The Terms

Dialectical Behavior Therapy (DBT): A science-backed Third Wave Therapy developed by Dr. Marsha Linehan, influenced by Zen Buddhism and principles of mindfulness. It helps people manage difficult emotions, improve relationships, and make more effective decisions by balancing acceptance and change. DBT is an evidence-based approach for a variety of mental health problems across diverse populations of people. 

Third Wave Therapies: A group of therapies that build on traditional cognitive-behavioral therapy (CBT) by adding mindfulness, acceptance, and emotional flexibility. These therapies, like Acceptance and Commitment Therapy (ACT) and DBT, focus on how we relate to our thoughts and feelings rather than just changing them, emphasizing living in the present and making value-driven choices to build a life we experience as worth living. 

Cognitive Behavioral Therapy (CBT): A type of structured therapy that helps you understand how your thoughts, feelings, and behaviors are connected. CBT teaches practical tools to change unhelpful thought patterns and behaviors, giving you strategies to improve your mental health in everyday life.

Emotion Mind: The state of mind where emotions take over and drive your thoughts, decisions, and actions. When you're in Emotion Mind, it’s easy to act impulsively or react based on how you feel in the moment, often without thinking through the consequences.

Reasonable Mind: The opposite of Emotion Mind. This is the state of mind where you suppress your emotions and think logically and rationally, focusing on facts and reason. While useful for problem-solving, Reasonable Mind neglects emotional needs and feelings.

Wise Mind: A balance between Emotion Mind and Reasonable Mind. Wise Mind honors both your emotions and the facts of the situation, helping you make decisions that feel right and are in line with your values. It’s that deep inner knowing or intuition where you can step back, pause, and find a clear path forward.

Observer Mind: Observer Mind is an extension of the Wise Mind model developed by guts., akin to Acceptance and Commitment Therapy’s (ACT’s) Self-as-Context. Being in the Observer Mind means being aware of your state of mind, without judgment or attachment. Instead of being caught up in Emotion Mind or Reasonable Mind, Observer Mind helps you take a step back to transition to Wise Mind (e.g., “I know I’m really angry and can’t be effective right now, but I’m not sure what Wise Mind is”).

Acceptance and Commitment Therapy (ACT): A research-supported Third Wave Therapy that helps you accept difficult thoughts and feelings instead of fighting them, while also committing to actions that align with your values. ACT teaches you to be more mindful of your experiences, detach from unhelpful thoughts, and focus on living a meaningful, value-driven life, even when things feel tough.

Mindfulness: Mindfulness is the practice of paying attention to the present moment, on purpose and without judgment. It involves bringing awareness to your own thoughts, your own emotions, your own urges, or your surroundings through your five senses. Mindfulness helps you respond thoughtfully instead of reacting impulsively, and has numerous physical and mental health benefits. Mindfulness doesn’t mean emptying your mind, but simply noticing reality as it is.

Mindfulness WHAT Skills: Mindfulness WHAT Skills are a DBT concept that describe the specific actions you can take to practice mindfulness:

• Observe: Notice what’s happening around you or inside you (thoughts, emotions, sensations) without labeling it or trying to change it.

• Describe: Put words to what you observe, sticking to the facts without adding judgments or interpretations.

• Participate: Fully engage in what you’re doing in the moment, throwing yourself into the experience.

Mindfulness HOW Skills: Mindfulness HOW Skills are a DBT concept that describe the ways you practice mindfulness, guiding how you observe, describe, and participate:

One-Mindfully: Focus on one thing at a time. Give your full attention to whatever you're doing without distraction.

• Non-Judgmentally: Notice and experience without labeling things as “good” or “bad.” Let go of judgments, and see things as they are.

• Effectively: Do what works in the moment, based on your goals and values, even if it’s not what feels “right” or ideal.

Overthinking: Process of continuously thinking about the same thoughts, which can lead to a cycle of persistent and repetitive thinking without productive problem solving.It’s when you get stuck analyzing or worrying about something over and over again, taking you out of the present moment.

