In this article you will read about:
Dialectical Behavior Therapy (DBT), developed by Marsha M. Linehan, is a cognitive-behavioral treatment originally designed for individuals with chronic suicidality and Borderline Personality Disorder (BPD), and it has since been extended to a wide range of conditions marked by emotion dysregulation and impulsive behavior (Linehan, 1993). One of DBT’s four core skills modules is Distress Tolerance, which focuses on surviving intense emotional states without making the situation worse. Within this module, the Self-Soothe skill plays a central role in helping individuals manage acute distress by using sensory-based, comforting experiences rather than resorting to self-destructive behaviors (Linehan, 2015).
This article explores the theoretical underpinnings of the Self-Soothe skill, its components and use in therapy, the current empirical support for distress tolerance skills, and the limitations and practical challenges that clinicians and clients may encounter.
Theoretical Foundations of the Self-Soothe Skill
The Self-Soothe skill is grounded in the broader DBT construct of distress tolerance, defined as the ability to withstand aversive internal states without engaging in impulsive or self-damaging behaviors (Linehan, 2015). For many individuals with BPD, distress is experienced as overwhelming, urgent, and “unbearable,” and research suggests that people with BPD often exhibit lower distress tolerance compared to other clinical groups (Bornovalova et al., 2008).
From a DBT perspective, problem behaviors such as self-harm, binge eating, substance misuse, or explosive anger are understood as maladaptive attempts to rapidly change or escape emotional pain—strategies that may work in the short term but carry serious long-term costs (Linehan, 1993). The Self-Soothe skill offers an alternative pathway: instead of trying to eliminate distress or act on urges, individuals learn to comfort and calm themselves through the five senses, reducing emotional intensity to a level where safer, more effective coping becomes possible.
Self-soothing is a natural human capacity. Many people intuitively use it—listening to music, taking a hot shower, cuddling a pet, or sipping tea—but individuals with severe emotion dysregulation may not access these strategies in crises, or may never have learned to use them in an intentional, structured way. DBT formalizes self-soothing into a conscious, skillful practice, encouraging clients to build personalized, sensory-based routines they can use when overwhelmed (Linehan, 2015; Neacsiu et al., 2010).
The Components of the Self-Soothe Skill
The Self-Soothe skill is organized around the five senses—sight, hearing, smell, taste, and touch. Each sense provides an avenue for shifting physiological arousal and emotional tone, especially when engaged mindfully and intentionally.
Sight
Visual stimuli can exert a profound influence on mood and arousal. In the Self-Soothe framework, clients are encouraged to deliberately surround themselves with visually calming or uplifting stimuli, such as:
Photographs of loved ones, meaningful places, or positive memories.
Nature scenes—trees, mountains, water, sunsets, or starry skies.
Soft lighting, warm colors, or aesthetically pleasing objects in their environment.
DBT handouts highlight strategies like looking at pictures in a beautiful book, watching the clouds, or creating a visually pleasing corner at home as practical ways to support nervous system down-regulation (Linehan, 2015). Exposure to natural and aesthetically pleasing visual environments has been linked in broader research to reductions in stress and improvements in mood, which reinforces the use of visual self-soothing in clinical practice.
Hearing
Sound is a powerful regulator of emotional states. The Self-Soothe skill encourages individuals to work with soothing auditory experiences, such as:
Calming or comforting music (instrumental, gentle vocals, or personally meaningful songs).
Nature sounds (ocean waves, rainfall, birdsong).
Guided meditations or relaxation recordings.
Systematic reviews and meta-analyses indicate that music interventions can reduce anxiety, stress, and physiological arousal across a variety of medical and psychological populations (Bradt et al., 2014; Bradt et al., 2016). In DBT, clients are often invited to create “soothe playlists”—collections of songs that reliably evoke calm, safety, or hope, to be used during episodes of emotional distress (Linehan, 2015).
Smell
The sense of smell has a direct and often rapid impact on mood and memory due to its close connection to limbic brain structures. Research on olfaction and mood suggests that certain odors can modulate emotional states and physiological responses (Herz, 2009; Sowndhararajan & Kim, 2016).
Within the Self-Soothe skill, clients might use:
Essential oils (e.g., lavender, chamomile, citrus) in diffusers or on a handkerchief.
