Opposite Action DBT: Examples and a Printable Worksheet

Opposite action is the DBT emotion regulation skill for an emotion that doesn't fit the facts. The client checks whether the feeling matches what is actually happening, notices what the feeling is pushing them to do, and then does the opposite, all the way: in what they do, how they hold their body, what they say and where they put their attention. This page gives you opposite action DBT examples for seven emotions, a printable opposite action worksheet written to your client, and the part most guides skip: when the emotion fits the facts and opposite action is the wrong tool.

After the worksheet comes the part for you: how to teach and rehearse the skill in session, how to adapt it for teens, how to note it in a progress note, and what the research does and doesn't show. Print this page or save it as a PDF, and fill in the first worksheet together in session.

About this page. Opposite action comes from Marsha Linehan's dialectical behavior therapy (DBT). Our explanations are based on her DBT Skills Training Manual, 2nd edition (Guilford Press, 2015); Guilford published a revised edition in August 2025 that keeps the same skills. Linehan's handouts and worksheets are copyrighted, and we don't reproduce them. The wording, examples and layout of the worksheet here are our own.

Every client and example in this article is invented. Any resemblance to a real person is a coincidence.

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What is opposite action in DBT?

Opposite action belongs to the emotion regulation module of DBT, in the group of skills for changing an emotional response, alongside check the facts and problem solving. Our DBT worksheets page covers the four modules and has a short version of each of these skills. For every skill in every module, see our DBT skills list.

The idea is simple. Every emotion comes with an urge to act. Fear pushes us to escape or avoid. Anger pushes us to attack. Sadness pushes us to withdraw. Shame pushes us to hide. Acting on the urge tends to keep the emotion going: each avoided situation feels a little more dangerous next time, and each day in bed makes the next day harder to start. When the emotion fits the situation, that urge is useful. When it doesn't, acting against it gives the emotion a chance to fade.

Two questions decide whether to use the skill:

Does the emotion fit the facts?That means the emotion itself, and also its strength and how long it has lasted. Fear of a dog that bit you last week fits. Panic every time any dog is across the street is fear that has grown past the facts.
Would acting on the urge be effective here?Even a fitting emotion can push toward something that makes life worse. Anger at an unfair manager can fit perfectly, and shouting at them can still cost the client their job.

Opposite action is not suppressing a feeling, pretending to be happy, or deciding the feeling is wrong. The client names the emotion, accepts that it is there, and chooses an action that doesn't feed it. Linehan's phrase for the last part is acting opposite "all the way". Going to the party while staring at the floor and rehearsing an exit is half the way; so is a polite word said through clenched teeth. All the way means:

What you do:the opposite action itself, not a watered-down version.
Your body:posture, face and hands that match the opposite action (shoulders down and hands open instead of fists, head up instead of hidden).
Your voice and words:a steady, warm or matter-of-fact tone, depending on the emotion.
Your thoughts and attention:for anger, trying to see the other person's side instead of replaying the insult; for fear, attention on the task instead of on scanning for danger.
Again and again:one try rarely shifts a well-practiced emotion. Repeat it until the emotion comes down.

Opposite action overlaps with two treatments most therapists know. For fear, it works like exposure: approach instead of avoid, and stay long enough to learn something new. For sadness and depression, it works like behavioral activation: act on a plan, not on the mood. What DBT adds is a single method a client can use across many emotions, starting with one question about the facts.

Linehan included opposite action in her first skills manual in 1993, and it has been part of the emotion regulation module since. It also appears outside DBT: the Unified Protocols for children and adolescents introduce a skill they also call opposite action, practiced through behavioral experiments (Ehrenreich-May et al., 2017).

The steps of opposite action

Linehan's manual breaks the skill into steps. Here is our version, in our own words:

Name the emotion. Be specific: "ashamed" rather than "bad", "jealous" rather than "upset". Rate it from 0 to 10.
Check the facts. What happened, as a video camera would record it? What is the mind adding to the facts? Does the emotion fit, and does its size fit?
Name the urge. What does the emotion want you to do or say? Write it as an action: "cancel the plans", "check his phone", "stay in my room".
Ask whether acting on the urge would help. Would it move you toward what you want, or make things worse? Do you want this emotion to change right now?
Choose the opposite action. The opposite of the urge, plus the body, voice and thoughts that go with it.
Do it all the way. Not halfway, not with an escape hatch. Expect the emotion to rise for a moment before it falls, especially with fear.
Repeat until the emotion comes down. Rate it again afterward, and do it again the next time the emotion shows up.