Rumination: Rumination is when a person gets stuck thinking over and over about the difference between how things are and how they wish things were, which keeps them feeling stuck and makes it harder to handle their emotions. Often used synonymously with ‘overthinking.’

Cognitive Fusion: Cognitive fusion is an ACT concept. It happens when you get so caught up in your thoughts that you treat them literally or as absolute facts, even when they might not be true. It’s like wearing a pair of glasses that changes how you see the world, where your thoughts dominate your behavior and emotions.

Cognitive Defusion: Cognitive defusion is an ACT concept. It is the process of stepping back from your thoughts and seeing them as just thoughts—not facts or truths. It helps you create distance between yourself and your mind, so you can act based on your values instead of getting stuck in unhelpful thinking patterns.

Thought Visualization: Thought visualization is a cognitive defusion technique where you imagine your thoughts as objects you can observe from a distance. For example, you might picture your thoughts as leaves floating down a stream or clouds passing by in the sky. This exercise helps you see your thoughts as temporary and less overwhelming.

Thought Repetition: Thought repetition is a cognitive defusion technique where you repeat a troubling thought over and over until it loses its emotional charge. By repeating it out loud or in your mind, it starts to feel like just a series of words rather than something that controls your feelings or actions. You can even say it in a funny voice or sing it to reduce its power.

Model of Emotions: The Model of Emotions is a concept developed by Dr. Marsha Linehan that explains the complex process of how emotions are prompted and unfold. It breaks down the steps that happen when you have an emotional response, from the initial event that prompts your feeling to the thoughts and reactions that follow. Understanding this model helps you communicate and manage your emotions more effectively.

Prompting Event: A prompting event is something that happens either inside or outside of you that sets off an emotional response. It could be a situation, like someone cutting you off in traffic, or something internal, like a memory or thought that pops up unexpectedly.

Vulnerability Factors: Vulnerability factors are things that make you more likely to have a strong emotional reaction. These could be things like being tired, hungry, stressed, or sick, which can lower your ability to handle situations effectively. 

Physiological Arousal: Physiological arousal refers to the physical changes that happen in your body when you experience an emotion. These might include things like a racing heart, sweating, or feeling tense. These physical sensations are part of why we often call emotions "feelings.” 

Primary Emotion: A primary emotion is the first, automatic emotion that arises in response to a prompting event. It's the direct reaction to the situation, like feeling fear when someone cuts you off in traffic. Primary emotions usually pass quickly unless they are intensified or re-prompted by other factors.

Secondary Emotion: A secondary emotion is an emotional response to your initial feeling, like feeling angry after first feeling fear. Secondary emotions can keep you stuck in an emotional loop if they take over, and they can sometimes be more intense than the primary emotion.

Sympathetic Nervous System: The sympathetic nervous system is the part of your autonomic nervous system that activates your body's "fight, flight, or freeze" response during moments of stress, threat, or intense emotions. When activated, it increases your heart rate, quickens breathing, and releases stress hormones like adrenaline, preparing your body to respond quickly to perceived danger. While necessary for survival, prolonged or frequent activation of the sympathetic nervous system can contribute to anxiety, exhaustion, and chronic stress. Parasympathetic Nervous System: Part of your autonomic nervous system that helps you rest, relax, and restore. When activated through skills like the DEEP skills, the parasympathetic nervous system calms the body, slows heart rate, decreases anxiety, and helps you regain emotional balance during a crisis.

Distress Tolerance: Distress tolerance refers to your ability to manage and endure emotional pain or stress without making the situation worse. Instead of reacting impulsively or destructively, distress tolerance skills help you respond thoughtfully, calm your nervous system, and gain control over intense emotions.

Crisis Survival Skills: Crisis survival skills are short-term strategies within Dialectical Behavior Therapy designed to help you get through a crisis without engaging in behaviors that may make the situation worse. They are not meant to solve the problem, but rather to help you manage distress safely and effectively until you can use problem-solving skills.

