Depression, Self-Growth, Wellbeing

How to Conquer Difficult Emotions with Dialectical Behavior Therapy

By Aliza Dinerstein, LMSW

Throughout life individuals encounter a kaleidoscope of experiences,
each one eliciting a specific emotional reaction ranging from joy,
love and hope, to anxiety, anger, or fear. Although one instinctively
strives to increase positive feelings and decrease negative ones, it
is important to remember that, at times, encountering painful emotions
is an inevitable part of life. Dialectical Behavior Therapy (DBT), a
composite of therapeutic interventions geared toward helping
individuals build a life worth living, focuses on the science of
‘emotion regulation,’ i.e., one’s capacity to work through difficult
emotions in an effective way. DBT provides concrete, empirically based
practices such as building awareness, mindfulness skills, and specific
behavioral change that can be utilized in day to day life, helping
individuals approach challenging emotions in constructive and
rewarding ways.

The first step is to increase emotional awareness. Oftentimes, strong
emotional reactions occur and individuals are unable to identify their
own emotions or recognize their impact on thoughts and actions.
Therefore, one of the most fundamental tools in responding effectively
to difficult feelings is learning to identify and label present
emotions as they arise, while gaining an understanding of how those
feelings work in conjunction with one’s thoughts and behaviors.
Emotional awareness is developed through monitoring five specific
elements: 1) events that trigger emotional responses, 2) one’s
thoughts and cognitive interpretations of these event, 3)
physiological reactions and bodily sensations, 4) behavioral response
(i.e., actions), and 5) most important, the outcome of one’s
emotional, cognitive and behavioral responses – also known as
“effectiveness”. Building emotional awareness is a skill that takes
time and practice to acquire through the use of daily monitoring. But
this is the foundation of DBT, as it enables us to develop emotional
mastery and regulation.

Another core concept in DBT is to grant yourself the freedom to feel.
Usually, people try to avoid painful feelings such as anger, sadness,
fear and anxiety. However, inhibiting these emotions does not make
them disappear and in fact it usually makes them worse. Thus, DBT
emphasizes the importance of “mindfulness” which involves truly
experiencing emotions instead of blocking, suppressing, or avoiding
them. In mindfulness practice, emotions are understood as waves that
naturally rise and fall. When we allow our emotions to operate
naturally, the intensity of the feelings are minimized and we can move
through strong emotional responses in a more healthy and integrative
way. A related DBT concept is that one should aim to radically accept
each emotion without judgement. Mindful awareness is a key element for
truly allowing one’s self to feel, and mindfulness practice enables
us to work through emotions with mindfulness, presence, and

A third key DBT principal is learning to take care of the body in
order to take of the mind. Our capacity to cope with challenges in
moments of adversity is impacted not only by one’s emotional health,
but also by the condition of one’s physical wellbeing. DBT’s  emotion
regulation ‘PLEASE’ skill encapsulates these very dimensions of
physiology, which include 1) treating any existing Physical iLlness,
2) maintaining balanced Eating, 3) avoiding mood Altering drugs, 4)
creating healthy Sleep habits, and 5) engaging in regular Exercise.
Although these targets may seem simplistic, research shows that the
more one decreases physical and environmental stressors, the less
prone to emotional reactivity one becomes.

Although experiencing painful emotions is unavoidable over the course
of life, it does not mean that anyone must suffer through them. These
and other principals of DBT explain that one can change maladaptive
behavioral, emotional, and cognitive responses while mindfully
experiencing life in the present and accepting reality as it is. This
understanding, coupled with the skills that DBT provides, can help us
cultivate awareness, acceptance, resilience, and growth.

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