If the client can't name the emotion, start there. Opposite action aimed at the wrong emotion can backfire: treating hurt as if it were anger, or shame as if it were guilt, leads to the wrong opposite.

Does the emotion fit the facts? Choosing between opposite action and problem solving

There are three common answers, and each leads somewhere different:

The emotion fits, and acting on it would help:act on it, and solve the problem. Fear of an unsafe situation means getting safe. Anger at being treated unfairly may mean asking for a change, and our DEAR MAN worksheet and therapist guide helps with that conversation.
The emotion fits, but acting on the urge would make things worse:don't act on the urge, and still solve the problem. Opposite action can bring the intensity down far enough for the client to think. A client who is rightly angry at a parent can walk away, unclench, and come back to the conversation tomorrow.
The emotion doesn't fit, or it's much bigger or longer-lasting than the facts call for:opposite action, all the way.

"Partly" is a common answer. Some anger fits a coworker taking credit for your work; rage at 9 out of 10 that lasts a week may not. In that case, problem solving deals with the part that fits, and opposite action deals with the size.

The check is about the facts, not about whether the client is allowed to feel something. "Your fear makes sense given what happened to you before. Does it fit this situation?" keeps the validation and the question in the same breath.

Opposite action DBT examples for seven emotions

For each emotion below: when it usually fits the facts, the urge that comes with it, what acting opposite all the way looks like, an invented example, and what to do if the emotion fits instead.

Opposite action for fear

Fits the facts when:there's a real threat to your life, health or wellbeing, or to someone you care about.
The urge:escape, avoid, freeze, check again, ask for reassurance, bring a "safe" person or object.
Opposite action, all the way:approach the thing you've been avoiding, a step at a time, and stay. Do it again and again. Do things that build a sense of competence. Head up, shoulders down, slow breath, steady voice. Drop the safety behaviors one by one.
Example (invented):Leo, 34, hasn't driven on the highway since a minor accident two years ago and now takes a 50-minute side route to work. The facts: his driving record is clean and the road is ordinary. He starts with one exit on a quiet Sunday morning, then two, then the commute, with the radio on and his hands loose on the wheel instead of gripping it.
If it fits:get safe, and solve the problem. Fear of a partner who has hurt you fits. Approaching that person is not the opposite action; a safety plan is.

Opposite action for anger

Fits the facts when:something important to you is blocked, or you or someone you care about is attacked, hurt, insulted or threatened.
The urge:attack, yell, criticize, slam a door, send the message, replay the insult over and over.
Opposite action, all the way:gently step away from the person instead of attacking, and stop rehearsing the argument in your head. Do something a little kind, or at least not hostile. Try to see the situation from the other person's side. Unclench your jaw and hands (Linehan calls open, relaxed hands "willing hands"), breathe slowly, and soften your voice. A slight, relaxed half-smile, not a forced grin, is part of the same skill.
Example (invented):Dana, 41, gets a curt one-line email from her sister about their mother's care and starts typing a three-paragraph reply. She checks the facts: her sister works nights and writes short emails to everyone. Dana closes the laptop, goes for a walk, and the next morning replies with one warm line and a question.
If it fits:don't act on the urge to attack, and solve the problem: ask for what you need, set a limit, or report the mistreatment. Anger at discrimination or abuse fits. Opposite action is never a way to make a client swallow an injustice.