Scented candles or incense that evoke feelings of safety or comfort.
Pleasant, familiar smells such as a favorite perfume, freshly laundered clothes, or the smell of coffee or baked goods.
Therapists are encouraged to help clients experiment with scents and notice which ones reduce tension, foster calm, or evoke positive associations, while also being mindful of cultural meanings and possible negative associations.
Taste
Taste can be a grounding, sensory anchor that connects individuals to the present moment. In DBT, taste is used mindfully, not as a vehicle for numbing out or bingeing. Examples include:
Slowly savoring a small piece of chocolate, a mint, or a favorite snack.
Drinking herbal tea, warm milk, or another soothing beverage.
Practicing mindful eating, paying attention to flavor, temperature, and texture, one bite at a time.
Mindfulness-based interventions that incorporate mindful eating have been associated with reductions in stress, emotional eating, and psychological distress (Kabat-Zinn, 2003). When used as Self-Soothe, the emphasis is on quality of awareness (savoring) rather than quantity of intake, which is especially important for clients with binge-eating or substance-use vulnerabilities.
Touch
Touch is central to emotional regulation and stress buffering. Soothing tactile experiences may include:
Taking a warm shower or bath.
Wrapping up in a soft blanket or wearing comfortable, cozy clothing.
Holding a comforting object (a smooth stone, stuffed animal, or textured fabric).
Petting a dog or cat or cuddling with a trusted person (with consent).
Neuroscience and psychophysiological research shows that both physical comfort and social touch can reduce stress responses and support allostatic regulation (McEwen, 2008; Krahé et al., 2016). In DBT, clients are encouraged to notice which tactile experiences help them feel grounded, safe, or soothed, and to incorporate those intentionally into their self-soothe routines.
Integrating the Senses
While each sense can be used individually, the Self-Soothe skill is often most effective when multiple senses are engaged together. DBT handouts explicitly encourage clients to create multi-sensory experiences—such as taking a warm bath (touch), with candlelight (sight), scented bath salts (smell), and calming music (hearing)—to deepen the calming effect (Linehan, 2015).
This multi-sensory approach:
Enhances immersion and present-moment focus.
Increases the likelihood of shifting physiological arousal.
Allows customization: clients can design routines that fit their preferences, culture, and environment.
Over time, these personalized self-soothing rituals become conditioned cues of safety, signaling the nervous system that it is possible to de-escalate even in the presence of intense emotion.
“Strength does not come from winning. Your struggles develop your strengths. When you go through hardships and decide not to surrender, that is strength.”
Application of the Self-Soothe Skill in Therapy
In standard DBT, the Self-Soothe skill is introduced in the Distress Tolerance module during group skills training, and reinforced in individual therapy (Linehan, 2015). Therapists typically:
Explain the rationale: Self-Soothe is not about avoidance, but about surviving emotional storms without engaging in behaviors that make things worse.
Review each of the five senses and brainstorm examples with clients.
Help clients generate individualized lists of soothing activities and stimuli for each sense.
Encourage clients to assemble a “self-soothe kit”—a physical or digital collection of items and resources they can access quickly in distress.
A self-soothe kit might include, for example: a photo or small art print (sight), a music playlist (hearing), a scented lotion (smell), herbal tea bags or hard candy (taste), and a soft scarf or stress ball (touch). Clinicians often assign homework where clients practice Self-Soothe both in mild stress situations and, when safe, during more intense episodes of distress, so the skill becomes more automatic over time.
Practical Activity: Designing Your Self-Soothe Kit
Clients (and readers) can use this simple exercise to turn the Self-Soothe concept into a concrete, personalized plan.
List Soothing Experiences for Each Sense
On a sheet of paper or in a journal, create five columns: Sight, Hearing, Smell, Taste, Touch. Under each heading, list at least 5–10 things that feel calming, comforting, or pleasant.
Identify What’s Realistic and Accessible
Mark which items you:
Already have at home.
Could obtain easily or at low cost.
Might need to adapt due to allergies, sensory sensitivities, or living situation.
Assemble a Physical or Digital Kit
Place small items (photos, oils, tea bags, stones, scarves) into a box, bag, or drawer that’s easy to reach.
Create a digital “Self-Soothe” folder or note with links to playlists, meditation audios, or images.
