Fear or panic
For anxiety peaks, near panic, fear of loss of control or massive concern.
- 14
- entries
- 4
- roles
- 8
- Clusters
What this is about
Anxiety and panic form a continuum in DBT, with chronic background worry at one end and full panic with physiological symptoms at the other. DBT does not treat anxiety as intrinsically pathological — it treats it as a signal whose intensity has become dysregulating. The relevant skill categories are emotion regulation (check-the-facts, opposite action to anxiety, vulnerability reduction), distress tolerance for peak moments, and mindfulness for observing the wave without amplifying it.
A key clinical distinction: anxiety justifies avoidance behaviors, which maintain anxiety — a common failure mode when skills are used to suppress rather than process the emotion. The core prescription of opposite action for unjustified anxiety is approach rather than avoidance: actively entering what is feared, not pulling away from it, and doing so repeatedly and all the way until the response decreases.
How this emotion shows up
Body signals, typical action urge, and course as orientation for entering fitting skills.
- BodyRacing heart, tightness in the chest and throat, shallow breathing, muscle tension, sweating, trembling, dizziness
- Action urgeFlee or leave the situation, freeze and freeze, seek and secure control, avoid the next contact
- Course and intensityCourse from chronic background worry to acute panic attack. Physical symptoms increase quickly and subside more slowly. Often wave character.
First entry (1)
The most direct first step for this situation.
Understand (6)
Explains connections and deepens understanding.
Check the Facts
If before opposing action or problem solving, it must first be checked whether the emotion and its intensity are appropriate to the facts.
Also in: Mindfulness
Accumulating Positive Emotions
When what is needed is not primarily acute crisis regulation, but rather the long-term development of positive counterweights, joy and closeness to life.
Also in: Distress Tolerance · Mindfulness
Emotion Exposure
When a feeling not only has to be understood, but also endured within a protected framework so that its power over behavior decreases.
Also in: Distress Tolerance
Functions of emotions
When, before regulation or behavioral change, it must first be understood what an emotion actually stands for in the current context.
Also in: Mindfulness · Distress Tolerance
PLEASE Skills
When not only acute regulation is needed, but the reduction of basic vulnerability via everyday body factors.
Also in: Distress Tolerance · Mindfulness
The DBT emotion model
If, before actually choosing a skill, a model is needed that breaks down emotional reactions into their components and points of intervention.
Also in: Mindfulness · Distress Tolerance
Apply (6)
Concrete exercises and skills for the situation.
Check the Facts Worksheet
When Check the Facts needs to not only be understood, but actually applied to a real situation.
Figuring Out How to Change Unwanted Emotions
If, after checking the facts, it is not the term that is used, but the specific next direction of action.
Exposure-Based Cognitive Rehearsal
When impending stress, fear or risky situations require targeted preparation so that old, automatic behavior does not take control again.
Also in: Emotion Regulation · Distress Tolerance
Improving the Moment
If the secondary overload of the moment should be reduced so that perseverance, thinking and later skill use become possible again.
Also in: Mindfulness · Emotion Regulation
Mindfulness of Current Emotions
When emotion avoidance magnifies the problem and mindful contact with the present feeling is needed first.
Also in: Distress Tolerance · Mindfulness
Opposite Action
If Check the Facts speaks against the emotional reaction direction and the situation itself does not need to be changed primarily.
Also in: Distress Tolerance
Prepare (1)
Prepares for future similar situations.