Opposite action for sadness

Fits the facts when:you've lost someone or something that mattered, or things aren't turning out the way you wanted or hoped.
The urge:withdraw, stay in bed, go quiet, cancel plans, stop doing things that used to matter.
Opposite action, all the way:get active. Approach people and activities instead of avoiding them, do something that gives a small sense of mastery, and pay attention to what's in front of you while you do it. Sit up, open the curtains, speak a little more brightly than you feel. This is opposite action for depression in the form most clients will recognize, and it overlaps with behavioral activation.
Example (invented):Amir, 58, retired in the spring and has barely left the house since. He used to coach youth soccer. He agrees to watch one practice from the sideline on Saturday, then to bring the oranges the week after, and rates his mood before and after each.
If it fits:grief after a loss fits. Let it be grief: talk about the person, accept support, and allow the sadness. Opposite action can still help with the parts that have grown past the loss, such as months of not seeing anyone. If low mood keeps going, screen for depression and for suicidal thoughts; the PHQ-9 scoring calculator adds up the score for you.

Opposite action for shame

Fits the facts when:people or a group who matter to you would reject you if they knew about something you did or something about you.
The urge:hide, avoid people, look down, cover up, over-explain, attack yourself.
Opposite action, all the way:let yourself be seen by people who won't reject you. Tell a trusted person, or keep doing the thing in the open. Hold your head up, make eye contact if that feels right to you, and speak in a steady, matter-of-fact voice. Don't apologize for something that isn't wrong.
Example (invented):Nadia, 29, was let go from her job three weeks ago and has been dodging her friends' calls, afraid they'll see her as a failure. She checks the facts: two of these friends have been laid off themselves. She calls one and says it plainly, without a long defense: "I lost my job. I'm looking. I could use a coffee."
If it fits:there are two kinds of fit. If shame comes from something that also harmed someone, repair it (see guilt, below). If a group would reject the client for something that isn't wrong by the client's values, such as their sexuality, a disability, a mental health condition, or being a survivor, the shame fits that group's facts but not the client's values. Then the client chooses: keep it private from that group for now, look for people and communities who won't reject them, and practice opposite action with those people. Keeping something private for safety is a legitimate choice, not a failed skill.

Opposite action for guilt

Fits the facts when:what you did goes against your own values or moral code.
The urge:over-apologize, over-explain, make up for it again and again, punish yourself, avoid the person.
Opposite action, all the way:if the guilt doesn't fit, keep doing what set it off, as long as it fits your values. Keep saying no, keep resting, keep the boundary. Stop apologizing and stop justifying. Stand and speak as someone who hasn't done anything wrong, because you haven't.
Example (invented):Grace, 45, feels guilty every time she leaves her father with a paid caregiver for an evening, though he's safe and well looked after. She checks the facts: taking an evening off doesn't break any value she holds. She keeps her Thursday class and stops texting the caregiver every half hour.
If it fits:apologizing and repairing is what you do when guilt fits the facts. It isn't the opposite action. Repair the harm, apologize sincerely once, accept the consequences, commit to doing differently, and then let it go. Many handouts blur shame and guilt here; the difference matters, because "apologize" helps fitting guilt and feeds unfitting shame.

Opposite action for jealousy

Fits the facts when:a relationship or something you value is at real risk of being taken away, or someone is actually trying to take it.
The urge:check their phone, ask where they were, accuse, cling, control who they see, compete.
Opposite action, all the way:stop checking and stop questioning. Let go of controlling the other person. Relax your face and hands, slow your breathing, and look at all the facts, not just the ones that feed the suspicion. Share time and attention instead of guarding.
Example (invented):Malik, 37, feels his chest tighten when his wife mentions lunch with a new coworker. He checks the facts: she told him about it herself, and nothing else has changed. Instead of asking three follow-up questions, he asks how her day was, and puts his phone away during dinner.
If it fits:if there's real evidence of an affair or a threat to the relationship, talk about it directly, and make decisions about the relationship. Jealousy can also be part of coercive control. If your client is on the receiving end of a partner's monitoring and control, it's a safety question, not a skills exercise.

