GUIDE · DBT

DBT mindfulness skills: what to do with your attention, and how to do it

You're halfway through a work email when you realize you've read the same sentence three times, and your jaw has been clenched since lunch. Mindfulness in dialectical behavior therapy (DBT) gives you six concrete skills for moments like that one: three for what you do with your attention and three for how you do it. Linehan, who developed DBT, calls them the core skills, and her notes treat distress tolerance as growing out of them.

What DBT mindfulness skills are, and why they come first

Dialectical behavior therapy (DBT), developed by Marsha Linehan, teaches four sets of skills: mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance. Linehan's handouts call the mindfulness set the core skills. Her teaching notes describe distress tolerance as a natural next step from them, and they send readers back to observing and nonjudgment more than once.

The handouts name three aims: suffering less and feeling happier, gaining more control over your own mind, and seeing reality as it is. Mindfulness there means paying attention to the present moment on purpose, without judging it and without clinging to it. You don't need a meditation cushion. The handouts say you can practice anytime and anywhere, in the middle of whatever you're doing, and they count walking, yoga and prayer as forms of practice.

The skills start from wise mind, the state where reason and emotion both get a say, and that page covers it in detail. The six skills below are the moves you make while you practice. Three describe what you do, and three describe how you do it.

The "what" skills: observe, describe, participate

Observe means noticing what comes in through your senses and what passes through your mind, on purpose, right now. You steer your attention but don't edit what you find, so you don't push anything away or hold onto it. Linehan's image is thoughts drifting past like clouds and feelings rising and falling like waves. Waiting for a late train, you might notice the screech of brakes, cold air on your hands, a tight chest and the thought that you'll miss your meeting.

Describe means putting plain words on what you observed. A thought gets called a thought and a feeling gets called a feeling, so "I'm getting fired" becomes "I'm having the thought that I'll get fired." The handout's test is strict: if your senses didn't pick it up, it doesn't belong in the description. "My boss frowned and closed her door" passes, while "My boss is furious with me" is a guess about her mind.

Participate means throwing yourself fully into what you're doing instead of standing off to the side and commenting. Think of dancing at a wedding without checking how you look, or laughing with a friend while you clear the table after dinner. Linehan pictures a skilled dancer who moves with the music and the partner, neither forcing things nor freezing up. It also asks you to act from wise mind.

The "how" skills: nonjudgmentally, one-mindfully, effectively

Nonjudgmentally means sticking to the facts and leaving out labels like good, bad, stupid or pathetic. It doesn't mean pretending everything's fine. You can still tell helpful from harmful, and you can still have values and preferences. What you drop is the verdict, so "I'm an idiot for forgetting the meeting" turns into "I forgot the meeting, and I want a calendar alert so it doesn't happen again."

One-mindfully means giving your whole attention to whatever you're doing right now. Eat when you're eating. If you're going to worry, give the worry your full attention instead of half-worrying through dinner while you scroll. Your mind will wander, and each time it does, you bring it back, as often as it takes. If you catch yourself doing two things at once, stop and pick one.

Effectively means doing what works in the situation you're actually in, not the one that would be fair or the one you wish you had. Jordan (a made-up example) gets a parking ticket he's sure is unfair. Arguing with the officer would feel righteous, while contesting it in writing later gives him a real shot and gets him home on time. The handout ties this skill to knowing your goal in the moment and not letting emotion mind take the wheel.

A week of DBT mindfulness practice

Linehan's handouts suggest practicing a skill first when you don't need it, so it comes more easily when you do. Use ordinary moments this week and save the hard ones for later.

1. Pick an anchor activity. Choose something you do every day, like making coffee, showering or walking to the bus, and use it as your practice slot.
2. Observe for one minute. Stop and listen to the sounds around you, then to the quiet between them. When a thought pulls you away, notice it and come back to listening.
3. Describe what you noticed. Jot down a few lines that stick to your senses, like "warm mug, bitter taste, shoulders tight," and tag thoughts as thoughts: "I'm having the thought that today will be awful."
4. Eat one meal one-mindfully. Leave your phone in another room and give the food your full attention, its taste, smell and texture. Each time your mind drifts to your inbox, bring it back to the plate.
5. Count judgments for a day. Move a coin from one pocket to the other each time you catch a judgment, including judgments about yourself. In the evening, rewrite one of them as plain facts.
6. Throw yourself into one activity. Pick something with motion, like dancing in the kitchen or a game with your kids, and stay inside it instead of watching yourself do it.
7. Ask what works before a hard moment. Before a tense call or meeting, write your goal in one sentence. Then choose the move most likely to get you there, even if another one would feel more satisfying.
8. Look back at the end of the week. Note which skill came easiest and which was hardest, and give the hardest one another week of low-stakes practice.

If a practice leaves you more stirred up than settled, switch to a different one or stop for the day, and read the note on getting help below.

Three snags that trip people up

Judging yourself for judging. Once you start noticing judgments, you'll find plenty, and the next thought is often "I'm terrible at this." That's one more judgment. Linehan's handout answers it directly: when you catch yourself judging, don't judge your judging. Her practice ideas include noting "a judgmental thought came up" and moving on, or counting judgments for a day by shifting coins from one pocket to the other. Treat the count as information about a habit.

