Using Somatic Therapy to Support DBT in the Therapy Room
Play the audio version on Substack →
This week’s Tend to it Tuesday focused on the ways somatic therapy can enhance Dialectical Behaviour Therapy (DBT), a widely respected modality for emotional regulation. Today, I’m sharing what that looks like from the therapist’s perspective — especially when clients are trying to apply what they’ve learned in real-life, high-intensity moments.
🧘♀️ Skills Work Better When the Body Feels Safe
DBT offers powerful, life-changing skills — mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness — but for many clients, there’s a catch:
“I know the skill… but I can’t use it when I need it most.”
As a therapist, I’ve heard this again and again. And I believe them. Not because the skill isn’t effective — but because the nervous system needs to feel safe enough to use it.
This is where somatic therapy becomes an ally. Before reaching for a worksheet or checklist, I often guide clients into their bodies. We might take 30 seconds to feel their feet on the ground, notice their breath, or even track tension in the jaw or belly.
The goal isn’t to replace DBT — it’s to prepare the system to receive it.
🛋️ In the Therapy Room
Here’s how I use both DBT and somatic therapy together with clients:
If a client comes in flooded, we’ll begin with grounding: orienting to the room, deepening breath, or using sensory focus (like textures or temperatures).
Then we explore: What skill do you wish you could’ve used? And, What got in the way?
Somatically, we might ask: Where does that urgency or fear live in your body? Can we stay with it together, just a little longer?
Over time, the body begins to associate skill use with safety — not stress.
This is especially useful for clients navigating:
Complex PTSD
High sensitivity or hypervigilance
Black-and-white thinking
Overwhelm in conflict or crisis
It’s not about perfection. It’s about widening the window of possibility.
✨ A Practice for Therapists and Clients
Before you practice a skill, practice presence.
Here’s a short prep ritual I often recommend (and use myself):
Sit with your feet planted or your back supported.
Take one hand to your chest or belly. Feel your breath rise and fall.
Ask:
What’s happening in my body right now?
What emotion is most present?
What do I need before I move into action?
Sometimes the wisest skill is simply pausing.
📣 Call to Action
If you’re finding DBT helpful in theory, but hard to access in practice, it might be time to bring your body into the conversation.
Somatic therapy can help build the bridge between knowing and feeling. Between theory and choice.
