Collect moments of positive emotion to build resilience.

# Accumulating Positive Experiences

---

## Definition

---

**Accumulating Positive Experiences (APE)** is a DBT Emotion Regulation skill designed to help you build a life worth living by consistently adding enjoyable, meaningful activities in the short and long term.

---

## Purpose

---

Used to:

- Increase positive emotions over time.
- Reduce vulnerability to negative emotions.
- Strengthen motivation and resilience.
- Counteract hopelessness and depression.

---

## When to Use

---

Use this skill when:

- You feel your life lacks joy or purpose.
- You are stuck in patterns of avoidance or numbness.
- You want to create habits that build happiness and meaning.

---

## When *Not* to Use

---

Avoid using if:

- You are in an acute crisis—use Distress Tolerance skills first.
- You are trying to avoid processing serious emotions (e.g., grief) without acknowledgment.
- You expect instant results; this is a long-term strategy.

---

## How-To

---

**Short Term:**

1. List pleasant activities you can do today or this week.
2. Schedule them on your calendar.
3. Participate fully and mindfully.

**Long Term:**

1. Identify important life areas (relationships, hobbies, career, spirituality).
2. Set realistic goals in each area.
3. Take small steps consistently.
4. Track your progress and celebrate successes.

---

## Tips & Variations

---

- Choose activities that align with your values.
- Start small—5–10 minutes a day can help.
- Use One-Mindfully to stay present while doing pleasant activities.
- Avoid judging yourself if you don’t feel “happy enough.”
- Pair with Build Mastery for an extra sense of accomplishment.

---

## Example

---

*Liam felt disconnected and sad after a breakup.*

**Short Term:**

- Called a friend for lunch.
- Watched a favorite movie.
- Took a walk in the park.

**Long Term:**

- Joined a local hiking club.
- Resumed painting as a hobby.
- Set a goal to reconnect with family monthly.

---

## Inventor / Origin

---

Developed by **Marsha Linehan, PhD**, as part of DBT’s Emotion Regulation module.

---

## Related Skills

---

- Build Mastery
- PLEASE
- Cope Ahead
- Opposite Action

---

## Limitations

---

May not be effective if:

- You expect immediate relief.
- You are unwilling to experiment with new activities.
- You are severely depressed and unable to engage—start smaller or seek professional support.

---

## Evidence Base

---

Research shows:

- Behavioral activation and pleasant event scheduling reduce depressive symptoms.
- Consistent positive experiences strengthen neural pathways associated with well-being.

---

## Further Reading

---

- *DBT Skills Training Manual* by Marsha Linehan
- [Behavioral Activation for Depression](https://www.apa.org/pubs/journals/features/ccp-74-4-459.pdf)
- *The Happiness Advantage* by Shawn Achor

---

## References

---

- Linehan, M.M. (2015). *DBT Skills Training Manual, Second Edition*. Guilford Press.
- Lewinsohn, P.M. (1974). *A behavioral approach to depression*. In R.J. Friedman & M.M. Katz (Eds.), *The Psychology of Depression: Contemporary Theory and Research*.
- Achor, S. (2010). *The Happiness Advantage*. Crown Business.

Accumulating Positive Experiences

Do activities that make you feel competent and effective.

# Build Mastery Skill

---

## Definition

---

**Build Mastery** is a DBT Emotion Regulation skill that involves engaging in activities that create a sense of accomplishment and competence, reducing feelings of helplessness and increasing confidence over time.

---

## Purpose

---

Used to:  

- Strengthen self-efficacy by regularly doing things that matter to you.
- Decrease vulnerability to depression and anxiety.
- Create positive emotions through achievement.
- Build resilience to stress.

---

## When to Use

---

Use Build Mastery:  

- When you feel stuck, unmotivated, or ineffective.
- To counter self-critical thoughts.
- As a daily practice to increase life satisfaction.
- When recovering from setbacks or failures.

---

## When *Not* to Use

---

Avoid using if:  

- You’re in crisis and need immediate distress tolerance skills.
- You’re physically unwell and need rest first.
- You’re using mastery activities to avoid addressing pressing problems.

---

## How-To

---

1. **Identify Mastery Areas:**

   - What are meaningful skills, hobbies, or tasks you care about?
   - What activities give you a sense of competence?

2. **Choose an Activity:**

   - Pick something achievable but slightly challenging.
   - Examples: cooking a new recipe, organizing a space, practicing an instrument.