DEEP Skills: DEEP Skills are a set of distress tolerance techniques adapted by guts. from the DBT TIPP skills, designed to quickly and effectively help you manage intense emotional pain by directly changing your body’s physiology. "DEEP" stands for:

• Dive: Activates your body’s Mammalian Dive Reflex, rapidly calming the nervous system and reducing intense emotions by immersing your face in cold water or using a cold, wet compress.

• Exhale (Paced Breathing): A distress tolerance technique where you intentionally slow and deepen your breaths, focusing especially on lengthening your exhale. This slow diaphragmatic breathing activates your parasympathetic nervous system, calming your mind and body during high emotional distress.

• Exercise Intensely: Engage in intense aerobic exercise (e.g., jumping jacks, running) for about 20 minutes to release built-up emotional energy, reduce anxiety, and quickly shift your emotional state.

• Paired Muscle Relaxation (or Progressive Muscle Relaxation): Systematically tensing and relaxing different muscle groups to reduce muscle tension and promote a sense of relaxation, helping lower emotional arousal and distress.

• Mammalian Dive Reflex: The mammalian dive reflex is a natural, physiological response activated when cold water touches your face, particularly around your eyes and upper cheeks. This reflex rapidly slows your heart rate, redirects blood flow to essential organs, and calms your nervous system. Intentionally activating the mammalian dive reflex—such as by briefly submerging your face in cold water—can quickly reduce emotional intensity, lower stress, and help you regain emotional balance during moments of extreme distress or crisis.

Radical Acceptance: Radical Acceptance is the practice of fully acknowledging and accepting reality exactly as it is, even if you don’t approve or like it. It means letting go of resistance, resentment, and the struggle against things you cannot change. Radical Acceptance reduces unnecessary emotional suffering by helping you shift your energy from fighting reality toward taking effective action aligned with your values.

Pain vs. Suffering: Pain refers to the inevitable emotional discomfort or distress everyone experiences in life, such as sadness, loss, or frustration. Suffering, however, happens when we refuse to accept reality, resist painful situations, or hold onto resentment, bitterness, or regret. Radical Acceptance teaches that while pain cannot always be avoided, suffering—caused by non-acceptance—can be reduced or eliminated.

Acceptance vs. Approval: Acceptance is often misunderstood as agreement, approval, or passivity. However, in DBT, radical acceptance simply means acknowledging reality clearly without judgment or resistance. It doesn’t mean approving, liking, or agreeing with a situation. Instead, acceptance allows you to move forward more effectively, reducing unnecessary suffering and focusing energy on meaningful action.

Turning the Mind: Turning the Mind is a DBT skill that involves intentionally and repeatedly choosing to accept reality as it is. Acceptance is rarely a one-time event; instead, it requires ongoing effort to gently redirect your attention from resistance ("this shouldn’t be happening") toward acceptance ("this is how things are right now").

Willfulness vs. Willingness: In DBT, willfulness means stubbornly resisting reality and refusing to accept things as they are, which keeps you stuck in emotional pain. Willingness is the opposite—actively choosing to open yourself up to reality, even when it’s hard, allowing you to move forward effectively and reduce suffering.

Willing Hands: Willing Hands is a DBT acceptance skill involving physically opening your hands, uncurling fingers, relaxing palms upward, and placing them gently in your lap or by your sides. This posture signals openness and acceptance to your brain and body, helping to reduce resistance, anger, and distress.

Half-Smiling: Half-Smiling is another DBT acceptance skill that involves gently relaxing your face and turning the corners of your mouth slightly upward, creating a subtle, relaxed expression (you can feel it, but others can’t see it). This skill helps ease emotional tension and activates feelings of openness, calmness, and acceptance in your nervous system.

Dialectics: Dialectics in DBT refer to the concept that two seemingly opposite truths can coexist at the same time. Radical Acceptance highlights this dialectical approach by teaching you that you can fully accept a painful or difficult reality while simultaneously working to change it. This skill helps balance acceptance of current circumstances with motivation toward meaningful change.

