Opposite Action: A DBT Skill for Managing Emotions and Changing Unhelpful Behaviors

Opposite Action is a Dialectical Behavior Therapy (DBT) emotion regulation skill that helps you respond differently when an emotion is pushing you toward an action that does not fit the facts, does not match your values, or would make the situation worse. Emotions often come with action urges: fear may urge avoidance, shame may urge hiding, anger may urge attacking, and sadness may urge withdrawing. Sometimes these urges are protective and wise; other times, they keep a painful cycle going. Opposite Action invites you to notice the emotion, identify the urge, check whether the emotion fits the facts, and choose a behavior that moves in the opposite direction when the original urge is not effective. Research on DBT skills supports the role of skills use in emotion regulation and one laboratory-based study specifically examined opposite action in borderline personality disorder (Linehan et al., 2015; Neacsiu et al., 2010; Sauer-Zavala et al., 2019). Broader studies and reviews also support DBT skills training as a stand-alone intervention for emotion dysregulation (Neacsiu et al., 2014; Valentine et al., 2015).

To practice, begin by naming the emotion as clearly as you can. Then name the urge that comes with it. Ask yourself: What is this emotion pushing me to do? Would acting on this urge help the situation, fit my values, or move me toward the kind of response I want to have? If the urge would make things worse, choose a realistic opposite action. If fear is urging avoidance, the opposite action may be taking one small step toward approach. If shame is urging hiding, it may be making eye contact, speaking honestly, staying present, or keeping your posture open. If anger is urging attack, it may be unclenching your hands, lowering your voice, relaxing your face, stepping back, or using a softer tone. If sadness is urging isolation, it may be opening the curtains, sitting near another person, sending one message, or doing one small activity that keeps you connected to life. 

Opposite Action works best when the step is specific and possible. You do not have to feel confident, calm, or convinced before practicing. The behavior often comes first, and the emotion may shift later. A small opposite action can still count: attending an appointment, taking one step outside, answering one message, turning toward support, or staying present for one more minute. The purpose is to interrupt an emotion-driven pattern that is no longer helping and give your body a new experience to learn from.

Opposite Action should not be used to override safety, ignore boundaries, or force yourself into harmful situations. If fear is warning you about real danger, protection is the skillful response. If guilt is appropriate, repair or accountability may be needed. If anger is pointing to mistreatment, boundaries, problem-solving, or direct communication may be more appropriate. Opposite Action is most useful when the emotion is real, but the action urge is not effective for the situation you are in now. 

References

Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., McDavid, J., Comtois, K. A., & Murray-Gregory, A. M. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: A randomized clinical trial and component analysis. JAMA Psychiatry, 72(5), 475-482. https://doi.org/10.1001/jamapsychiatry.2014.3039

Neacsiu, A. D., Eberle, J. W., Kramer, R., Wiesmann, T., & Linehan, M. M. (2014). Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: A pilot randomized controlled trial. Behaviour Research and Therapy, 59, 40-51. https://doi.org/10.1016/j.brat.2014.05.005

Neacsiu, A. D., Rizvi, S. L., & Linehan, M. M. (2010). Dialectical behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder. Behaviour Research and Therapy, 48(9), 832-839. https://doi.org/10.1016/j.brat.2010.05.017

Sauer-Zavala, S., Wilner, J. G., Cassiello-Robbins, C., Saraff, P., & Pagan, D. (2019). Isolating the effect of opposite action in borderline personality disorder: A laboratory-based alternating treatment design. Behaviour Research and Therapy, 117, 79-86. https://doi.org/10.1016/j.brat.2018.10.006

Valentine, S. E., Bankoff, S. M., Poulin, R. M., Reidler, E. B., & Pantalone, D. W. (2015). The use of dialectical behavior therapy skills training as stand-alone treatment: A systematic review of the treatment outcome literature. Journal of Clinical Psychology, 71(1), 1-20. https://doi.org/10.1002/jclp.22114