3. **Schedule It:**

   - Plan when and where you will do it.

4. **Do It Mindfully:**

   - Focus on the process, not perfection.

5. **Acknowledge Your Effort:**

   - Notice and appreciate the accomplishment, no matter how small.

6. **Gradually Increase Challenge:**

   - Over time, select harder or more complex tasks.

---

## Tips & Variations

---

- Use a **Mastery Log** to track progress.
- Start with very small steps if you feel overwhelmed.
- Combine with **Opposite Action** when you want to avoid activity.
- Celebrate your successes with supportive people.

---

## Example

---

*Jordan felt worthless and unproductive.*

- **Mastery Area:** Photography.
- **Activity:** Take 10 photos in the neighborhood.
- **Outcome:** Felt proud and energized, less self-critical.

---

## Inventor / Origin

---

Developed by **Marsha Linehan, PhD**, as part of the Emotion Regulation module in Dialectical Behavior Therapy (DBT).

---

## Related Skills

---

- Accumulating Positive Emotions
- Opposite Action
- Check the Facts
- Mindfulness Skills

---

## Limitations

---

May not be effective if:  

- Tasks are too overwhelming or unrealistic.
- You expect instant gratification.
- You’re using it to avoid essential responsibilities.

---

## Evidence Base

---

Research shows:  

- Mastery experiences improve mood and reduce depression.
- Small, daily accomplishments contribute to long-term well-being.
- Behavioral activation is an evidence-based treatment for depression.

---

## Further Reading

---

- *DBT Skills Training Manual* by Marsha Linehan
- [Behavioral Activation for Depression](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081881/)
- *The How of Happiness* by Sonja Lyubomirsky

---

## References

---

- Linehan, M.M. (2015). *DBT Skills Training Manual, Second Edition*. Guilford Press.
- Martell, C.R., Dimidjian, S., & Herman-Dunn, R. (2010). *Behavioral Activation for Depression*. Guilford Press.
- Lyubomirsky, S. (2008). *The How of Happiness*. Penguin Press.

Build Mastery

Align your emotions with the reality of the situation.

# Check the Facts Skill

---

## Definition

---

**Check the Facts** is the skill of evaluating whether your emotional reactions fit the actual situation.  
It involves comparing your interpretation of events with objective reality to help regulate intense emotions.

---

## Purpose

---

Used to:

- Reduce unnecessary emotional suffering.
- Align emotions with reality.
- Prevent impulsive or destructive behavior based on assumptions.
- Cultivate balanced thinking.

---

## When to Use

---

Use this skill when:

- Your emotions feel overwhelming or confusing.
- You’re about to act on strong urges.
- You suspect you might be jumping to conclusions.
- You want to respond more effectively.

---

## When *Not* to Use

---

Avoid using if:

- You’re in immediate danger (use crisis skills first).
- You are deliberately ignoring evidence (be willing to be honest).
- You’re using it to invalidate legitimate feelings without reflection.

---

## How-To

---

1. **Identify the Emotion:**

   - Name the emotion you feel.

2. **Describe the Situation:**

   - Stick to observable facts.

3. **Check for Interpretation:**

   - What are you telling yourself about the situation?

4. **Identify Facts:**

   - What evidence supports your thoughts?
   - What evidence does not support your thoughts?

5. **Ask:**

   - Is this emotion justified by the facts?
   - Does the intensity of the emotion fit the facts?

6. **Change or Act:**

   - If facts do not justify the emotion, consider changing thoughts or using Opposite Action.

---

## Tips & Variations

---

- Write down your interpretations vs. facts in two columns.
- Ask a trusted person for an outside perspective.
- Use mindfulness to observe interpretations without judgment.
- Revisit the situation later—facts often become clearer with time.

---

## Example

---

*Alex felt angry when a friend didn’t text back.*

- **Emotion:** Anger
- **Interpretation:** “She doesn’t care about me.”
- **Facts:** She was sick last week. She often takes time to respond.
- **Check:** No evidence she is ignoring me intentionally.
- **Action:** Decided to wait before assuming rejection.

---

## Inventor / Origin

---

Developed by **Marsha Linehan, PhD** as part of DBT emotion regulation.  
Related to principles in Cognitive Behavioral Therapy (CBT).

