ABC Please: How to Use This Dialectical Behavior Therapy (DBT) Skill

We all have moments when we might feel stressed out, sad, or anxious in response to everyday experiences, but when these feelings become persistent and difficult to manage, it’s a struggle often called emotional dysregulation — a brain-based symptom making one unable to control their emotional responses. Dysregulation is often present in diagnosable mental health conditions, but it can be common for anyone — in fact, it affects 4% to 6% of the population. Symptoms of emotional dysregulation can include intense emotions, impulsive behaviors, indecisiveness, trouble managing one’s behaviors, and an overall lack of positive emotional awareness, making it hard to think clearly or even get through the day. Thankfully, dysregulation can be helped. One form of therapy that can help you regain balance and keep overwhelming emotions in check is called DBT therapy, or Dialectical Behavioral Therapy. Within DBT, there’s a practice called ABC Please, a practical and pragmatic series of approaches that focus on small, intentional actions meant to increase your resilience to emotional triggers. 

What does the combination of ABC Please DBT involve, and what can you expect? Keep reading to learn more. 

What Is Dialectical Behavior Therapy (DBT) 

What is DBT therapy? Dialectical Behavioral Therapy, or DBT, is a type of psychotherapy that helps you develop tools and skills to manage intense, overwhelming emotions, manage destructive behaviors, and improve your interpersonal relationships, which can suffer when someone’s emotions are in dysregulation. 

With the help of a counselor or psychologist, working with a series of DBT worksheets, DBT is designed to impart four core skills so you can improve your life and well-being, including: 

• Mindfulness to become more aware of your emotions, free of judgment 

• Acceptance and distress tolerance to learn how to cope with difficult situations 

• Emotional regulation, to manage negative emotions and create new, positive ones 

• Interpersonal effectiveness, to better foster healthy relationships and navigate conflict 

Why is it called dialectical? According to the Cleveland Clinic, “dialectical” means to unite opposing ideas — change and acceptance. DBT involves helping you accept reality, not only including any harmful emotions that have led to damaging behaviors and experiences, but the fact that you can change your life with new, more positive thoughts and experiences.  

“The ‘dialectic’ in dialectical behavior therapy is an acknowledgment that real life is complex, and health is not a static thing but an ongoing process,” notes Psychology Today. “DBT acknowledges the need for change in a context of acceptance of situations and recognizes the constant flux of feelings — many of them contradictory — without having to get caught up in them.” 

DBT was developed in the 1970s by psychologist Marsha Linehan, who used DBT to treat her own borderline personality disorder (BPD). “Dialectics is a cornerstone of DBT, but it’s far from the only element. The therapy encompasses distress tolerance skills, mindfulness, and radical acceptance,” Lineman said in a recent interview.  

She continued, “Dialectics allows opposites to coexist. You can be weak, and you can be strong; you can be happy, and you can be sad. In the dialectical worldview, everything is in a constant state of change. There is no absolute truth and no relative truth, either: no absolute right or wrong. Truth evolves over time. Values that were held in the past might not be held in the present. Dialectics is the process of seeking the truth at the moment, drawing on a synthesis of opposites.” 

Are DBT and CBT the Same Thing? 

DBT is a type of Cognitive Behavioral Therapy (CBT), another psychotherapy with the intent of recognizing and reframing negative thought patterns and how they influence one’s behavior. 

But while DBT therapy and CBT are inextricably linked therapeutically, DBT takes this a step further by emphasizing emotional regulation and acceptance. When comparing DBT vs CBT, there are a few key differences: 

• Core approach: DBT focuses on helping you accept and manage your emotions, while CBT emphasizes reshaping unhelpful thoughts and behaviors. 

• Therapy format: DBT combines structured group skills training with individual therapy, while CBT is usually more flexible and personalized in one-on-one sessions. 

• Best fit: DBT is especially helpful for managing overwhelming emotions and impulsive behaviors, making it a strong choice if traditional CBT feels insufficient. 

What Can DBT Treat? 