Values: Values are your deeply held beliefs or priorities that provide meaning and direction to your life. They serve as an internal compass, guiding your choices and actions toward what feels authentic and fulfilling to you. 

Goals vs. Values: A goal is a specific, measurable outcome you can achieve and “check off” a list (e.g., “call my friend weekly”). A value is a broader, ongoing pursuit or principle guiding your life (e.g., “valuing connection”). Goals help you practically embody and live according to your values.

Values Inventory: A Values Inventory is a reflective exercise or tool designed to help you identify and clarify your personal values. Completing a values inventory helps you distinguish your authentic values from external pressures, societal expectations, or obligations from others.

80th Birthday Party Exercise: An Acceptance and Commitment Therapy (ACT) exercise developed by Dr. Russ Harris that helps you identify your values by imagining your 80th birthday party. It involves reflecting on what you'd want important people in your life to say about you, helping clarify what matters most to you.

Values to Action Steps: A structured DBT exercise that breaks abstract values down into clear, achievable goals, and further into manageable action steps. This approach makes values easier to implement practically in daily life, helping you consistently align your actions with what matters to you.

Behavioral Specificity: Behavioral specificity is clearly defining your goals or action steps in concrete, measurable, and observable terms. It involves stating exactly what you'll do, how often, or under what conditions, making it easier to track progress and stay accountable as you align your actions with your values.

Validation: Validation is the practice of recognizing and acknowledging another person’s thoughts, feelings, or behaviors without judgment. It involves communicating that their internal experience makes sense and is understandable, even if you don't agree with it. 

Invalidation: Invalidation is the act of dismissing, ignoring, or judging another person’s emotions, thoughts, or experiences as wrong, unimportant, or exaggerated. This can happen intentionally or unintentionally and often leads to increased emotional pain, misunderstanding, and disconnection in relationships.

Levels of Validation: Derived from DBT, the six levels of validation offer a structured approach to effectively validating someone:

• Being Present: Offering undivided attention, demonstrating genuine interest, and practicing active listening.

• Accurate Reflection: Repeating back or summarizing what the person has shared to show understanding.

• Mind Reading: Reflecting what is not necessarily stated. Acknowledging and validating emotions that are not explicitly stated but can be inferred.

• Understanding in Context: Recognizing how a person’s past experiences, biology, or current circumstances influence their feelings and behaviors.

• Acknowledging the Valid: Communicating that it’s understandable someone would feel or react a certain way, given the situation. Anyone might feel this way.

• Radical Genuineness: Relating to the other person as an equal, with respect and authenticity, avoiding condescension. Not treating the other person as fragile or incompetent. 

Functional Validation: Functional validation involves going beyond verbal affirmation to actively supporting someone’s needs in a practical way. It means responding to emotional or physical needs with concrete actions—like offering a hug when someone is upset, bringing a drink to someone who is thirsty, or helping to solve a problem if someone asks. This form of validation communicates care and understanding through action. 

Self-Validation: Self-validation is the process of recognizing and affirming your own internal experiences without judgment. It means acknowledging your emotions, thoughts, and behaviors as valid and understandable, even when they’re painful or difficult. You can use the same six levels of validation for yourself. 

Empathy vs. Validation: Empathy is the ability to feel and understand another person's emotional experience. Validation is the act of expressing that understanding. Empathy is internal, while validation is external and communicated.

• Apology: An apology is an acknowledgment of wrongdoing, paired with an effort to repair harm and prevent future mistakes. A meaningful apology focuses on the impact of one’s actions rather than just their intentions, and includes accountability, validation, and repair.

• Accountability: Accountability is taking responsibility for your actions and their impact on others. It involves recognizing mistakes without excuses, validating the harm caused, and committing to meaningful change. A strong apology includes both words and actions that demonstrate accountability.

• Defensive Apologizing: Defensive apologizing happens when someone says “sorry” while simultaneously justifying, minimizing, or shifting blame. These apologies often center the apologizer’s discomfort rather than the person harmed. Example: "I'm sorry you feel that way, but I didn’t mean to hurt you."