---

## Related Skills

---

- Opposite Action
- Observe
- Describe
- Mindfulness of Thoughts

---

## Limitations

---

May not be effective if:

- You’re unwilling to look at evidence honestly.
- You use it to dismiss all feelings rather than regulate them.
- You cannot access enough information to check your assumptions.

---

## Evidence Base

---

Research shows:

- Fact-checking interpretations can reduce anxiety and depression.
- Reappraising situations improves emotional resilience.
- Practicing this skill regularly strengthens cognitive flexibility.

---

## Further Reading

---

- *DBT Skills Training Manual* by Marsha Linehan
- *Mind Over Mood* by Greenberger & Padesky
- [DBT Skills Handouts](https://www.dbtselfhelp.com/html/check_the_facts.html)

---

## References

---

- Linehan, M.M. (2015). *DBT Skills Training Manual, Second Edition*. New York: Guilford Press.
- Greenberger, D., & Padesky, C. (2016). *Mind Over Mood*. Guilford Press.
- Beck, A.T. (1979). *Cognitive Therapy of Depression*. Guilford Press.

Check the Facts

Mentally rehearse how you will handle difficult situations.

# Cope Ahead Skill

---

## Definition

---

**Cope Ahead** is an Emotion Regulation skill in Dialectical Behavior Therapy (DBT) that involves mentally rehearsing how you will cope with a future difficult situation. It’s a form of proactive problem-solving and visualization.

---

## Purpose

---

Used to:  

- Prepare for challenging events or emotions in advance.
- Increase confidence that you can handle distress.
- Reduce anxiety and avoidance.
- Develop a clear plan for effective coping.

---

## When to Use

---

Use Cope Ahead when:  

- You know you will face a stressful situation (e.g., a confrontation, public speaking, an anniversary of a trauma).
- You anticipate powerful emotions like anger, shame, sadness, or fear.
- You want to practice responding skillfully.

---

## When *Not* to Use

---

Avoid using if:  

- You’re currently in crisis (use crisis survival skills instead).
- You feel highly dissociative and visualization increases distress.
- You are prone to excessive rumination and the rehearsal fuels anxiety without solution.

---

## How-To

---

1. **Identify the Situation:**

   - Be specific about what will happen and why it might be difficult.

2. **Describe the Emotions:**

   - What emotions are likely to come up?

3. **Plan Skillful Coping:**

   - Choose which DBT skills you will use (e.g., Wise Mind, Opposite Action, Self-Soothing).

4. **Visualize the Scenario:**

   - Close your eyes and imagine yourself in the situation.
   - Picture handling it effectively from start to finish.

5. **Rehearse Coping:**

   - In your mind, walk through each step of using your skills.
   - Imagine managing thoughts, feelings, and behaviors successfully.

6. **Plan Aftercare:**

   - Decide what you will do to support yourself afterward.

7. **Repeat:**

   - Practice visualization regularly until you feel confident.

---

## Tips & Variations

---

- Write down your plan to make it more concrete.
- Pair with deep breathing to lower anticipatory anxiety.
- If visualization feels too intense, start with imagining just part of the situation.
- Combine with **PLEASE skills** (taking care of your body) for better emotional regulation.

---

## Example

---

*Maria was worried about a job interview.*

- **Situation:** Interview with potential employer.
- **Emotions:** Anxiety, self-doubt.
- **Skills:** Deep breathing, self-validation, Wise Mind.
- **Visualization:** Imagined greeting the interviewer, answering questions calmly, and thanking them.
- **Aftercare:** Planned a relaxing walk afterward.

---

## Inventor / Origin

---

Developed by **Marsha Linehan, PhD**, as part of the Emotion Regulation module in Dialectical Behavior Therapy.

---

## Related Skills

---

- Check the Facts
- Opposite Action
- Mindfulness
- Radical Acceptance

---

## Limitations

---

May not be effective if:  

- You don’t follow up with action.
- You only focus on worst-case scenarios.
- You avoid doing the actual practice.

---

## Evidence Base

---

Research shows:  

- Imagery rehearsal helps reduce anxiety and improve performance.
- Coping ahead increases perceived self-efficacy.
- Visualization can lower the intensity of emotional reactivity.

