Living With DBT Skills: Real Stories, Real Strategies
By James Okafor, LMFT • 8/8/2025
I got an email last week from a reader that stopped me in my tracks. They wrote: "I feel like nobody actually understands what this is like."
I want to try.
The Practical Part
I want to be careful here because this gets oversimplified a lot.
When I was in training, my supervisor said something that I still think about: "People don't come to therapy because they're broken. They come because they're stuck." There's a crucial difference.
What to Try This Week
This is where things get interesting — and where most generic advice falls short.
The approach I recommend to most clients follows this sequence:
Week 1-2: Awareness. Don't try to change anything. Just notice when it happens. What triggered it? What were you doing? What time of day? Track it in your phone.
Week 3-4: Experimentation. Try one new coping strategy each week. See what resonates. Discard what doesn't.
Week 5-8: Consistency. Take the strategies that worked and build them into your daily routine. Attach them to existing habits (after brushing teeth, during commute, before bed).
Ongoing: Adjustment. What works changes over time. Stay flexible. Give yourself permission to try new approaches.
The Nuance Nobody Mentions
A 2023 meta-analysis in the Journal of Clinical Psychology looked at this exact question. Here's what they found.
I had a client — let's call her Meera — who struggled with exactly this for years. She'd tried everything the internet suggested. The apps, the journals, the morning routines. Nothing stuck. What finally made a difference was surprisingly simple: she stopped trying to fix herself and started trying to understand herself.
Moving Forward
I want to be careful here because this gets oversimplified a lot.
Here's my "right now" emergency list — things you can do in the next 60 seconds:
- Splash cold water on your face. This triggers the mammalian dive reflex and immediately slows your heart rate.
- Hold something cold. An ice cube, a frozen water bottle. The sensation interrupts the anxiety circuit.
- Do the physiological sigh. Two quick inhales through your nose, then one long exhale through your mouth. Repeat three times.
- Push your feet hard into the floor. This activates your proprioceptive system and grounds you in your body.
- Hum or sing. The vibration stimulates your vagus nerve, which controls your parasympathetic (calming) nervous system.
You deserve to feel better than this. Not in a toxic positivity way — in a genuine, "your suffering matters and there are things that can help" way. Start small. Be patient. And know that literally millions of people have walked this exact path and come out the other side.
This article is for educational purposes only and does not replace professional medical or mental health advice. If you're in crisis, please contact your local emergency services or crisis helpline.