Opposite action for disgust

Fits the facts when:something could contaminate or sicken you, or someone's behavior or beliefs could harm you or people you care about.
The urge:push away, avoid, look away, scrub, show contempt.
Opposite action, all the way:move closer to the person or thing, and take in what you're seeing instead of turning away. Be kind to the person. Try to understand their point of view. Relax your face; disgust shows quickly around the mouth and nose.
Example (invented):Rosa, 52, feels disgust whenever her adult son, now eight months sober, comes to visit, and finds herself keeping her distance. She checks the facts: he is sober and the visits have gone well. She sits next to him on the porch, asks about his work, and lets the conversation run on.
If it fits:keep your distance from what is truly harmful: spoiled food, a person who is a danger, an unwanted sexual advance. Disgust in those moments is protective. For contamination fears in OCD, exposure and response prevention is the specialist treatment, and opposite action should be part of that plan rather than separate homework.

Two more: envy and love. Linehan's handouts also cover envy and love. Envy fits when someone has something you want or need and don't have; acting opposite means stopping the put-downs and the sabotage and noticing what you do have. Love fits when the person (or animal or thing) makes your life better. When love doesn't fit, for example love for a partner who keeps hurting you, the opposite action is distance: less contact, fewer reminders, and a list of the reasons this love doesn't serve you. For a client in an abusive relationship, that list belongs in a safety plan.

When not to use opposite action

The emotion fits the facts, and acting on it helps.Fear of real danger, anger at real mistreatment, grief after a real loss, guilt after real harm. Validate it and solve the problem.
Safety is at stake.Never ask a client to approach a person who has hurt them or who frightens them. Safety planning comes first, and in the US the National Domestic Violence Hotline can help a client make a plan (1-800-799-7233, or text START to 88788).
Suicidal or self-harm behavior is active.DBT treats life-threatening behavior before anything else. Assess risk and make or update a safety plan; our safety plan template is one place to start. Opposite action homework can wait. In the US, the 988 Suicide & Crisis Lifeline takes calls and texts.
The emotion is too intense to think.At 9 or 10 out of 10, nobody checks the facts. Use crisis survival skills first, such as the TIPP plan in our DBT worksheets, and come back to opposite action once the intensity drops.
Trauma reminders, flashbacks or dissociation.Approaching trauma reminders is exposure work, and it belongs inside a trauma-focused plan, not as ad hoc homework. Ground first, with something like our 5-4-3-2-1 grounding worksheet, and check the client is within their window of tolerance.
An eating disorder or a medical condition is involved."Eat the food that disgusts you" or "do the exercise you fear" needs a coordinated plan with the client's medical and eating disorder team.
It's being used to self-invalidate.If a client uses the skill to tell themselves "I shouldn't feel this", slow down and go back to check the facts. The skill starts with accepting the emotion.
The emotion is misread.Anxiety that is really anger, or guilt that is really shame, needs naming before choosing an opposite.

Opposite action worksheet

Doing the opposite of what an emotion is pushing you to do

Every emotion comes with an urge. Fear says run. Anger says attack. Sadness says pull away. Shame says hide. When the emotion fits what's really happening, the urge can be useful. When it doesn't fit, or it's much bigger than the situation, acting on the urge usually makes the feeling stronger. Doing the opposite, all the way, gives it a chance to settle.

Fill this in with your therapist the first time. After that, use it on your own.

Part 1: Check it

The emotion I'm feeling: ______________________
How strong it is, 0 to 10: ______
What happened, only the facts a video camera would record: ______________________
What my mind is adding (guesses, assumptions, what I think it means): ______________________
Does the emotion fit the facts? Yes, partly or no: ______
Does its strength fit the facts? Yes, partly or no: ______
If I act on the urge, will things get better or worse? ______________________
Do I want this emotion to change right now? ______

If the emotion fits and acting on it would help, stop here and work on the problem itself, with your therapist if you need to.

