to address different aspects of emotional well-being, making DBT especially effective for anxiety. It gives you the tools to not only cope with overwhelming feelings but also to develop a more balanced approach to life.

Why Does DBT Work for Anxiety?

Anxiety often thrives on extremes: overthinking, avoiding situations, or reacting impulsively. DBT helps create balance—teaching you how to pause, assess, and choose the best course of action. Its mindfulness techniques allow you to recognize and interrupt anxious thought patterns, while distress tolerance skills prepare you to ride out anxiety without letting it spiral. In short, DBT gives you practical, step-by-step methods to break free from anxiety’s grip.

Meet Emma

Emma, a 29-year-old teacher, is a perfect example of how DBT can make a difference. Her anxiety began as a mild annoyance but grew into a constant presence in her life. She dreaded work meetings, avoided social gatherings, and lay awake at night replaying conversations or worrying about the next day. Her anxiety made her feel like she was losing control.

After seeking help from a therapist trained in DBT, Emma discovered that her anxious thoughts and behaviors weren’t unchangeable. Through DBT, she learned actionable skills that helped her regain control of her life. From managing spiraling thoughts during work meetings to facing her fear of social events, Emma found the relief she had been searching for.

With Emma’s story in mind, let’s dive into the specific DBT skills she—and you—can use to tackle anxiety head-on. These skills are practical, evidence-based, and can be applied to real-life situations, no matter how overwhelming they seem.

Mindfulness Skills for Anxiety

Anxiety has a sneaky way of pulling us out of the present moment. Instead of enjoying what’s in front of us, we get stuck in endless loops of “What if?” thoughts or obsessing over what went wrong. Mindfulness, the cornerstone of Dialectical Behavior Therapy (DBT), offers a lifeline. It teaches us to step out of this mental chaos, stay grounded, and engage with the here and now.

What is Mindfulness?

Mindfulness is the practice of intentionally focusing on the present moment while letting go of judgment. It’s about observing your thoughts, feelings, and surroundings as they are—without getting swept away by them. Instead of battling your anxiety or trying to avoid it, mindfulness allows you to acknowledge it and respond thoughtfully.

In DBT, mindfulness is broken down into three essential skills:

1. Observe: Notice what’s happening around you or within you without trying to change it.
   
   
2. Describe: Put words to your experience, like labeling emotions or sensations.
   
   
3. Participate: Fully engage in the current moment, whether it’s having a conversation, cooking, or simply breathing.

How Mindfulness Helps with Anxiety

Anxiety thrives on overthinking and avoidance. Mindfulness disrupts this cycle by grounding you in the present. Instead of worrying about the future or ruminating on the past, you redirect your focus to what’s happening right now. This reduces the power of anxious thoughts and helps you respond with greater clarity.

For instance, if you’re feeling panicked about an upcoming presentation, mindfulness might look like observing your rapid heartbeat, describing it as “My body’s preparing me to perform,” and grounding yourself by focusing on your breath. These small shifts in perspective can have a big impact.

Emma’s Story: Applying Mindfulness Skills

Emma, our case study from earlier, found mindfulness life-changing. She used to feel paralyzed during work meetings, consumed by thoughts like, What if I say something wrong? Everyone will judge me. Her therapist introduced her to a mindfulness exercise called Wise Mind Breathing.

Here’s how Emma practiced mindfulness:

• Observe: She started by noticing the physical signs of her anxiety—tight chest, racing thoughts, sweaty palms.
  
  
• Describe: Emma labeled these sensations: “I feel nervous. My heart is racing. My hands are sweaty.”
  
  
• Participate: She then focused her attention on her breath, inhaling deeply and exhaling slowly. When her mind wandered, she gently brought her attention back to her breath.
  
  

Over time, Emma found that mindfulness gave her a sense of control. While her anxiety didn’t disappear overnight, she learned to face stressful situations with a calmer, more grounded mindset.