• Over-Apologizing: Over-apologizing is the habit of saying “I’m sorry” excessively or unnecessarily, often for things that do not require an apology (e.g., existing, taking up space, setting boundaries). Chronic over-apologizing can diminish the impact of genuine apologies and contribute to people-pleasing behaviors.

• I’M SORRY Framework: A structured approach developed by Adams-Clark et al. (2022)  to making meaningful apologies by focusing on impact, accountability, and repair rather than guilt or justification. See our Episode 10 Infographics for the detailed steps. 

• Impact vs. Intention: A meaningful apology focuses on impact, not just intention. While intentions explain why someone acted a certain way, they don’t erase the harm caused. Example: Instead of saying, "I didn't mean to hurt you," a stronger apology acknowledges, "I see that my words hurt you, and I'm truly sorry for that."

• Validation in Apologies: Validation in apologies means recognizing and affirming the other person’s feelings as real and understandable, even if you didn’t intend harm. A validating apology might include: "I can see why what I said upset you.”

• DEAR MAN: A communication skill from Dialectical Behavior Therapy (DBT) that helps you ask for what you need—or say no—effectively, while preserving the relationship and your self-respect. “DEAR” is the script (what you say), and “MAN” is how you say it.

  • Describe: State the facts of the situation clearly and non-judgmentally. Avoid exaggeration or assumptions to keep the conversation grounded and less likely to trigger defensiveness. Example: “I noticed you came home after 7:30 PM three times this week.”

  • Express: Share your feelings and opinions about the situation. Use “I” statements to stay grounded in your experience and avoid blame. Whenever possible, be vulnerable and name primary emotions (e.g., lonely, disconnected) to invite understanding and connection.

  • Assert: Make your request or set your limit clearly and specifically. Avoid vague or passive language. Effective asserting is about knowing what you need and communicating it directly (e.g., “I’d like to have dinner together at 6:30 two nights a week.”).

  • Reinforce: Let the other person know what’s in it for them. Reinforcement is about showing how meeting your need can also benefit them. This helps strengthen collaboration instead of creating resistance. It’s not manipulation—it’s mutual respect.

  • Mindful: Stay focused on your goal and present in the interaction. Avoid getting sidetracked by emotional reactivity, past grievances, or defensive distractions. Being mindful helps you stay calm and effective.

  • Appear Confident: Use a confident tone, posture, and body language—even if you don’t feel confident. Avoid hedging, looking away, or apologizing for your ask when it’s unnecessary. Confidence helps others take your request seriously.

  • Negotiate: Be willing to find a middle ground. The other person doesn’t have to agree with your first request. Negotiation opens the door to alternative solutions that can work for both parties and helps avoid power struggles or stalemates.

• Three Interpersonal Goals (DBT): Every interaction contains three goals:

  • Objective Effectiveness – Getting what you want.

  • Relationship Effectiveness – Maintaining or improving the relationship.

  • Self-Respect Effectiveness – Acting in a way that aligns with your values and leaves you feeling proud of how you handled yourself.

• Limits (vs. Boundaries): In DBT, “limits” are used instead of “boundaries” to avoid rigidity. Limits are personalized guidelines that reflect what you’re able to tolerate or participate in, based on your needs and context. They’re flexible, human, and relationship-centered.

• Insomnia: A sleep-wake disorder characterized by difficulty falling asleep, staying asleep, or waking up too early, occurring at least three nights a week for three months or longer, and causing significant distress or impairment in daily functioning (APA, 2022).

• Acute Insomnia:
  Short-term episodes of sleep difficulty (less than three months). Common during times of stress but not considered a disorder unless persistent (APA, 2022).

• Sleep Efficiency: A measure of how effectively you sleep, calculated as:{(Total Sleep Time ÷ Time in Bed) × 100%}. The target is usually 85% or higher

• CBT-I (Cognitive Behavioral Therapy for Insomnia): An evidence-based treatment for insomnia that targets unhelpful sleep habits, thought patterns, and behaviors that keep insomnia going. Considered the gold standard treatment (Morin & Espie, 2003).

