A DBT Guide to Effective Self-Care: The PLEASE Skills

Most of us have experienced days when our emotional coping tanks feel like they’re

running on empty. Minor inconveniences such as a coffee spill, a passive-aggressive email from a colleague, or a flat tire might feel like the final straw, leading to extreme frustration, a rush of tears, or even an angry outburst. For some of us, living in this heightened state of emotional vulnerability is the norm. If a slight nuisance often feels like an insurmountable obstacle to you, you might be biologically predisposed to strong and sudden emotional experiences, making it even more difficult to regulate your reactions.

During these moments of overwhelm, it’s common to look for a quick fix. We might turn

to substances, mindless social media scrolling, or a sugary dessert to quiet the noise in our heads. While these emotional band-aids can soothe our senses in the short-term, they also have important drawbacks: they don’t truly refill our tanks, nor do they prevent the pattern from reoccurring tomorrow or next week. According to dialectical behavior therapy (DBT), there is another way out of this predicament. By taking care of our bodies on a regular basis, we can refuel our systems and better equip ourselves to handle stressful experiences.

The DBT “PLEASE” skills offer a step-by-step guide for balancing the body and

increasing our physical capacity to cope with stress. The first part of this five-step process is to treat physical illness and imbalances. An unbalanced body is especially prone to negative

emotions, so physical health becomes a priority when trying to improve psychological well-

being. This step might include regular visits to a physician, taking medication as prescribed, and treating physical symptoms when they arise. In many cases, behavioral and emotional

dysregulation may also be related to hormonal imbalances or menstrual cycle phases, so it may be helpful to request a hormone panel from your physician or consult with an endocrinologist or OB/GYN.

The next PLEASE skill is to eat in a balanced, intuitive way. Both hunger and overeating

can increase our susceptibility to “emotion mind,” so it is best to eat mindfully on a regular

schedule. Eat when you feel hungry, pay attention to your body’s cues while eating, and enjoy your food until you are comfortably satisfied. While there is no need to swear off entire food groups or view certain foods as “bad,” it may be helpful to add more nutritious, whole foods to your diet and limit foods that increase irritability or cause gastrointestinal discomfort.

The third PLEASE skill is to avoid mood-altering substances. Alcohol and drugs can

affect our mood and sleep and lower our inhibitions, potentially causing us to react in

unproductive or even self-destructive ways. For optimal physical and emotional health, try to

completely abstain from drugs and limit alcohol use as much as possible. It is also important to be mindful of how caffeine and sugar impact our moods, and to adjust our intake accordingly.

The fourth skill is to balance sleep by prioritizing rest and proper sleep hygiene. For

many of us, the guideline of 7-9 hours might be unattainable between kids and hectic work

schedules; the key is to optimize our sleep quality as much as possible so we can feel well-rested and energized the next day. Sticking to a consistent sleep schedule can also improve our emotion regulation abilities, making it easier for us to respond adaptively to daily challenges.

The final PLEASE skill is to move our bodies often and mindfully. Research shows that

consistent aerobic exercise can improve mood and help us build a sense of personal mastery. Mindful movement can also include walking, playing sports, or even deep cleaning your home, as long as you are active and on your feet. Try to move your body around five to seven days per week, aiming for around 20 minutes of movement each day.

Though there are many other DBT skills that help regulate emotions long-term, the

PLEASE skills allow us to build a biological foundation for lasting emotional resilience. By

taking care of our bodies, we can ensure that unpleasant physical states such as illness, hunger, or exhaustion do not worsen our moods or intensify our emotional reactions. These daily habits can also fill up our emotional “piggy banks” by providing us with the energy and resilience we need to “spend” during more challenging days or weeks. If you find yourself prone to extreme emotions even with regular self-care, consider pursuing dialectical behavior therapy (DBT), an evidence-based treatment for people with emotion regulation difficulties.