Describing interpretations as facts. "She's ignoring me" feels like a description, but it's a guess about what's going on in someone else's head. The part you can observe is "She hasn't answered my text in four hours." You can keep the interpretation as long as you label it as one: "I'm guessing she's annoyed." When a guess like that is driving a strong emotion, Check the Facts takes it further.

Using observe to avoid. Watching your feelings from a distance can turn into a way of never quite feeling them, or of never acting. Linehan's definition of mindfulness rules out avoiding, suppressing or blocking the present moment, and her observe skill tells you to push nothing away. If you've been "observing" a problem for days instead of handling it, switch to participate or effectively. Urge surfing, which appears on Linehan's list of ways to practice observing, asks you to stay with an urge as it rises and falls rather than step away from it.

How strong the evidence is for DBT mindfulness

We read four studies that tested the mindfulness module on its own. All four come from one research group in Barcelona, and all four enrolled people with borderline personality disorder (BPD). In a 2012 study, 60 patients got general psychiatric care, and 40 of them also took the module. That group improved more on a computer test of attention and impulsivity, and people who logged more practice minutes saw bigger drops in psychiatric and mood symptoms. A 2014 study of 35 patients found more symptom improvement after 10 weeks of the module, but no change in how strongly people reacted to upsetting pictures in the lab.

In a 2021 study of 102 people with BPD, mindfulness skills training reduced BPD symptoms more than training in interpersonal effectiveness skills. The analysis linked the gain to decentering, the ability to step back from your own thoughts. A 2024 study tracked 75 people week by week through a 10-week module. In weeks when people judged their inner experience less and noticed their bodies more than usual, they had less trouble regulating emotions the following week.

The evidence for the module alone is thin. The samples were small, one team ran all four studies, and none of them tested the skills as self-help. Most DBT evidence comes from trials of the whole package. A 2015 trial of 99 women at high risk of suicide found that versions including skills training cut self-injury and depression more than DBT without it, and a 2010 analysis linked growing skills use to fewer suicide attempts. Neither looked at mindfulness separately. A 2015 review of 17 trials of skills training without the rest of DBT called the evidence preliminary. Practicing these skills on your own is a reasonable thing to try, but it doesn't treat any condition.

Practice DBT mindfulness with Helpy

The chat below runs with Helpy, the site's AI assistant. Describe a moment from your day, like an argument or a stressful commute, and it can help you sort what you observed from what you assumed and rewrite a judgment as plain facts.

Evidence and sources

• Mindfulness handouts, Linehan, DBT Skills Training Handouts and Worksheets, Second Edition (Guilford, 2015): the goals and definition of mindfulness, the overview of core mindfulness skills, the "what" and "how" skills and ideas for practicing observing and nonjudgment. A sample the publisher posts; handouts, not research.
• Distress Tolerance chapter (teaching notes), Linehan, DBT Skills Training Manual, Second Edition (Guilford, 2015): calls distress tolerance a natural progression from mindfulness skills and refers back to observing and nonjudgment. This sample covers distress tolerance, not the mindfulness chapter.
• Soler et al., Behaviour Research and Therapy, 2012 (PubMed): 60 patients with BPD; adding the mindfulness module to general psychiatric care improved attention and impulsivity scores, and more practice minutes went with more symptom improvement. Small, with only 20 people in the comparison group, and the abstract doesn't say assignment was random; we read only the abstract.
• Feliu-Soler et al., Clinical Psychology and Psychotherapy, 2014 (PubMed): 35 patients with BPD; 10 weeks of the module plus general care improved symptoms more than care alone but didn't change lab reactions to unpleasant images. Patients were assigned in sequence rather than at random, and the authors call the results preliminary; we read only the abstract.
• Schmidt et al., Psicothema, 2021 (PubMed): 102 people with BPD; mindfulness skills training reduced BPD symptoms more than interpersonal effectiveness skills training, and decentering appeared to carry the effect. Same research group as the studies above; we read only the abstract.
• Schmidt et al., Borderline Personality Disorder and Emotion Dysregulation, 2024 (PubMed): 75 outpatients with BPD in a 10-week mindfulness module; weeks with more nonjudgment and body awareness than usual were followed by less emotion dysregulation. No comparison group, so it can't show the training caused the change; we read only the abstract.
• Linehan et al., JAMA Psychiatry, 2015 (PubMed): 99 women with BPD at high suicide risk; versions with skills training reduced self-injury and depression more than DBT without it. The mindfulness module wasn't tested separately; we read only the abstract.
• Neacsiu, Rizvi and Linehan, Behaviour Research and Therapy, 2010 (PubMed): in 108 women from three trials, rising skills use accounted for drops in suicide attempts and depression and better anger control. Self-reported use, averaged across all skills; we read only the abstract.
• Valentine et al., Journal of Clinical Psychology, 2015 (PubMed): a review of 17 trials of DBT skills training without the rest of DBT found preliminary evidence. Study limits rule out strong conclusions, and it doesn't single out mindfulness; we read only the abstract.

Read next

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