Practice in Low-Stress Moments
Rather than waiting for a crisis, choose one time each day to use a self-soothing activity mindfully for 5–10 minutes. Notice how your body feels before and after.
Use the Kit During Distress
When you notice rising emotional intensity (e.g., a 6–7 out of 10), deliberately choose at least one soothing activity from two or more senses. Afterward, briefly reflect: “What changed? What helped? What didn’t?”
This kind of repeated, structured practice is consistent with research showing that increased DBT skills use is linked with better treatment outcomes and reductions in self-harm and emotional dysregulation (Neacsiu et al., 2010).
Case Example: Applying Self-Soothe in Practice
“Sarah,” a 35-year-old woman with BPD and a history of binge eating and self-harm, frequently reported feeling “flooded” by shame and anger after interpersonal conflicts. Her usual coping strategies—overeating and cutting—temporarily numbed her pain but led to intense guilt and physical health problems.
In DBT, Sarah was introduced to the Self-Soothe skill and collaborated with her therapist to build a self-soothe kit that reflected her preferences and history. Her kit included:
A playlist of gentle piano music (hearing).
A lavender-scented candle (smell).
A small notebook and pen for brief expressive writing (sight/touch).
A soft scarf she associated with warmth and safety (touch).
A few pieces of dark chocolate for mindful tasting (taste).
Sarah practiced using her kit in session and between sessions during moderate stress. Over several weeks, she noticed that when she used Self-Soothe early—before distress reached its peak—her urges to binge or self-harm often decreased from “intense and uncontrollable” to “strong but manageable.”
One afternoon, after a painful criticism from a coworker, Sarah felt a surge of shame and the familiar urge to binge. Remembering her DBT skills, she paused, rated her distress as 8/10, and decided to try Self-Soothe for 20 minutes before making any decisions. She lit her lavender candle, wrapped herself in her scarf, put on her playlist, and slowly savored a small piece of chocolate while focusing on its texture and flavor. Her distress dropped to 5/10, and she was then able to journal about the interaction and later discuss it in therapy, without engaging in binge eating or self-harm.
This case illustrates how Self-Soothe can interrupt the chain from emotional trigger → overwhelming affect → maladaptive behavior, and replace it with a safer, more compassionate sequence.
Empirical Support for the Self-Soothe Skill
While there are few studies examining Self-Soothe in isolation, there is substantial evidence supporting DBT skills use and distress tolerance as mechanisms of change in BPD and related disorders.
DBT skills use as a mediator: Neacsiu et al. (2010) found that increases in DBT skills use (including distress tolerance strategies such as Self-Soothe) mediated reductions in suicidal behavior, depression, and difficulties controlling anger among individuals with BPD.
Emotional responding and distress tolerance: Rosenthal et al. (2008) highlighted that individuals with BPD display patterns of emotional responding and low distress tolerance that are central to their difficulties, underscoring the importance of skills that enable them to endure emotions without harmful action.
Mindfulness-based interventions: Mindfulness-based interventions, many of which incorporate sensory soothing and relaxation components, have demonstrated benefits in reducing anxiety, depression, and stress, supporting the broader rationale for Self-Soothe as a mindfulness-compatible distress tolerance strategy (Kabat-Zinn, 2003).
Sensory interventions: Evidence from music therapy, aromatherapy, and touch-based interventions consistently suggests that sensory modalities can reduce physiological arousal and improve mood, which aligns directly with the Self-Soothe model (Bradt et al., 2014, 2016; Herz, 2009; Sowndhararajan & Kim, 2016; McEwen, 2008).
Together, these findings support the clinical intuition that sensory-based self-soothing, when used deliberately and in combination with other DBT skills, can contribute to decreased maladaptive behaviors and improved emotional regulation.
Limitations and Considerations
Despite its value, the Self-Soothe skill is not a panacea. Several limitations and cautions are important to consider:
Short-term relief vs. long-term change
Self-Soothe is primarily a crisis survival and stabilization tool. It may not directly address chronic interpersonal problems, trauma, or systemic stressors. In situations of ongoing abuse or severe environmental stress, additional interventions—such as trauma-focused therapy, safety planning, or structural supports—are essential.