---

## Further Reading

---

- *DBT Skills Training Manual* by Marsha Linehan
- [Visualization Techniques in CBT and DBT](https://psychcentral.com/lib/visualization-and-guided-imagery)
- *The Relaxation and Stress Reduction Workbook* by Martha Davis

---

## References

---

- Linehan, M.M. (2015). *DBT Skills Training Manual, Second Edition*. Guilford Press.
- Davis, M., Eshelman, E.R., & McKay, M. (2008). *The Relaxation and Stress Reduction Workbook*. New Harbinger Publications.
- Leahy, R.L. (2015). *Emotional Schema Therapy*. Guilford Press.

Cope Ahead

Recognize and name your feelings accurately.

# Identifying Emotions Skill

---

## Definition

---

**Identifying Emotions** is the practice of mindfully observing, labeling, and understanding your emotions in the moment.  
It helps you build emotional awareness so you can respond skillfully instead of reacting impulsively.

---

## Purpose

---

Used to:

- Increase clarity about what you feel.
- Reduce confusion, numbness, or overwhelm.
- Improve communication about your emotions.
- Make effective decisions in line with your values.
- Decrease emotional vulnerability over time.

---

## When to Use

---

Use Identifying Emotions when:

- You feel upset but don’t know exactly why.
- You have intense or mixed feelings.
- You want to regulate or validate your emotions.
- You are preparing to communicate your feelings to someone else.

---

## When *Not* to Use

---

Avoid using if:

- You feel unsafe or too activated to reflect (first regulate with TIPP or self-soothing).
- You are trying to suppress or overanalyze emotions.
- You’re judging yourself harshly for having feelings.

---

## How-To

---

1. **Pause and Notice:**

   - Stop what you’re doing.
   - Take a breath.

2. **Check Physical Sensations:**

   - Notice your body (e.g., tight chest, racing heart).

3. **Observe Thoughts:**

   - What thoughts or urges are present?

4. **Identify Emotions:**

   - Name the feeling(s) as precisely as you can.
   - Use an emotion word list if needed.

5. **Check Intensity:**

   - Rate how strong the emotion feels (0–10).

6. **Validate:**

   - Remind yourself it’s okay to feel this way.

---

## Tips & Variations

---

- Keep an **emotion journal** to track feelings over time.
- Use apps like Moodnotes or Daylio for daily mood logging.
- Pair this skill with **Describe** and **Observe**.
- Practice when calm so it’s easier during crises.

---

## Example

---

*Alex felt tense and irritable after work.*

- Paused and breathed.
- Noticed clenched fists and headache.
- Identified emotions: frustration (6/10), sadness (3/10).
- Validated: “Of course I feel this way; it was a hard day.”

---

## Inventor / Origin

---

Developed by **Marsha Linehan, PhD** as part of DBT’s Emotion Regulation module.  
Grounded in:

- Cognitive-behavioral therapy.
- Mindfulness practices.
- Emotion theory research by Paul Ekman and others.

---

## Related Skills

---

- Observe
- Describe
- Check the Facts
- Opposite Action

---

## Limitations

---

May not be effective if:

- You rush or force yourself to find a “perfect” label.
- You judge or shame yourself for emotions.
- You try to skip validation and move straight to problem-solving.

---

## Evidence Base

---

Research shows:

- Naming emotions reduces amygdala reactivity and calms the nervous system.
- Labeling feelings increases emotional clarity and distress tolerance.
- Awareness practices are linked to better emotion regulation.

---

## Further Reading

---

- *DBT Skills Training Manual* by Marsha Linehan
- *Emotions Revealed* by Paul Ekman
- [Greater Good: How to Identify Your Emotions](https://greatergood.berkeley.edu/article/item/how_to_identify_your_emotions)

---

## References

---

- Linehan, M.M. (2015). *DBT Skills Training Manual, Second Edition*. New York: Guilford Press.
- Ekman, P. (2003). *Emotions Revealed*. New York: Times Books.
- Kircanski, K., Lieberman, M.D., & Craske, M.G. (2012). Feelings into words: Contributions of language to exposure therapy. *Psychological Science*, 23(10), 1086–1091.

Identifying Emotions

Build a life aligned with your values and purpose.

# Increase Positive Emotions (Long Term)

---

## Definition

---

**Increase Positive Emotions (Long Term)** is a skill from the Emotion Regulation module of Dialectical Behavior Therapy (DBT) that focuses on building a life worth living by creating a sustained sense of fulfillment, satisfaction, and meaning over time.

---

## Purpose

---

Used to:

- Reduce vulnerability to negative emotions and depression.
- Develop habits that bring ongoing joy and satisfaction.
- Support long-term mental health and resilience.
- Foster a sense of purpose and accomplishment.