Part 2: Name the urge

What the emotion wants me to do: ______________________
What it wants me to say: ______________________
What my body is doing (face, hands, shoulders, breathing): ______________________
What my mind keeps going back to: ______________________

Part 3: My opposite action, all the way

What I'll do instead: ______________________
How I'll hold my body (posture, face, hands): ______________________
How my voice will sound: ______________________
What I'll say, if I'm talking to someone: ______________________
Where I'll put my attention, or what I'll think instead: ______________________
When and where I'll do it: ______________________
How many times I'll do it this week: ______

Part 4: After

How strong the emotion is now, 0 to 10: ______
Did I do it all the way? Yes, partly or no: ______
Anything I did halfway, or any escape hatch I kept: ______________________
What I noticed in my body and my thoughts: ______________________
What I'll do the same or differently next time: ______________________

Urges and their opposites: a quick guide

Fear says avoid. The opposite: approach, a step at a time, and stay.
Anger says attack. The opposite: step away gently, unclench, and be a little kind.
Sadness says withdraw. The opposite: get active and reach out.
Shame says hide. The opposite: let people who won't reject you see you, head up.
Guilt that doesn't fit says keep apologizing. The opposite: stop apologizing and keep doing what's right for you.
Jealousy says check and control. The opposite: stop checking and give the person room.
Disgust says push away. The opposite: move closer and be kind, as long as it's safe.

Practice log

The emotion often stays the same, or gets stronger, the first time you act opposite. That's normal. It usually takes a few tries.

Date: ______ Emotion: ______ Before, 0 to 10: ______ All the way? ______ After, 0 to 10: ______
Date: ______ Emotion: ______ Before, 0 to 10: ______ All the way? ______ After, 0 to 10: ______
Date: ______ Emotion: ______ Before, 0 to 10: ______ All the way? ______ After, 0 to 10: ______
Date: ______ Emotion: ______ Before, 0 to 10: ______ All the way? ______ After, 0 to 10: ______
Date: ______ Emotion: ______ Before, 0 to 10: ______ All the way? ______ After, 0 to 10: ______

Bring this sheet to your next session, including the times it didn't work. Those tell your therapist the most.

When not to use this on your own

If you're afraid of someone, don't approach them because of this sheet. Talk to your therapist first: staying safe comes before any skill. In the US, the National Domestic Violence Hotline is 1-800-799-7233, or text START to 88788.
If your emotion is so strong you can't think, use your crisis plan first and come back to this later.
If you might hurt yourself or someone else, call or text 988, call 911, or go to the nearest emergency room.

End of the worksheet. The rest of this page is for therapists.

How to teach opposite action in session

Linehan describes three stages of learning a skill: acquiring it, strengthening it through practice with feedback, and generalizing it to daily life. One session can do the first two. The third takes weeks of practice between sessions. A sequence that works in individual sessions:

Start with a recent moment from the client's week when an emotion took over: the plans they canceled, the text they sent, the day they stayed in bed. That moment becomes the first worksheet.
Teach what emotions are for. Each one prepares us to act, and the urge is information, not an order. Clients who see emotions as useful find it easier to question one that doesn't fit.
Check the facts together before you mention the opposite. If you jump straight to "do the opposite", the client hears "your feeling is wrong".
Write the urge as a behavior, something a camera could record. "Feel less anxious" isn't an urge; "leave the store" is.
Build the opposite in every channel: the action, the body, the voice, the words and the thoughts. Ask the client to show you the posture, not just describe it.
Practice it in the room. For shame, the client says the sentence they've been hiding, to you, head up and voice steady, two or three times, rating shame each time. For anger, they describe the person while keeping their hands open and their voice soft, and notice whether anything changes. For fear, they take the first step during the session: open the email, make the call, stand at the door. For sadness, they choose and schedule one activity before they leave.
Rate before and after, from 0 to 10, every time. The numbers show the client the emotion moving, and give you something to note.
Plan the week: which situation, when, where, and how many times. One emotion at a time.
Review the practice log first at the next session, before the week's events take over the hour.

When it "didn't work", work through the usual reasons:

The emotion was misnamed, so the opposite was aimed at the wrong target.
The emotion fit the facts, and problem solving was the better tool.
It wasn't all the way. Sarcasm, a stiff smile, an escape route kept open, or ruminating the whole time all count as halfway.
Once wasn't enough. Emotions that have been practiced for years need repetition, and fear often rises before it drops.
The client didn't want the emotion to change. Anger can feel protective, and some sadness feels loyal to the person who was lost. Talk about that openly, and weigh the pros and cons of changing it, before assigning more practice.