Individual differences and cultural context
Sensory preferences vary widely. A scent that is relaxing in one culture or family context may be unpleasant or triggering in another. Clinicians should collaborate with clients to identify culturally congruent and personally meaningful soothing strategies rather than imposing a generic list.
Risk of avoidance or over-reliance
There is a risk that some individuals may use Self-Soothe primarily to avoid confronting difficult issues or processing emotions. DBT addresses this by positioning Self-Soothe as one skill among many, to be used along with problem-solving, emotion regulation, and interpersonal effectiveness—not instead of them (Linehan, 2015).
Sensory sensitivities and trauma triggers
Clients with trauma histories or sensory processing differences may find certain stimuli distressing (e.g., certain smells, being touched, or particular sounds). Self-Soothe work must be carefully individualized and titrated, with attention to any triggers or adverse reactions.
Contextual limitations
In some settings (e.g., inpatient units, prisons, or resource-limited environments), access to certain soothing items may be restricted. Therapists and clients may need to be creative and resourceful, focusing on what is available (breathing, imagery, simple tactile objects) rather than ideal scenarios.
Practical Challenges in Implementing the Self-Soothe Skill
Therapists commonly encounter several practical challenges when teaching Self-Soothe:
Skepticism or unfamiliarity: Some clients may initially minimize Self-Soothe as “too simple” or “not serious enough” compared to their level of distress. Psychoeducation, modeling, and linking the skill to neurobiological concepts (e.g., arousal, allostatic load) can increase buy-in (McEwen, 2008).
Limited resources: Clients with financial constraints may feel unable to assemble elaborate kits. Therapists can emphasize low-cost or no-cost options (e.g., free meditation apps, nature walks, tap water baths, home-made scent sachets).
Inconsistent practice: As with all DBT skills, Self-Soothe works best with repetition. Clients may need encouragement, reminders, and in-session practice to build the habit of using the skill before crises peak (Neacsiu et al., 2010).
Group dynamics: In DBT skills groups, clients have diverse backgrounds and triggers. Facilitators must carefully present examples that are inclusive and flexible, inviting participants to adapt the skill to their own lives.
When these challenges are addressed collaboratively and creatively, Self-Soothe can become a natural part of a client’s coping repertoire rather than a technique they only remember on paper.
Conclusion
The Self-Soothe skill is a core element of DBT’s Distress Tolerance module, offering individuals a structured, sensory-based approach to surviving intense emotional states without resorting to self-harm or other maladaptive behaviors. Grounded in the understanding that people with BPD and related difficulties often experience distress as intolerable, Self-Soothe provides a practical, accessible way to activate the body’s natural calming systems using sight, hearing, smell, taste, and touch (Linehan, 2015).
When embedded within a comprehensive DBT program—and used alongside mindfulness, emotion regulation, and interpersonal effectiveness skills—Self-Soothe can help clients:
Reduce the intensity of acute emotional crises.
Interrupt chains that lead from emotional pain to self-destructive behavior.
Develop a more compassionate, nurturing relationship with themselves.
Although Self-Soothe has limitations and must be tailored to each individual’s context, preferences, and sensitivities, its theoretical rationale is strong and its use is supported by research on DBT skills, distress tolerance, and sensory-based interventions. As part of the broader DBT toolkit, Self-Soothe offers a concrete, hopeful path toward safer, kinder ways of managing emotional pain and building a life that feels more stable and worth living.
FAQ
Most frequent questions and answers about the "HOW" Skills in DBT
The Self-Soothe skill is a Distress Tolerance strategy in DBT that uses the five senses (sight, hearing, smell, taste, touch) to calm and comfort yourself during emotional distress. Instead of acting on urges like self-harm, bingeing, or lashing out, you deliberately engage in soothing, sensory-based activities to reduce emotional intensity and help your nervous system settle.
Self-Soothe is about surviving the moment safely, not permanently escaping reality. The goal is to:
Lower your emotional arousal enough so you don’t make things worse.
Create space to later use problem-solving, emotion regulation, or interpersonal skills.
Avoidance means you never return to the problem. Self-Soothe means: “I’m too overwhelmed to think clearly right now, so I will calm myself first, then come back to it more wisely.”
Here are easy, everyday options:
Sight: Look at nature, candles, fairy lights, art, or photos you love.
Hearing: Listen to calming music, nature sounds, or a grounding podcast.