Simple Mindfulness Exercises to Try

If mindfulness sounds intimidating, don’t worry—it’s easier than you think! Here are a few quick exercises to help you stay present:

1. Five Senses Exercise: Pause and name:
   
   • 5 things you can see,
   • 4 things you can touch,
   • 3 things you can hear,
   • 2 things you can smell,
   • 1 thing you can taste. This practice quickly grounds you when anxiety feels overwhelming.
     
     
2. Wise Mind Breathing: Take slow, deep breaths, inhaling for four counts, holding for four counts, and exhaling for six counts. Imagine calm washing over you with each exhale.
   
   
3. Mindful Observation: Pick an object nearby (like a plant or a coffee cup). Spend a minute observing it closely—its color, shape, texture—without letting your mind wander.
   
   

By integrating mindfulness into your daily routine, you’ll not only build resilience against anxiety but also find moments of peace in your day. Like Emma, you’ll learn that staying present is one of the most powerful ways to quiet an anxious mind. Next, we’ll explore how distress tolerance skills can help you handle anxiety when it feels completely overwhelming.

Distress Tolerance Skills

Sometimes, anxiety can feel like a tidal wave crashing over you—heart pounding, mind racing, and the urge to do anything to escape the discomfort. In moments like these, it’s easy to react in ways that make things worse, like avoiding responsibilities, lashing out, or shutting down entirely. This is where DBT’s distress tolerance skills come to the rescue, helping you weather emotional storms without letting them take over.

What Are Distress Tolerance Skills?

Distress tolerance is about surviving intense emotions without making impulsive or harmful decisions. These skills focus on grounding yourself, riding out emotional waves, and managing crises in a way that preserves your long-term well-being. They’re not about fixing the situation immediately but about getting through tough moments in a healthy, constructive way.

Core Distress Tolerance Skills

Here are some of the most effective distress tolerance techniques from DBT:

1. TIPP (Temperature, Intense Exercise, Paced Breathing, Paired Muscle Relaxation):
   
   • Temperature: Use cold water or an ice pack on your face to activate the body’s relaxation response.
     
     
   • Intense Exercise: Engage in brief, vigorous activity (like jumping jacks) to burn off excess anxiety energy.
     
     
   • Paced Breathing: Slow your breathing with deep inhales and extended exhales to calm your nervous system.
     
     
   • Paired Muscle Relaxation: Tense and release muscle groups to release physical tension.

2. Radical Acceptance:
   
   • This involves acknowledging a situation for what it is, even if you don’t like it. Fighting reality often worsens emotional pain. Instead, you can say, “It is what it is, and I can handle it”.
     
     

3. 5 Senses Grounding:
   
   • Engage your senses to bring yourself back to the present moment. Notice what you can see, hear, touch, smell, and taste. This interrupts anxious spirals by redirecting your focus.

Emma’s Story: Using Distress Tolerance Skills

For Emma, social gatherings were a major source of anxiety. She often felt overwhelmed before events, imagining all the ways things could go wrong. Her therapist introduced her to the TIPP skill, and it became her go-to strategy for managing pre-event anxiety.

Here’s how Emma used TIPP:

• Temperature: Before heading out, she held an ice pack on her cheeks for 30 seconds, which helped lower her heart rate and calm her body.
  
  
• Paced Breathing: While getting ready, she practiced slow breathing: inhaling for four counts and exhaling for six.
  
  
• Paired Muscle Relaxation: She tensed and released her shoulders, fists, and jaw, which helped ease the physical tension caused by her anxiety.

Using these skills, Emma found herself better equipped to face social situations. While she still felt nervous, the intense physical symptoms of anxiety no longer controlled her decisions.

Practical Distress Tolerance Exercises

Here are a few quick exercises you can try when anxiety feels unbearable:

1. Ice Cube Hold: Hold an ice cube in your hand and focus on the cold sensation. This shifts your attention from racing thoughts to the present moment and helps you regain control.
   
2. “STOP” Skill:
   
   • S: Stop what you’re doing.
   • T: Take a step back to pause and prevent impulsive reactions.
   • O: Observe what’s happening inside and around you.
   • P: Proceed mindfully, choosing a response that aligns with your goals.
     