• ACT for Insomnia:Acceptance and Commitment Therapy approaches applied to sleep. Focuses on acting in line with values despite feeling tired and changing one’s relationship to anxious or catastrophic sleep-related thoughts, reducing the struggle with insomnia (Salari et al., 2020). 

• SLEEP Acronym (guts’ Self-Help Strategy): A practical five-step framework introduced in this episode for improving sleep:

  • S – Stimulus Control: Associate your bed only with sleep and sex; leave the bed if awake for more than ~20 minutes.

  • L – Limit Time in Bed: Match time in bed to actual sleep time to boost sleep efficiency.

  • E – Explore Your Thoughts: Notice and release catastrophic thinking about sleep through mindfulness or defusion strategies.

  • E – Engage in Your Life: Keep living according to your values and commitments even when tired, instead of canceling plans.

  • P – Plot Progress: Track sleep with a diary or app to notice patterns, while avoiding obsession over the data.

• Stimulus Control:  A behavioral principle (based on classical conditioning) that strengthens the association between bed and sleep by limiting other activities in bed.

• Sleep Hygiene: Traditional behavioral recommendations for improving sleep comfort, such as keeping the room cool, dark, and free of screens. Helpful, but less effective for true insomnia compared to CBT-I techniques.

Self-Soothing: Self-soothing involves intentionally comforting yourself during times of emotional distress using your five senses. Rather than turning to unhealthy coping behaviors, self-soothing skills help calm intense emotions, decrease stress, and provide immediate emotional relief by creating a sense of safety and comfort in the present moment.

Distress Tolerance (Revisited): Distress tolerance refers to your ability to effectively manage emotional pain or difficult situations without making things worse. Self-soothing is one category of distress tolerance skills, specifically aimed at providing comfort and relief from intense emotions through sensory-based experiences.

The Five Senses (Self-Soothing Skill): Self-soothing emphasizes deliberately using each of your five senses (sight, sound, smell, taste, touch) to calm and comfort yourself. This technique quickly redirects your attention away from emotional distress toward grounding, pleasurable sensory experiences.

Self-Soothing Kit: A personalized collection of comforting items, activities, or experiences organized around your five senses. Having a sensory toolkit ready can help you quickly access soothing resources during moments of distress or emotional discomfort. Examples include calming scents, textures, music playlists, visuals, or comforting foods.

Self-Compassion: Self-compassion is the practice of treating yourself with kindness, care, and understanding, especially during moments of pain, failure, or emotional distress. Rather than criticizing or harshly judging yourself, self-compassion involves acknowledging your own suffering and responding with warmth and gentle support. Self-compassion is closely connected to self-soothing, as both involve intentionally comforting and calming yourself when experiencing difficult emotions. Practicing self-compassion enhances the effectiveness of self-soothing skills.

• Avoidance: Avoidance is when you stay away from something you don’t like or want to deal with. This can be external (avoiding people, places, or tasks) or internal (avoiding thoughts, feelings, or memories that are uncomfortable)

• Experiential Avoidance: When a person tries to avoid or suppress their internal experiences—like emotions, thoughts, body sensations, or memories—because they are uncomfortable. Examples include drinking to numb anxiety, scrolling to avoid loneliness, or avoiding feedback to escape shame

• Exposure / Exposure Hierarchy: A behavioral strategy for overcoming avoidance. Exposure involves gradually facing what you fear in small, manageable steps, allowing your nervous system to relearn safety. An exposure hierarchy (or “ladder”) breaks down avoided situations into steps from least to most distressing, helping build tolerance and confidence over time

• Subjective Units of Distress Scale (SUDs): A tool for rating distress or anxiety on a scale (commonly 0–10 or 0–100). It helps track how stressful something feels and guides the pace of exposure. Anticipated distress is often higher than actual distress once someone engages in the avoided task.