Smell: Use a favorite perfume, lotion, essential oil, or smell coffee/tea.
Taste: Slowly savor a mint, piece of chocolate, or warm tea mindfully.
Touch: Wrap yourself in a soft blanket, hold a smooth stone, pet an animal, or take a warm shower.
The key is to pay attention to the sensations, not just do them on autopilot.
Use Self-Soothe when:
Your distress is high (for example, 7–10 out of 10).
You notice strong urges to self-harm, binge, use substances, or explode.
You feel emotionally “flooded,” numb, or overwhelmed and can’t think clearly.
It’s also helpful to practice when you’re only mildly stressed, so the skill feels more natural and available when a real crisis hits.
That’s very common, especially at the beginning. A few tips:
Start by experimenting: what feels even 5% more calming or less tense? It doesn’t have to be perfect.
Make it personal: soothing might mean listening to metal at lower volume, organizing a drawer, or holding an ice cube—whatever genuinely helps you.
Expect awkwardness at first; new skills often feel “fake” before they feel natural.
Over time, as you repeat Self-Soothe on purpose, your brain begins to associate these activities with safety and relief, making them more effective and less “silly” with practice.
The Self-Soothe Skill Book Recommendations
Here is a collection of the best books on the market related to the Self-Soothe Skill:
Our commitment to you
Our team takes pride in crafting informative and well-researched articles and resources for our readers.
We believe in making academic writing accessible and engaging for everyone, which is why we take great care in curating only the most reliable and verifiable sources of knowledge. By presenting complex concepts in a simplified and concise manner, we hope to make learning an enjoyable experience that can leave a lasting impact on our readers.
Additionally, we strive to make our articles visually appealing and aesthetically pleasing, using different design elements and techniques to enhance the reader’s experience. We firmly believe that the way in which information is presented can have a significant impact on how well it is understood and retained, and we take this responsibility seriously.
Click on the icon to see all your thoughts in the Dashboard.
Your Thoughts about the Self-Soothe Skill in DBT
It’s highly recommended that you jot down any ideas or reflections that come to mind regarding the Self-Soothe Skill in DBT, including related behaviours, emotions, situations, or other associations you may make. This way, you can refer back to them on your Dashboard or Reflect pop-ups, compare them with your current behaviours, and make any necessary adjustments to keep evolving. Learn more about this feature and how it can benefit you.
References
- Bornovalova, M. A., Gratz, K. L., Daughters, S. B., Hunt, E. D., Malone, T., & Lejuez, C. W. (2008). A multimodal assessment of the relationship between emotion dysregulation and borderline personality disorder among inner-city substance users in residential treatment. Journal of Psychiatric Research, 42(9), 717–726.
- Bradt, J., Dileo, C., & other collaborators. (2014). Music interventions for mechanically ventilated patients. Cochrane Database of Systematic Reviews, 2014(12), CD006902.
- Bradt, J., Dileo, C., & Magill, L. (2016). Music interventions for improving psychological and physical outcomes in cancer patients. Cochrane Database of Systematic Reviews, 2016(8), CD006911.
- Herz, R. S. (2009). Aromatherapy facts and fictions: A scientific analysis of olfactory effects on mood, physiology and behavior. International Journal of Neuroscience, 119(2), 263–290.
- Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156.
- Krahé, C., Paloyelis, Y., Sprenger, C., & Fotopoulou, A. (2016). Keep calm and cuddle on: Social touch as a stress buffer. Social and Personality Psychology Compass, 10(7), 359–377.
- Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
- Linehan, M. M. (2015). DBT® skills training manual (2nd ed.). Guilford Press.
- 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.
- Rosenthal, M. Z., Gratz, K. L., Kosson, D. S., Cheavens, J. S., Lejuez, C. W., & Lynch, T. R. (2008). Borderline personality disorder and emotional responding: A review of the research literature. Clinical Psychology Review, 28(1), 75–91.
- Sowndhararajan, K., & Kim, S. (2016). Influence of fragrances on human psychophysiological activity: With special reference to essential oils. BioMed Research International, 2016, Article 154–213.
- McEwen, B. S. (2008). Central effects of stress hormones in health and disease. Dialogues in Clinical Neuroscience, 10(4), 359–368.