     
3. Radical Acceptance Statement: Repeat to yourself, “I don’t have to like this, but I can handle it.” This simple shift can reduce the fight-or-flight response.
   

By practicing distress tolerance skills, you can learn to handle anxiety in a way that feels manageable and productive. Like Emma, these tools can help you face life’s challenges without feeling paralyzed by fear or discomfort. Next, we’ll explore emotion regulation skills—another powerful tool for navigating anxiety with confidence.

Emotion Regulation Skills

Anxiety often feels like an emotional rollercoaster—you’re up one moment, down the next, with no control over when or where the ride ends. DBT’s emotion regulation skills are like your seatbelt on this ride, giving you the tools to better understand, manage, and even change your emotional experience. Instead of feeling powerless, you can take charge of your emotions in a way that reduces anxiety’s grip on your life.

What is Emotion Regulation?

Emotion regulation is the ability to recognize and name your emotions, understand their triggers, and respond to them in healthy ways. Instead of letting your emotions control your actions, you learn to steer them in a direction that aligns with your goals and values.

For anxiety, emotion regulation can help you:

• Reduce Emotional Vulnerability: Build resilience so anxiety isn’t as overwhelming.
  
  
• Respond Effectively: Choose behaviors that align with your long-term well-being, rather than acting impulsively.
  
  
• Challenge Emotional Intensity: Use strategies to reduce the intensity of overwhelming feelings.

Core Emotion Regulation Skills

Here are some of the most powerful DBT techniques for managing emotions:

1. Opposite Action:
   
   • When anxiety urges you to avoid a situation (like skipping a presentation), do the opposite. Show up, face the fear, and engage fully. Over time, this rewires your brain to associate the feared situation with less anxiety.
     
     
2. Check the Facts:
   
   • Anxiety often distorts reality. This skill involves questioning your anxious thoughts. Ask yourself:
     • “What’s the evidence this fear will come true?”
     • “What’s the worst-case scenario, and how likely is it?”
     • “Is there another way to view this situation?”.
       
       
3. ABC PLEASE:
   
   • This acronym focuses on self-care to prevent emotional vulnerability:
     • Accumulate positive experiences: Schedule enjoyable activities to balance out stress.
     • Build mastery: Engage in tasks that make you feel competent and capable.
     • Cope ahead: Plan for challenging situations to reduce anxiety.
     • PLEASE: Address physical vulnerabilities, like sleep, nutrition, and exercise.

Emma’s Story: Regulating Her Anxiety

Emma’s anxiety was fueled by her harsh inner critic. Before big work presentations, she would spiral into thoughts like, I’m going to mess up, and everyone will think I’m incompetent. Her therapist introduced her to the Check the Facts skill, and it became a turning point in her anxiety journey.

Here’s how Emma used it:

1. Identify the Thought: “Everyone will think I’m terrible at my job if I mess up.”
   
   
2. Examine the Evidence: Her therapist asked, “Has anyone ever told you this before? Are you often praised for your work?” Emma realized her fear wasn’t supported by facts.
   
   
3. Challenge the Thought: She reframed her belief: “It’s possible I’ll stumble, but I’m prepared, and one mistake doesn’t define my abilities.”
   
   

By checking the facts and reframing her thoughts, Emma entered presentations with less dread and more confidence. Over time, she started applying this skill in other areas of her life, like social gatherings and decision-making.

Practical Emotion Regulation Exercises

If you’re looking to gain control over anxiety, try these emotion regulation strategies:

1. Opposite Action Challenge:
   
   • Next time anxiety urges you to avoid something, try doing the opposite. If you’re scared to call someone, pick up the phone. If you’re nervous about joining a group activity, show up anyway.
     
     
2. Thought Journal for “Check the Facts”:
   
   • Write down your anxious thought. Ask yourself:
     • “What evidence supports this?”
     • “What evidence goes against it?”
     • “What’s a more balanced perspective?”
       Practicing this regularly trains your brain to challenge negative thinking patterns.
       