---

## When to Use

---

Use this skill when:

- You feel empty, numb, or directionless.
- You are ready to invest in long-term improvements.
- You want to create a more meaningful and satisfying life.
- You feel stuck in chronic dissatisfaction or boredom.

---

## When *Not* to Use

---

Avoid using if:

- You are in acute crisis or overwhelmed (use distress tolerance first).
- You lack basic safety or stability (e.g., housing, sobriety).
- You need immediate relief from intense distress.

---

## How-To

---

1. **Identify Values:**

   - Reflect on what matters most to you (e.g., family, learning, health).

2. **Set Long-Term Goals:**

   - Break down big dreams into clear, manageable objectives.

3. **Make a Plan:**

   - List steps to move toward your goals.

4. **Act Consistently:**

   - Schedule regular actions that align with your values.

5. **Track Progress:**

   - Notice small successes and adjust plans as needed.

6. **Reward Yourself:**

   - Reinforce positive steps with encouragement or treats.

---

## Tips & Variations

---

- Be specific—vague goals are hard to achieve.
- Celebrate progress, not perfection.
- Pair this skill with **Build Mastery** to develop competence.
- Use a journal or app to monitor goals.
- Expect setbacks—it’s normal. Problem-solve instead of quitting.

---

## Example

---

*Maria valued creativity and connection.*

- **Values:** Creativity, helping others.
- **Goal:** Volunteer to teach art.
- **Steps:**

  - Research local nonprofits.
  - Apply to volunteer.
  - Schedule first class.

- **Outcome:** Over several months, Maria felt more fulfilled and proud.

---

## Inventor / Origin

---

Developed by **Marsha Linehan, PhD**, as part of Dialectical Behavior Therapy’s Emotion Regulation skills.

---

## Related Skills

---

- Build Mastery
- Accumulating Positive Emotions (Short Term)
- Cope Ahead
- Mindfulness of Current Emotions

---

## Limitations

---

May not be effective if:

- You expect instant gratification.
- You’re not clear about your core values.
- You lack support or resources to work toward goals.

---

## Evidence Base

---

Research shows:

- Long-term goal pursuit builds well-being and reduces depression.
- Values-based action increases meaning and satisfaction.
- Regular engagement in meaningful activities strengthens resilience.

---

## Further Reading

---

- *DBT Skills Training Manual* by Marsha Linehan
- *The Happiness Trap* by Russ Harris
- [ACT Mindfully](https://www.actmindfully.com.au/)

---

## References

---

- Linehan, M.M. (2015). *DBT Skills Training Manual, Second Edition*. Guilford Press.
- Harris, R. (2008). *The Happiness Trap*. Trumpeter Books.
- Seligman, M.E.P. (2011). *Flourish: A Visionary New Understanding of Happiness and Well-Being*. Free Press.

Increase Positive Emotions (Long Term)

Engage in activities that bring immediate joy or pleasure.

# Increase Positive Emotions (Short Term)

---

## Definition

---

**Increase Positive Emotions (Short Term)** is an Emotion Regulation skill in Dialectical Behavior Therapy (DBT) that involves intentionally engaging in activities that create positive feelings in the moment. It helps counterbalance negative emotions by adding pleasant experiences to daily life.

---

## Purpose

---

Used to:

- Boost your mood in the short term.
- Build resilience against distress.
- Break patterns of avoidance and withdrawal.
- Encourage mindful enjoyment of life.

---

## When to Use

---

Use this skill when:

- You feel stuck in sadness, anger, or emptiness.
- You’ve been neglecting pleasurable activities.
- You want to increase motivation and energy.
- You need a mood lift to prevent escalation into crisis.

---

## When *Not* to Use

---

Avoid using if:

- You’re in immediate crisis requiring distress tolerance.
- You feel too overwhelmed to participate in any activity.
- Engaging in pleasurable activities could reinforce harmful behaviors (e.g., overspending, substance use).

---

## How-To

---

1. **Identify Positive Activities:**

   - Make a list of things you usually enjoy or have enjoyed in the past.

2. **Schedule and Plan:**

   - Choose at least one activity to do each day, even if it’s brief.

3. **Act Mindfully:**

   - Focus your attention fully on the experience without multitasking.

4. **Participate Fully:**

   - Engage with openness and willingness.

