DBT and Mindfulness — Self-Directed Resources
Context: arrived at most of the core tenets independently before having names for them. Familiar with mindfulness generally and DBT secondhand (ex with BPD). This is a reading list to fill in the gaps and pick up specific tools, not start from scratch.
Related notes: 2026-06-21 - Eating Disorder - Self-Harm Framework and the Anorexic Voice, Self-Harm Recovery, Bipolar I vs Bipolar II
What DBT Actually Is
Developed by Marsha Linehan (who had BPD herself — worth knowing). Originally built for BPD but the core problem it solves — emotional intensity that exceeds current regulation capacity — maps directly onto BD2 and NSSI. Four skill modules:
- Mindfulness — the observer-mode foundation everything else builds on
- Distress Tolerance — surviving crisis moments without making it worse
- Emotion Regulation — understanding and reducing emotional vulnerability over time
- Interpersonal Effectiveness — maintaining relationships while holding your own needs
The “dialectical” part is the core tension it holds: you are doing the best you can AND you need to change. Both are true simultaneously.
Where to Start
Best single entry point
Self-Directed DBT Skills — Kiki Fehling PhD & Elliot Weiner PhD
- Written specifically for self-directed use, not therapy-dependent
- 12-week structure, one chapter per week, exercises at the end of each
- Both authors are Linehan-board-certified
- Penguin Random House | Goodreads reviews
The definitive workbook (more comprehensive, less structured)
The Dialectical Behavior Therapy Skills Workbook — McKay, Wood & Brantley
- Over a million copies, the standard self-help DBT text
- More reference-style than the Fehling book — good to have both
- New Harbinger
The source material (free)
DBT Skills Training Handouts and Worksheets — Marsha Linehan
- The actual clinical handouts used in DBT programs
- Dense but comprehensive — good if you want the unfiltered version
- Internet Archive (free)
TIPP Skills — Start Here for Acute Moments
TIPP is in the Distress Tolerance module. Physiological interventions that interrupt the urge-to-action gap fast — the clinical equivalent of “it’s 11pm and I can’t be bothered with wound dressing logistics.”
T — Temperature Cold water on the face, ice cube, cold shower. Activates the dive reflex, drops heart rate, interrupts emotional escalation physiologically. Fastest acting of the four.
I — Intense Exercise Short burst — sprint, jumping jacks, anything that burns the adrenaline. Metabolises the stress hormones driving the state.
P — Paced Breathing Inhale for 5 seconds, exhale for 7. The longer exhale activates the parasympathetic system. Simple, works anywhere.
P — Paired Muscle Relaxation Tense muscle groups on the inhale, release on the exhale. Progressive, works through the body.
Free worksheet: Therapist Aid — TIPP Full explainer: dialecticalbehaviortherapy.com — TIPP Full distress tolerance toolkit: dbt.tools
Other Distress Tolerance Skills Worth Knowing
IMPROVE the Moment — Imagery, Meaning, Prayer, Relaxation, One thing at a time, Vacation (brief), Encouragement. For getting through a difficult stretch rather than a crisis spike. Therapist Aid — IMPROVE
Radical Acceptance — Fully accepting reality as it is, not as it should be, without approval or resignation. Distinct from tolerance. Relevant to the “waiting for it to crash” pattern — non-acceptance of the current good state keeps the anxiety alive.
PLEASE skills (Emotion Regulation module) — treat PhysicaL illness, balanced Eating, avoid mood-Altering substances, balanced Sleep, Exercise. The basics, but framed as emotional regulation inputs not lifestyle advice. Directly relevant given the eating history.
Mindfulness — Filling the Gaps
You’re already running the core of this. The formal terms for what you’re doing:
Wise Mind — DBT’s term for the intersection of Emotion Mind (all feeling) and Reasonable Mind (all logic). The observer mode that can see both without being consumed by either. You’ve been operating from Wise Mind for years without the label.
Observe, Describe, Participate — the three “what” skills of mindfulness. Observing without reacting, describing without judging, participating fully when appropriate. The clinical framing of what you do naturally.
Non-judgmentally, One-mindfully, Effectively — the three “how” skills. How to do the above. “Effectively” is the one worth noting — doing what works given the actual situation, not what’s “right” or “fair.”
Mindfulness resources
- Positive Psychology — DBT Worksheets and Techniques — good overview with free worksheets
- Insight Timer — free guided meditations, huge library, no subscription required for the basics
- Headspace — more structured if you want a course format (paid, but polished)
The BD2 Specific Angle
Standard mindfulness and DBT were not designed with bipolar in mind and there’s a nuance worth knowing: during hypomanic phases, some mindfulness practices can increase arousal rather than reduce it. The distress tolerance and grounding skills (TIPP, cold water, paced breathing) are safer across mood states. Something to be aware of rather than a reason to avoid it.
DBT has been formally adapted for bipolar — DBT-BP — but it’s mostly a clinical programme rather than a self-directed thing. The standard DBT skills still apply, just worth knowing the mood-state context.
Quick Reference
| Need | Tool |
|---|---|
| Acute urge, need to interrupt fast | TIPP — cold water first |
| Getting through a hard stretch | IMPROVE |
| Reducing baseline emotional vulnerability | PLEASE skills |
| Understanding the framework | Fehling workbook |
| Going deeper | Linehan handouts (free, Internet Archive) |
| Free worksheets for anything | Therapist Aid |