 Here is what DBT is used to treat at a recovery center: 

Substance Use Disorders 

Emotional dysregulation can lead to substance use disorders since addiction often stems from a lack of self-control. DBT proves effective in helping disorders like alcoholism or drug addiction since it helps to stabilize emotions and lessen one’s urge to self-medicate or use substances to ease emotional pain. Through DBT, you can become mindful during stressful moments when you might reach for a drink or ingest a depressant. 

But most importantly, DBT, like its counterpart CBT, teaches you to go forward in recovery by building and embracing the change of newer, healthier habits and accepting a life without drugs and alcohol. 

Mental Health Disorders 

Initially developed to treat BPD, DBT for mental health can treat a variety of other common conditions: 

• Depression and anxiety: By emphasizing mindfulness and emotional regulation, DBT helps you interrupt negative thought patterns and refocus on healthier coping strategies. 

• Post-Traumatic Stress Disorder (PTSD): DBT provides grounding skills to manage distressing emotions and process trauma in a safe, controlled way. 

• Anger management: DBT equips you with tools to recognize emotional triggers, reduce the intensity of anger, and respond to situations constructively. 

Co-Occurring Disorders 

A co-occurring disorder is when someone has a substance use disorder and a mental health disorder at the same time. And since DBT can treat both types of conditions independently, it’s often utilized in therapy for people with co-occurring disorders. 

DBT is often a component in dual diagnosis treatments since the emphasis on emotional regulation and shedding negative thoughts complements the development of new, healthier DBT skills to help you navigate the emotional and physical challenges that mental illness and drug addiction carry. 

What Is ABC Please? 

Part of DBT is the ABC PLEASE skills, a valuable set of practices to help you regulate your emotions. ABC PLEASE is an acronym, with each letter representing a separate element of the skill set you can incorporate into your daily life to maintain balance and emotional stability. 

• Accumulate positive experiences 

• Build mastery 

• Cope ahead 

• physical health 

• Eat well 

• Avoid substances 

• Sleep 

• Exercise 

ABC in Dialectical Behavior Therapy 

Accumulate Positive Experiences  

To accumulate positive experiences means to fill your daily life with as many activities and moments that bring you joy and peace — by proactively seeking out and engaging in fulfilling moments, you can offset the burden of negative ones. 

You might spend time with loved ones or engage in hobbies that fuel happiness and wellness, like starting a new fitness regimen or revisiting activities you once enjoyed. By starting small and building from there, keeping “A” in mind, you can begin to reframe your worldview and find emotional balance every day. 

Build Mastery 

ABC PLEASE skills are meant to follow a natural progression. Once you’ve accumulated and amassed experiences that are emotionally elevating, getting better at and mastering them can boost your confidence and reduce feelings of helplessness whenever emotional situations would normally overwhelm before DBT. 

How can you start? Take on challenges that push you just outside your comfort zone, like cooking or learning how to play a musical instrument. Focus on building these skills to give yourself a sense of competence and accomplishment and celebrate those small victories. 

Cope Ahead  

Part of the mindfulness aspect of DBT is knowing that stressful situations that may normally create mood swings or intense emotions will still exist. But by anticipating triggers and preparing for them, you can navigate challenges with greater confidence.  

In this respect, the “C” of ABC ties back to acceptance and distress tolerance. What can you do to cope ahead of time? Visualize upcoming situations and identify potential obstacles. How would you normally react to these? Instead, develop a plan to address these challenges in advance — and through mindfulness, practice relaxation techniques or coping strategies before the event occurs. 

PLEASE, in Dialectical Behavior Therapy  

ABC PLEASE skills continue with six more promises you can make to yourself to focus on your physical health and self-care. Emotional regulation is deeply tied to your physical well-being, and neglecting your body can make managing emotions even harder. Here’s how to start: 

Physical Illness 

Your physical health is like a direct conduit to your emotional well-being — and vice versa. When you’re unwell, it’s harder to cope with stress, and if you neglect your physical health, your mental health can worsen in tandem. Feeling physically well, in turn, prepares you to manage life’s emotional ups and downs more effectively. 

Experts recommend simple, achievable actions. Take care of your physical health by following necessary prescription medications, visiting your doctor as needed and following through on medical advice.  

Eat Well 

The idiom “you are what you eat” couldn’t be truer. What and how you eat can significantly influence your mood. Eating too little/skipping meals or too much/overeating can conjure a host of negative feelings, like irritability or emotional instability.  