       
3. Daily Self-Care with ABC PLEASE:
   
   • Plan one enjoyable activity every day, like walking your dog or calling a friend.
   • Build mastery by practicing a skill you want to improve, like cooking or writing.
   • Create a plan for handling an upcoming challenge, like preparing talking points for a meeting.

By practicing emotion regulation skills, you can learn to navigate anxiety without feeling at its mercy. Like Emma, you’ll gain tools to replace self-doubt with self-compassion and fear with confidence. Next, we’ll explore interpersonal effectiveness, a set of skills that will help you strengthen relationships and reduce social anxiety.

Interpersonal Effectiveness

Anxiety often makes navigating relationships feel like a tightrope walk. You might avoid asking for what you need, fear upsetting others, or struggle to set boundaries. When social interactions trigger anxiety, you can end up feeling drained, frustrated, or even resentful. DBT’s interpersonal effectiveness skills empower you to handle relationships with confidence and clarity—strengthening your connections without sacrificing your own needs.

What is Interpersonal Effectiveness?

Interpersonal effectiveness is about balancing three important goals in relationships:

1. Getting Your Needs Met: Asking for what you need or saying no when necessary.
2. Maintaining Relationships: Strengthening bonds while handling conflict.
3. Preserving Self-Respect: Standing up for yourself while staying true to your values.
   
   

These skills are especially helpful for social anxiety, which often stems from fears of rejection, conflict, or being judged.

Core Interpersonal Effectiveness Skills

Here are some essential techniques to manage anxiety in relationships:

1. DEAR MAN:
   
   • A step-by-step framework for making requests or saying no without guilt:
     
     
     • Describe the situation clearly.
     • Express your feelings.
     • Assert your needs or wishes.
     • Reinforce why your request benefits both parties.
     • Mindfully stay focused on your goal.
     • Appear confident.
     • Negotiate if needed.
       
       
2. GIVE:
   
   • Skills for maintaining healthy relationships:
     
     
     • Gentle tone and approach.
     • Interest in the other person’s perspective.
     • Validate their feelings and experiences.
     • Easy manner (stay calm and approachable).
       
       
3. FAST:
   
   • Protecting self-respect in interactions:
     
     
     • Fairness: Be fair to yourself and others.
     • Apologies: Only apologize when necessary.
     • Stick to your values.
     • Truthfulness: Be honest and genuine.

Emma’s Story: Building Confidence in Relationships

For Emma, setting boundaries at work was a major source of anxiety. She often felt pressured to take on additional responsibilities, even when her plate was already full. Saying no made her worry she’d come across as selfish or incapable.

Her therapist introduced her to the DEAR MAN framework, and it became a game-changer. Here’s how Emma used it to decline an extra project her supervisor asked her to take on:

• Describe: “I’ve already taken on several major assignments this month.”
• Express: “I’m feeling overwhelmed and concerned about meeting deadlines if I add more.”
• Assert: “I’d like to focus on completing my current tasks before taking on anything new.”
• Reinforce: “That way, I can ensure everything I deliver is high-quality and on time.”

By practicing this skill, Emma was able to assert herself without guilt. Her supervisor respected her honesty and even appreciated her dedication to doing quality work. Over time, Emma’s confidence in setting boundaries grew, reducing her work-related anxiety.

Practical Interpersonal Effectiveness Exercises

Here are a few ways to practice these skills and reduce social anxiety in your relationships:

1. DEAR MAN Roleplay:
   
   • Think of a situation where you’ve hesitated to make a request. Write out a DEAR MAN script and rehearse it with a friend or therapist. Practicing in a safe space builds confidence for real-life situations.
     
     
2. Using GIVE in Difficult Conversations:
   
   • Next time you’re in a tense interaction, focus on staying gentle, showing genuine interest, and validating the other person’s feelings. This approach often diffuses tension and builds trust.
     
     
3. Self-Respect Check with FAST:
   
   • Before agreeing to something, ask yourself:
     • Am I being fair to myself?
     • Will this align with my values?
     • Am I saying yes just to avoid conflict?

