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Back to the Basics with DBT

By Eric Dean JD, MBA, MA, MA, LPC, CADC

What can I do to feel better? This is a common question that I hear from clients. DBT provides some helpful guidance on this matter. Dialectical Behavioral Therapy (DBT) is a widely utilized modality that is comprised of four components: Distress Tolerance, Interpersonal Effectiveness, Mindfulness, and Emotional Regulation. Each component consists of acronyms that represent skills and ideas helpful for the respective topics. Here I will be describing the acronym PLEASE from emotional regulation:

Physical Illness

Taking care of our physical health is essential to stable emotional, mental, and spiritual health. Going to the doctor at least once per year for a physical exam can be part of a physical self-care routine. Identifying symptoms of illness early on can lead to successful treatment. Adopting a healthy lifestyle (see below) and being proactive can-do wonders for your physical wellbeing. As Benjamin Franklin said: “An ounce of prevention is worth a pound of cure.”

Eat balanced meals

Eating 3 larger meals, or 5 small meals, per day is recommended. Food is fuel for our bodies and minds. We are not at our best when we are hungry, or as some people call it, hangry. Diets rich in fruits, vegetables, fiber, Omega-3 fatty acids, and protein and low in sugar, sodium, saturated fats, and trans fats are associated with improved mood, a healthy immune system, and greater life expectancy. That is not to say that you should not indulge occasionally. Treating yourself to ice cream and pizza (my personal favorites) in moderation can be a great way to reward yourself for a job well-done.

Avoid mood altering drugs

Alcohol and drugs may provide temporary relief with longer-term costs. Mind-altering chemicals are appealing for emotional regulation because they act quickly, and the effects are predictable. Mood-altering substances, however, do not provide a sustainable solution to emotional challenges. Prescription medication prescribed and taken as such and moderate alcohol consumption may be excepted here. The key word is moderation, which is defined by the CDC as up to two drinks per day for men and up to one drink per day for women. However, the safe limit will vary based on your individual health and circumstances, which is why it is important to speak with your doctor about this. 


Sleep is essential to good health – 7 to 9 hours of sleep per night is recommended for adults. This gives our body ample time to experience all four stages of the sleep cycle for maximum restoration. It is during sleep that our body clears away the toxins that have accumulated during the day from regular activities. Moreover, during sleep our mind engages in a process called memory consolidation in which our experiences are catalogued for later access. Lack of sleep is associated with a plethora of physical and mental health conditions such as diabetes, heart disease, depression, and anxiety. 


Physical exercise has numerous health benefits. It can lower the risk of heart disease and relieve mild depression. Physical exercise includes activities such as running, jogging, walking, yoga, weightlifting, and cycling, to name some. The CDC recommends about 150 minutes per week which could be 30 minutes per day for 5 days. Many people report that after a workout they feel happy and relaxed. It is likely that they have experienced an increase in endorphins (short for endogenous morphine) which trigger these positive feelings. Consistent exercise has also been associated with other positive changes such as having a more balanced diet and increasing neurogenesis, which is the creation of new connections/neurons in the brain.

Mental exercise is also important. Intellectual stimulation can help keep our minds sharp. This could be doing a crossword puzzle, Sudoku, reading, and other activities that require focus and thinking. 

The above may seem obvious and many of us know what we should do, but acting is much more challenging. Start with one small change and then work your way up to bigger changes. With incremental progress, you will start feeling better and that will provide motivation to continue a healthy path!

If you would like support in improving your overall health and well-being, please connect with one of our Chicago counselors. We offer in-person therapy sessions and online counseling services to support you.

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