Being mindful of how and when you eat ensures your body has the energy it needs to support emotional resilience. 

Avoid Mood Altering Substances  

As co-occurring disorders, substance use disorders and mental health conditions go hand-in-hand far too frequently. According to the National Institute on Drug Abuse, 35% of adults with a mental health disorder also struggle with a drug or alcohol addiction. 

And because substances like alcohol or drugs can disrupt your ability to manage emotions effectively (over time, they can weaken your natural coping skills, making it harder to regulate your mood), they don’t serve you well when your goal, through DBT, is to find focus and clarity. By cutting back or eliminating altogether addictive substances, you add an “A” to your PLEASE promise. 

Sleep Well 

“Sleep and mood are closely connected; poor or inadequate sleep can cause irritability and stress, while healthy sleep can enhance well-being,” states the Harvard Medical School Division of Sleep Medicine. In fact, the school cites a study that found participants limited to just 4.5 hours of sleep a night for one week expressed feelings of stress, anger, sadness, and mental exhaustion. 

It goes without saying, then, that the quality of your sleep plays an integral role in your self-care routine. Sticking to a consistent sleep schedule helps you stay emotionally steady and prepared for the dawn of each day ahead. 

Exercise Regularly   

Regular physical activity supports both your mental and physical health, as exercise releases feel-good chemicals and endorphins in the brain that boost mood, reduce stress and lead you to keep seeking out those feelings by exercising more. 

Just like starting out with your mental health, even small, consistent efforts — like walking or stretching — can go a long way to making a big difference in how you feel.  

What To Expect During Dialectical Behavior Therapy  

DBT is structured as individual and group treatments (in fact, the latter example is where much of your skills training may happen). Individual sessions usually last about an hour and focus on reviewing recent challenges, analyzing what led to them, and strategizing how to apply DBT skills effectively.  

Group sessions, on the other hand, consist of roughly four to 10 people at a time and run for 1.5 to 2 hours. 

Treatment, one-on-one with your therapist or in a group, is highly structured and requires active participation. Between sessions, you’ll complete homework assignments, such as tracking your emotions as they arise in a diary card — much like journaling — or practicing specific skills in real-life situations. Many therapists also offer brief coaching between sessions during moments of emotional distress, offering real-time guidance to help you apply DBT techniques. 

A standard DBT program typically lasts six months to a year, but the exact duration depends on your individual needs and progress.  

What Are the Benefits of Dialectical Behavior Therapy? 

Managing Emotions 

DBT therapy carries a host of benefits, but the most pivotal is addressing emotional dysregulation. Statistics show that people suffering from major depression and BPD — two mental health conditions with extremely negative emotional facets — displayed improvements in emotional stability and resulting positive behaviors. Learning and adopting skills like ABC PLEASE provide the framework.  

Promoting Resilience 

If emotional vulnerability is one side of the DBT coin, building resilience is the other. DBT helps to fortify your emotional well-being and equip you with the tangible tools to handle life’s ups and downs with greater stability, empowering you with the fundamentals of acceptance and change. By accepting who you are as a unique human being, you learn to develop mindfulness and embrace change in each moment — emotions come and go, and you are in control of how you respond to them. 

Who Offers ABC Please and Dialectical Behavior Therapy? 

Each of Royal Life Centers’ eight locations across Arizona and Washington offers Dialectical Behavioral Therapy as part of its rehab programming, incorporating ABC PLEASE skills building into therapy. Part of our mental health and substance use disorder treatments, we take an evidence-based approach to CBT and DBT, meaning that the therapies we utilize are proven effective in helping people heal, achieve recovery and go forward living their best lives — even better than they imagined. 

If you’re facing addiction or if your mental state has begun weighing you down, the first step to seeking treatment is the bravest since you can become the change you seek. Signing up for treatment goes beyond the clinical; it means the opportunity to take advantage of holistic therapies to build your mind, body, and spirit and connect with peers in group support with the shared goal of seeking sobriety and recovery. 

If you’re ready to explore your options, or you just have more questions about what DBT involves, please reach out to us today. Change your life with one call.