Mindfulness is a powerful tool for grounding ourselves in the present moment. This is especially relevant for the current age of constant distraction and emotional overwhelm. One therapeutic approach that places mindfulness at its core is dialectical behavior therapy (DBT). DBT offers skills to cultivate awareness, reduce reactivity, and foster emotional resilience.
What Is DBT—and How Does It Differ from CBT?
DBT was developed by Marsha Linehan, PhD, and was originally designed to support individuals struggling with suicidal and self-harming behaviors, associated with emotional dysregulation. Unlike traditional therapies such as cognitive behavioral therapy (CBT), which focus heavily on changing thoughts and behaviors, DBT emphasizes a balance between acceptance and change.
Linehan discovered that solely promoting change often made patients feel invalidated, while focusing only on acceptance left them feeling stuck in their suffering, and similarly invalidated. DBT addresses this by integrating both approaches through the concept of dialectics—the idea that two seemingly opposite things can be true at once. In DBT, thinking dialectically involves recognizing and balancing opposing sides or tensions. It assumes that everything is interrelated, that tension is inevitable, and that change is constant. This balance is especially powerful for individuals and families who experience rigid, black-and-white thinking.
Pause and Practice
Dr. Andrea Gold joined Dr. Tanuja Gandhi and Dr. Gregory Fitz on the Mindcast: Healthy Mind, Healthy Child podcast to discuss the core mindfulness skills as taught and practiced in Dialectical Behavior Therapy (DBT) and its adolescent adaptation (DBT-A) with teens and their caregivers.
Understanding the three States of Mind: Emotion Mind, Reasonable Mind, & Wise Mind
A foundational skill in DBT involves the mindfulness skill of “States of Mind”. DBT teaches ways to identify three states of mind. One is emotion mind—when emotions take over and reasoning is lost. The other is reasonable mind—when logic dominates and emotions are dismissed. Many people initially want to get rid of emotions, but DBT emphasizes that emotions carry valuable wisdom when they align with reality. Problems arise when we’re stuck in emotion mind and act in ways that conflict with our values or long-term goals.
Wise mind is the third, balanced state that integrates both emotion and reason. It’s both intuitive and experience-based and integrates logic and long-term goals with our valid wants and feelings. Wise mind helps guide us to make thoughtful, values-aligned decisions. DBT teaches mindfulness skills to help us access wise mind, especially when emotions feel overwhelming or misleading. Tools like the STOP skill (stop, take a step back, observe, proceed mindfully) help create that mindful pause before reacting, giving space to act effectively rather than impulsively.
For example, if someone feels like they’re in a threat state, fight or flight, they want to avoid the source of the feeling, or they might feel like they need certainty in the moment. That's a sign to slow down.
This feeling might be anxiety. It might be avoidance. Or, it may actually be an effective thing to cancel, to postpone. By taking a moment to observe and describe our emotions we can use mindfulness to identify an effective response. For example, a person may notice having an anxious urge to avoid giving a presentation and then realize that giving a presentation is in line with their values. They can use their wise mind and say, “Let me approach instead of avoid. Let me do the prep I need to do. Let me feel my fear and do it anyway.”
How does mindfulness weave in with DBT?
Jon Kabat-Zinn defines mindfulness as “paying attention on purpose, in the present moment, nonjudgmentally.” While this definition is simple and accessible, DBT takes it a step further by breaking mindfulness down into concrete, practical skills that individuals can use anytime, anywhere, making the concept more actionable and easier to apply in daily life. DBT teaches specific skills for “what” to do when we’re practicing mindfulness (i.e., to observe, describe, and participate), as well as “how” to do it (i.e., one-mindfully, effectively, and non-judgmentally).
Instead of us being controlled by our minds or letting our emotions run the show, which takes us away from our values or how we want to live our lives, we can turn to mindfulness. We can then control our attention when we get hijacked by our emotions and subsequently make more effective choices. Mindfulness helps us to access skills and skills give us options for effective behaviors.
Tips for parents to practice mindfulness without judgment
Some tactics that might foster mindfulness include word games or introducing a sensory object. For example, try balancing a peacock feather or other light weight object on the tip of your finger. It grabs your attention and offers an opportunity to practice the skill of “one-mindfully” or doing just one thing in the moment. At the same time, it can bring up a lot of judgments, both positive ones and negative ones. Mindfulness practices give us opportunities to let go of judgments and observe and describe only what we can observe.
Practicing nonjudgmentally can be really hard, especially in the context of emotion dysregulation and how it affects the whole family. In order to mitigate that challenge, you can start with low-stakes, emotionally neutral exercises. For example, families might practice the mindfulness skill of “non-judgmentally” by simply describing each other’s shoes without adding opinions or judgments. This helps illustrate how quickly the mind jumps to judgment. It gives everyone a chance to build the skill in a safe, manageable way before applying it to more emotionally charged topics like curfews or conflict.
Being a parent is really, really hard. There's no question about it, especially when there's chaos in the world and when dealing with teens and emotion dysregulation, anxiety disorders, depression, or other mental health challenges. That said, it’s important for parents to notice when they’re feeling angry, when they’re feeling frustrated, and to replace that anger and frustration with curiosity. It's really hard to be angry when you’re curious, and it can help slow things down.
At the DBT-X Track within the Pediatric Anxiety Research Center (PARC), we teach these skills to children and families to help manage pediatric anxiety, obsessive-compulsive disorders, and other anxiety disorders that co-occur with emotional dysregulation, suicidal and self-harming behaviors. To learn more about the Pediatric Anxiety Research Center, visit us online at www.parcanxiety.org or call 401-432-1469.
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