Why Interpersonal Effectiveness Matters

Healthy relationships are one of the best buffers against anxiety, but they require effort and clarity. DBT’s interpersonal effectiveness skills can help you build trust, communicate assertively, and feel more confident in your interactions. Just like Emma, you’ll discover that strengthening your relationships doesn’t have to come at the expense of your own peace of mind.

Next, we’ll wrap things up by revisiting Emma’s journey and exploring how you can apply these DBT skills to reclaim control over your anxiety.

Real-Life Application and Success Stories

By now, you’ve learned about the powerful DBT skills of mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. These tools are practical, flexible, and designed to help you reclaim control over anxiety. But how do they come together in real life? Let’s revisit Emma’s story to see how applying these skills transformed her relationship with anxiety—and how they can work for you too.

Emma’s Journey with DBT Skills

When Emma first started therapy, anxiety dominated her life. She avoided social events, ruminated endlessly about work, and felt paralyzed by self-doubt. She was exhausted and didn’t know how to break free from the cycle. But through DBT, she discovered a toolkit of practical skills that gave her the confidence to manage her emotions and take back control.

Here’s how Emma applied these skills:

• Mindfulness: During work meetings, she used Wise Mind Breathing to stay present, preventing her thoughts from spiraling into “what ifs.”
  
  
• Distress Tolerance: Before social events, Emma relied on the TIPP skill, using cold water and paced breathing to calm her body and reduce the physical symptoms of anxiety.
  
  
• Emotion Regulation: When her inner critic told her she’d fail, Emma practiced Checking the Facts to challenge her negative thoughts and reframe them into more realistic ones.
  
  
• Interpersonal Effectiveness: At work, Emma used the DEAR MAN framework to set boundaries with her supervisor, reducing her workload and her stress.

Over time, Emma noticed that these small, consistent changes added up. She began attending social gatherings, confidently speaking up in meetings, and even carving out time for self-care without guilt. Anxiety still showed up in her life, but it no longer controlled her.

Your Turn: Applying DBT Skills to Your Life

Emma’s story shows that DBT isn’t just theory—it’s a practical way to create meaningful change. Here’s how you can start integrating these skills into your own life:

1. Start Small:
   
   • Choose one DBT skill to practice, such as mindfulness or TIPP. Start with a low-pressure situation to build confidence before using it during moments of high anxiety.
     
     
2. Create a Routine:
   
   • Make these skills part of your daily life. For example:
     • Practice mindfulness while brushing your teeth.
     • Write down a “check the facts” thought journal before bed.
     • Use paced breathing whenever you notice your anxiety creeping in.
       
       
3. Reflect on Progress:
   
   • Keep a journal of how using DBT skills impacts your anxiety. What works well? What could you adjust? Celebrate even small wins, like attending an event you might have avoided before.

A Final Word of Encouragement

Like Emma, you don’t need to let anxiety dictate your life. DBT skills offer a roadmap for navigating your emotions and handling life’s challenges with grace and resilience. It takes time, patience, and practice, but the rewards are worth it: greater self-confidence, healthier relationships, and the ability to face anxiety head-on.

Resources for Learning DBT Skills

Ready to get started? Here are some resources to help you dive deeper into DBT:

To deepen your understanding of DBT and learn how to apply these skills in your life, here are two excellent workbooks to get started:

DBT Explained by Suzette Bray: A beginner-friendly guide to DBT concepts and practical exercises. Perfect for anyone wanting a step-by-step introduction to these life-changing skills. 

DBT Workbook for Anxiety by Liz Corpstein: Tailored specifically for managing anxiety, this workbook offers hands-on exercises to help you practice DBT techniques and build emotional resilience.

Apps: Explore apps like “DBT Diary Card” to practice skills on the go.

Professional Help: Consider working with a DBT-trained therapist to guide your journey. If you’re looking for a convenient way to connect with a licensed professional from the comfort of your home, check out Online-Therapy.com. Use the code THERAPY20 to enjoy 20% off your first month.

Anxiety doesn’t have to control your story. By practicing DBT skills, you can take the first step toward living a life of greater peace, purpose, and connection. Start today—your future self will thank you.