5. **Savor the Experience:**

   - Notice what feels pleasant and allow yourself to appreciate it.

---

## Tips & Variations

---

- Start small—5 minutes of enjoyable activity is better than none.
- Try something new if old activities feel stale.
- Combine with **One-Mindfully** for maximum impact.
- Keep a journal to track positive experiences.
- Be patient; enjoyment can take time to return if you feel numb or depressed.

---

## Example

---

*Derek noticed he was feeling empty and disconnected.*

- **Chosen Activities:**

  - Listening to favorite music.
  - Drinking tea by the window.
  - Texting a friend.

- **Mindfulness:**

  - Focused fully on the taste of the tea and warmth in his hands.

- **Outcome:**

  - Felt calmer and more connected to the present.

---

## Inventor / Origin

---

Developed by **Marsha Linehan, PhD**, as part of the Emotion Regulation module of Dialectical Behavior Therapy.

---

## Related Skills

---

- Build Positive Experiences (Long Term)
- Mindfulness
- Self-Soothing
- Opposite Action

---

## Limitations

---

May not be effective if:

- You expect immediate, intense happiness.
- You engage in activities without mindfulness.
- You rely exclusively on short-term pleasure without working on long-term goals.

---

## Evidence Base

---

Research shows:

- Regular positive activities reduce depression and anxiety symptoms.
- Mindful savoring of pleasant experiences improves emotional well-being.
- Building positive emotions can increase resilience to stress.

---

## Further Reading

---

- *The How of Happiness* by Sonja Lyubomirsky
- [DBT Skills Training Manual](https://www.guilford.com/books/DBT-Skills-Training-Manual/Marsha-M-Linehan/9781462516995)
- [Positive Psychology Center](https://ppc.sas.upenn.edu/)

---

## References

---

- Linehan, M.M. (2015). *DBT Skills Training Manual, Second Edition*. Guilford Press.
- Lyubomirsky, S. (2007). *The How of Happiness: A New Approach to Getting the Life You Want*. Penguin Press.
- Fredrickson, B.L. (2001). "The Role of Positive Emotions in Positive Psychology: The Broaden-and-Build Theory of Positive Emotions." *American Psychologist*, 56(3), 218–226.

Increase Positive Emotions (Short Term)

Act opposite to your emotion’s urge when the emotion is not justified.

# Opposite Action Skill

---

## Definition

---

**Opposite Action** is the practice of doing the exact opposite of what your emotion urges you to do when the emotion does not fit the facts or its intensity is unhelpful.  
It is a powerful emotion regulation strategy to change emotional experiences by changing behavior.

---

## Purpose

---

Used to:

- Reduce the intensity of unhelpful emotions.
- Help you act effectively rather than react impulsively.
- Break patterns of avoidance, withdrawal, or aggression.
- Build mastery and confidence in emotional situations.

---

## When to Use

---

Use Opposite Action when:

- The emotion doesn’t fit the facts.

  - Example: Feeling shame when you’ve done nothing wrong.

- The emotion fits the facts but acting on it will be harmful.

  - Example: Feeling fear about giving a presentation but needing to do it anyway.

- You want to reduce the intensity of an emotion.

---

## When *Not* to Use

---

Avoid using if:

- The emotion **does** fit the facts and acting on it is helpful.

  - Example: Fear in the presence of real danger.

- You’re in crisis and need distress tolerance first.

- You’re trying to invalidate your feelings instead of regulating them.

---

## How-To

---

1. **Identify the Emotion:**

   - Name and validate what you feel.

2. **Check the Facts:**

   - Does the emotion fit the situation?

3. **Determine the Action Urge:**

   - What does the emotion make you want to do?

4. **Choose the Opposite Action:**

   - Do the opposite behavior, fully and wholeheartedly.

5. **Repeat:**

   - Practice consistently until the emotion changes.

---

## Tips & Variations

---

- Use body posture and facial expressions to help shift the feeling.
- Combine with mindfulness: be aware of resistance and do it anyway.
- Start with small steps if opposite action feels overwhelming.

---

## Example

---

*Maria felt sadness after a breakup and wanted to isolate.*

- **Emotion:** Sadness
- **Urge:** Stay in bed, avoid people.
- **Opposite Action:** Get out of bed, call a friend, engage in activities.
- **Outcome:** Mood improved after connecting with others.