In a skills group, teach with short demonstrations: one member says a sentence in a "shame posture" and again with head up, and the group notices the difference. Then practice in pairs with each member's own situation.

By video, posture, face and voice are easy to see and coach on camera. A client at home can also do a first approach step during the session, such as sending the message they've been avoiding, with you there.

Adapting opposite action for teens

DBT for adolescents teaches skills to teens and their caregivers together, usually in a multifamily group, and adds a fifth module, Walking the Middle Path (Rathus & Miller, 2015). The Unified Protocol for adolescents introduces opposite action in a module built around behavioral experiments, starting with sadness and withdrawal (Ehrenreich-May et al., 2017).

Call it an experiment. "Try the opposite twice this week and see what happens to the feeling" is easier for a teen to agree to than "this will make you feel better".
Use their situations: avoiding first period after a bad day, deleting a post and hiding after a group chat turns on them, checking a best friend's stories after she makes a new friend, a door slammed after a parent's no.
Keep it short. For a teen, the worksheet can be four lines: the emotion and its number, the urge, what I did instead, the number after. Phone notes or a voice memo are fine.
Teach caregivers the same skill. Parents who understand opposite action are less likely to accommodate avoidance (letting a teen skip school whenever anxiety spikes) and more likely to notice and praise approach.
Don't let it become a weapon. "Do your opposite action" shouted across the kitchen will kill the skill. Agree with caregivers on how they'll prompt it, if at all.
Check the facts carefully. A teen's fear of a bully, an unsafe adult or an online threat may fit. Then the job is problem solving and adult help, not approach.
Adapt the body cues. Eye contact isn't required for opposite action, and many autistic teens find it uncomfortable. Head up, a steady voice and staying in the room do the same job.
Agree on confidentiality first, and follow your safety and reporting procedures if a worksheet reveals self-harm, suicidal thinking or abuse.

How to note opposite action in a progress note

"Practiced DBT skills" tells a reviewer almost nothing. A useful note names the skill, ties it to a treatment goal, and records what the client could do.

The skill by name: "opposite action (DBT emotion regulation skill)", and the emotion it targeted.
The facts check: whether the emotion fit the facts, and how you decided.
How you taught it: explanation, modeling, a worksheet, rehearsal in session.
The client's response: ratings before and after, and whether they did it all the way.
The practice assigned or reviewed: which situations, how often, and what happened.
Safety: when you assessed risk, what you asked and what the client said.
The treatment goal the skill serves.

An example in BIRP format. Invented client: a 29-year-old we'll call Nadia, in her ninth video session of DBT-informed individual therapy for emotion dysregulation and self-criticism. Treatment goal 2: reduce avoidance of friends and family driven by shame.

Wording to copy26 lines

Behavior: Client joined by video from home inColorado, alone, private room confirmed. Reportedavoiding calls and messages from friends for threeweeks since losing her job: "They'll think I'm afailure." Shame 8/10 when describing it. Did notcomplete last week's practice log. Denied thoughtsof suicide or self-harm when asked.

Intervention: Reviewed the barrier to practice.Completed check the facts with client: two of thefriends she is avoiding have been laid offthemselves; no one has criticized her. Taughtopposite action for shame (DBT emotion regulationskill) using a written worksheet. Modeled telling afriend in a steady voice; client rehearsed thesentence 3 times with head up and withoutapologizing.

Response: Client rated the shame as stronger thanthe facts support. Shame fell from 8/10 to 5/10across the three rehearsals. Client described theskill accurately in her own words and identifiedover-explaining as her version of hiding.

Plan: Client will call one friend by Saturday, usethe practiced sentence, and log shame before andafter; second contact optional. Therapist willreview the log first next session. Goal 2continues. Next video session in one week.

A treatment plan objective this note supports: "Within 8 weeks, client will use opposite action for shame that doesn't fit the facts in at least 3 recorded situations a week, with shame ratings dropping 2 points or more in most entries." Our treatment plan template shows how to write goals and objectives around a skill.

