Dialectical Behavior Therapy (DBT) emotion regulation skills help people understand emotions, reduce vulnerability to emotion mind, and choose responses that fit a situation. They are not instructions to suppress every painful feeling. In Linehan’s materials, emotions can motivate action, communicate to others, and communicate information to ourselves. (Linehan, 2015, Emotion Regulation Handout 3)
Start with Check the Facts. Consider Opposite Action when the emotion does not fit the facts or its action urge would be ineffective; use Problem Solving for a changeable factual situation; and use PLEASE to reduce body-based vulnerability over time. When both the situation and urge need intervention, skills may be combined. (Linehan, 2015, Emotion Regulation Handouts 9, 12, and 14) For the broader curriculum context, see the therapist’s guide to DBT’s four skills modules.
Emotion regulation is not crisis survival
Emotion regulation and distress tolerance can both matter during a difficult week, but they answer different immediate questions. Emotion regulation asks what prompted an emotion, what interpretations followed, what action urge appeared, and whether changing a response or vulnerability factor is possible. When arousal is so extreme that complicated skills are unavailable, Linehan directs clients toward crisis-survival skills instead. (Linehan, 2015, Emotion Regulation Handouts 5 and 23)
That boundary prevents a common mismatch. A person may first need a short-term skill to avoid making a crisis worse, then return to the emotion and solvable problem afterward. The DBT distress tolerance skills guide explains that crisis-survival side of the sequence.
Start with the prompting event and action urge
Linehan’s model separates an emotion episode into observable parts: a prompting event; vulnerability factors; interpretations; biological changes; expressions and actions; and aftereffects. Emotions also organize action urges—for example, fear may prompt avoidance, anger may prompt attack, and sadness may prompt withdrawal. Naming these links gives therapist and client something more precise to examine than “I felt bad.” (Linehan, 2015, Emotion Regulation Handouts 3 and 5–6)
A brief review might ask: What happened that could be observed? What did you assume it meant? What emotion arose, at what intensity? What did your body do? What did you feel pulled to do? The goal is not to rule the emotion right or wrong. It is to identify where a skill could fit.
When the clinical task is to reconstruct a target behavior rather than examine one emotion episode, the DBT behavior chain analysis guide follows the prompting event through thoughts, emotions, sensations, urges, actions, the target, and its consequences before mapping solutions to specific links.
Check the Facts
Check the Facts distinguishes observations from judgments, absolutes, and assumptions. The handout asks clients to identify the emotion and prompting event, describe what their senses observed, test interpretations, examine assumed threats, imagine coping with a feared outcome, and ask whether the emotion—and its intensity—fits the actual facts. (Linehan, 2015, Emotion Regulation Handouts 8–8a)
Checking does not mean talking someone out of a valid emotion. It may confirm that fear fits a real threat or that anger fits a blocked goal. It may also show that the available evidence supports several interpretations rather than the first one emotion mind supplied. That result guides the next choice.
Opposite Action
Opposite Action means acting opposite to an emotion’s action urge. Linehan specifies it when the emotion does not fit the facts or acting on the emotion would not be effective. The practice includes identifying the urge, choosing its opposite, acting opposite “all the way,” and repeating the action—not merely masking an expression while continuing the original behavior. (Linehan, 2015, Emotion Regulation Handouts 9–11)
Because fit and effectiveness matter, Opposite Action is not a universal recommendation to approach danger, disclose private information, or be kind in an unsafe interaction. A therapist can help define a specific, safe opposite behavior and assess whether another skill is more appropriate.
Fictional, non-diagnostic example: Jordan sees two coworkers whisper after a meeting and feels shame with an urge to avoid tomorrow’s team call. Checking the facts reveals no evidence that the conversation concerned Jordan. Jordan and the therapist plan one modest opposite action: join the call and contribute one prepared update. Afterward, they review what happened rather than treating attendance as proof that the emotion “should” disappear.
Problem Solving
Problem Solving addresses a factual situation that can be changed. Linehan’s sequence is to describe the problem, check the facts, identify the goal, brainstorm multiple solutions, compare likely consequences, choose one, act, and evaluate the result. Separately, when an emotion fits the facts but acting on its urge would be ineffective, the decision chart points toward not acting on that urge and considering Opposite Action. Both skills may be used when the situation needs solving and the ineffective urge also needs intervention. (Linehan, 2015, Emotion Regulation Handouts 9 and 12)
Fictional, non-diagnostic example: Lee feels anxious after learning that a required form is due tomorrow. The deadline is real and the form is available. Rather than using Opposite Action as a generic instruction, Lee breaks the solvable task into finding one document, completing the form, and contacting the office about one unclear field.
PLEASE reduces vulnerability
PLEASE is the body-care portion of the broader ABC PLEASE set. In the second-edition handout, it stands for treating PhysicaL illness, balancing Eating, avoiding mood-Altering substances, balancing Sleep, and getting Exercise. The wording matters: PLEASE is not “pleasure,” and it does not replace medical advice. (Linehan, 2015, Emotion Regulation Handouts 14 and 20)
PLEASE targets vulnerability rather than deciding what one specific emotion means. A therapist might use it to notice whether illness, irregular eating, substance use, disrupted sleep, or activity patterns repeatedly precede harder-to-regulate moments. Goals should account for health conditions, prescriptions, disability, access, culture, and resources.
Track the attempt, not just the acronym
A useful diary-card record connects context, choice, and result:
- emotion name and intensity;
- prompting event and key interpretation;
- vulnerability factors, including relevant PLEASE items;
- action urge;
- skill selected and what the person actually did;
- immediate result, later result, and anything that got in the way.
This record does not establish that a skill caused a change. It gives client and therapist concrete material for checking whether the skill matched the situation, whether it was practiced as intended, and what to adjust.
Skill selection remains collaborative and specific to the person and moment.
Further reading:
- Linehan, M. M. (2025). DBT Skills Training Manual: Revised Edition. Guilford Press. ISBN 978-1-4625-5635-9.
- Linehan, M. M. (2015). DBT Skills Training Handouts and Worksheets, Second Edition. Guilford Press.