---

## Inventor / Origin

---

Developed by **Marsha Linehan, PhD** in Dialectical Behavior Therapy (DBT).  
Inspired by behavioral activation approaches in CBT.

---

## Related Skills

---

- Check the Facts
- Problem Solving
- Mindfulness of Current Emotion

---

## Limitations

---

May not be effective if:

- You only do it halfway (must be wholehearted).
- You haven’t first checked that the emotion doesn’t fit the facts.
- The action requires more support or skills to implement safely.

---

## Evidence Base

---

Research shows:

- Opposite Action can reduce depression symptoms via behavioral activation.
- It is effective in reducing avoidance and improving functioning.
- Consistent practice rewires habitual emotional responses.

---

## Further Reading

---

- *DBT Skills Training Manual* by Marsha Linehan
- [DBT Self Help - Opposite Action](https://www.dbtselfhelp.com/html/opposite_action.html)
- *Behavioral Activation for Depression* by Martell et al.

---

## References

---

- Linehan, M.M. (2015). *DBT Skills Training Manual, Second Edition*. New York: Guilford Press.
- Martell, C.R., Dimidjian, S., & Herman-Dunn, R. (2010). *Behavioral Activation for Depression*. Guilford Press.
- Beck, A.T. (1979). *Cognitive Therapy of Depression*. Guilford Press.

Opposite Action

Reduce emotional vulnerability by taking care of your body.

# PLEASE Skill

---

## Definition

---

**PLEASE** is an acronym in DBT for a set of skills focused on reducing emotional vulnerability by taking care of your body and physical health.  
It stands for:  

- **PL**: Treat Physical iLlness  
- **E**: Balanced Eating  
- **A**: Avoid mood-altering drugs  
- **S**: Balanced Sleep  
- **E**: Exercise regularly

---

## Purpose

---

Used to:  

- Build a stable foundation for emotional regulation.
- Reduce reactivity to stress.
- Prevent mood swings triggered by neglecting physical self-care.
- Increase resilience and well-being.

---

## When to Use

---

Use PLEASE skills:  

- Daily as part of routine self-care.
- When feeling emotionally sensitive or prone to dysregulation.
- If you notice patterns of neglecting your body’s needs.
- During recovery from illness or major life changes.

---

## When *Not* to Use

---

Avoid using as a replacement for:  

- Crisis survival skills when in acute distress (use distress tolerance first).
- Professional treatment if medical issues require specialized care.
- Addressing trauma without therapeutic support.

---

## How-To

---

1. **Treat Physical Illness (PL):**

   - Get medical care.
   - Follow treatment plans.
   - Take prescribed medications.

2. **Balanced Eating (E):**

   - Eat regular meals.
   - Avoid extreme dieting or bingeing.
   - Monitor caffeine and sugar intake.

3. **Avoid Mood-Altering Drugs (A):**

   - Abstain from non-prescribed substances.
   - Reduce alcohol if it impacts mood.

4. **Balanced Sleep (S):**

   - Get enough sleep (7–9 hours for most adults).
   - Keep a consistent schedule.
   - Address insomnia proactively.

5. **Exercise Regularly (E):**

   - Move your body in ways you enjoy.
   - Aim for moderate activity most days.

---

## Tips & Variations

---

- Track your PLEASE habits in a journal.
- Pair with Mindfulness skills to notice how your body feels.
- Create a small daily ritual to check in on each area.

---

## Example

---

*Sam felt irritable and exhausted.*

- **Check:** Sleep was only 3 hours/night, skipping meals.
- **Action:** Improved sleep hygiene, scheduled meals.
- **Outcome:** Less reactive and more focused within a week.

---

## Inventor / Origin

---

Developed by **Marsha Linehan, PhD** as part of the Emotion Regulation module in Dialectical Behavior Therapy (DBT).

---

## Related Skills

---

- ABC PLEASE
- Check the Facts
- Opposite Action
- Self-Soothing

---

## Limitations

---

May not be effective if:

- Underlying medical conditions are untreated.
- Practiced inconsistently.
- You lack support to change long-standing habits.

---

## Evidence Base

---

Research shows:  

- Sleep and nutrition have significant impacts on emotional regulation.
- Exercise reduces depression and anxiety.
- Substance use worsens mood dysregulation.

---

## Further Reading

---

- *DBT Skills Training Manual* by Marsha Linehan
- [Behavioral Sleep Medicine](https://www.sleepfoundation.org/)
- *Why We Sleep* by Matthew Walker

---

## References

---

- Linehan, M.M. (2015). *DBT Skills Training Manual, Second Edition*. Guilford Press.
- Walker, M. (2017). *Why We Sleep*. Scribner.
- Substance Abuse and Mental Health Services Administration. (2020). *Treatment Improvement Protocol*.

PLEASE

Identify and act on practical steps to address issues.

# Problem Solving

---

## Definition

---

**Problem Solving** is an Emotion Regulation skill in Dialectical Behavior Therapy (DBT) that provides a structured approach to identifying and addressing practical problems that trigger emotional distress.

---

## Purpose

---

Used to:

- Reduce distress by taking effective action.
- Increase a sense of control and competence.
- Break down overwhelming situations into manageable steps.
- Prevent avoidance and procrastination.

---

## When to Use

---

Use this skill when:

- You face a solvable problem or obstacle.
- Avoidance or inaction is increasing your suffering.
- You feel stuck and need a clear plan.
- You want to build confidence in handling challenges.

---

## When *Not* to Use

---

Avoid using if:

- The situation is unsolvable (e.g., grief, the past)—use Radical Acceptance instead.
- You are in immediate crisis—use Distress Tolerance first.
- You need emotional support more than action in the moment.

---

## How-To

---

1. **Describe the Problem:**

   - Be specific and objective about what’s happening.

2. **Check the Facts:**

   - Make sure you have accurate information and aren’t assuming.

3. **Identify Your Goal:**

   - Clarify what you want to accomplish.

4. **Brainstorm Solutions:**

   - List as many options as possible without judging.

5. **Evaluate Pros and Cons:**

   - Consider each solution’s feasibility and consequences.

6. **Choose a Solution:**

   - Pick the most effective or least harmful option.

7. **Make an Action Plan:**

   - Break the solution into small, specific steps.

8. **Act and Evaluate:**

   - Try the plan, then assess whether it worked.

---

## Tips & Variations

---

- If overwhelmed, ask a trusted person to help brainstorm.
- Write down your plan to clarify steps.
- Remember: No solution is perfect. Aim for *effective enough*.
- If stuck, use the DBT skill **Cope Ahead** to visualize success.
- Practice self-validation if you feel discouraged.

---

## Example

---

*Sam was behind on bills and felt paralyzed with shame.*

- **Describe:** Bills are overdue by 2 months.
- **Facts:** Utilities will be shut off if unpaid.
- **Goal:** Pay at least part of the balance.
- **Brainstorm:**

  - Ask for payment extension.
  - Use savings.
  - Borrow money.
  - Set up payment plan.

- **Pros and Cons:**

  - Extension: buys time.
  - Savings: no debt.
  - Borrow: fast, but creates obligation.

- **Choose:** Request an extension.

- **Action Plan:**

  1. Call utility company by noon tomorrow.
  2. Request payment arrangement.
  3. Schedule payment reminder.

- **Outcome:** Extension granted. Shame reduced.

---

## Inventor / Origin

---

Developed by **Marsha Linehan, PhD**, as part of the Emotion Regulation and Problem-Solving modules in DBT.

---

## Related Skills

---

- Check the Facts
- Pros and Cons
- Cope Ahead
- Radical Acceptance

---

## Limitations

---

May not be effective if:

- The problem is not under your control.
- You lack motivation or resources to follow through.
- You’re using it to avoid emotions rather than address them.

---

## Evidence Base

---

Research shows:

- Structured problem solving reduces depression and anxiety.
- Effective problem solving increases self-efficacy and well-being.
- Skills training in problem solving is a key component of DBT’s success.

---

## Further Reading

---

- *DBT Skills Training Manual* by Marsha Linehan
- *Problem-Solving Therapy* by Arthur Nezu & Christine Nezu
- [Mind Tools Problem Solving Resources](https://www.mindtools.com/)

---

## References

---

- Linehan, M.M. (2015). *DBT Skills Training Manual, Second Edition*. Guilford Press.
- Nezu, A.M., Nezu, C.M., & D’Zurilla, T.J. (2012). *Problem-Solving Therapy*. Springer.
- D’Zurilla, T.J., & Goldfried, M.R. (1971). *Problem solving and behavior modification*. Journal of Abnormal Psychology, 78(1), 107–126.

Emotion Regulation DBT Tools