Phrases you can adapt:

"Checked the facts with client; fear rated as too strong for the situation."
"Taught opposite action for fear; client completed the first approach step in session."
"Client rehearsed opposite action posture and voice for shame 3 times; shame 8/10 to 5/10."
"Emotion judged to fit the facts; problem solving used instead of opposite action."
"Reviewed practice log: opposite action used 4 times; average anger rating 7/10 before, 4/10 after."
"Client identified half-hearted practice (kept an exit plan); rehearsed acting opposite all the way."

The same content fits other formats. In a DAP note, the facts check, rehearsal and ratings all go in Data. In a SOAP note, the client's report goes in Subjective and the rehearsal you watched in Objective. The BIRP note examples compare the formats line by line, and the progress notes cheat sheet lists intervention terms for DBT skills work, opposite action included.

Does opposite action work? What the research shows

Opposite action is used widely, but it has rarely been studied on its own. The research is small and worth knowing in detail:

Shame in borderline personality disorder.Shireen Rizvi and Linehan built a brief treatment for shame around opposite action and tested it in a small pilot (Rizvi & Linehan, 2005). In the dissertation behind it, five clients were treated after a pilot case; shame about specific events came down within sessions, shame ratings varied a lot from one measurement to the next, and no one dropped out (Rizvi, 2004).
A laboratory test of the skill itself.Sixteen adults with borderline personality disorder came to six lab sessions. After an emotion was induced, they acted opposite to it in some sessions and in line with it in others. Acting opposite brought sadness and guilt or shame down more than acting in line with them; for anxiety and anger there was no clear difference. The authors suggest the benefit for anxiety may need repeated practice over time, that acting on anger may feel rewarding to some people, and that the findings need replicating outside the lab (Sauer-Zavala et al., 2019).
Skills use as part of how DBT works.Across three studies of 108 women with borderline personality disorder, those in DBT reported using far more skills by the end of treatment, and skills use mediated the drop in suicide attempts and depression (Neacsiu, Rizvi & Linehan, 2010). That study measured DBT skills in general, not opposite action alone.

What this means in practice: teach opposite action as one skill inside a treatment plan, measure it with before and after ratings, and expect fear to need repetition. For fear, the approach behavior behind opposite action is the same principle as exposure therapy, which has a far larger evidence base of its own.

DBT or DBT-informed? Comprehensive DBT includes individual therapy, a skills group, phone coaching and a therapist consultation team (DBT-Linehan Board of Certification). Teaching opposite action in individual sessions without the rest is DBT-informed skills work. It's useful and common, but describe it accurately unless you deliver the full model, and if you haven't trained in DBT, take a course and ask a DBT-trained colleague to look at how you use it.

How to describe skills work like this on your practice website

People searching for help with intense emotions often look for "DBT" by name, and some are looking for a full program. Plain, accurate wording helps the right clients book with you. A starting point you can adapt for the "My approach" or "Services" section of your website:

How I work with intense emotionsTemplate

How I work with intense emotions

I teach practical skills from dialectical behaviortherapy (DBT) in individual sessions. Together welook at whether a feeling fits what is actuallyhappening, and when it doesn't, we practice small,concrete steps, such as doing the opposite of whatfear or shame is pushing you to do. You'll leaveeach session with something to practice duringthe week.

I offer DBT-informed individual therapy. I don'trun a full DBT program with a skills group andphone coaching.

Keep the last paragraph only if it's true for you, and change it if you do offer a group or coaching.

How this works in TranqBay

TranqBay is practice software for therapists in private practice: a practice website, online booking, video sessions and session notes in one place. Here's where opposite action work fits.

Your practice website is where people looking for help with intense emotions read how you work. The wording above would go in its "My approach" or "Services" section.
Online booking lets clients book the follow-up session where you review their practice log.
Video sessions are end-to-end encrypted and HIPAA-ready. TranqBay provides a Business Associate Agreement that applies when you accept the Terms, with no separate document to sign. Posture and voice rehearsal works well on camera, and a client can open this page during the session.
Session notes come in BIRP, DAP, SOAP or GIRP format, or as a blank note in your own words. The structured formats are part of the advanced note templates, which some plans include.
Forms for a session. The form library has ready-made templates you can send a client for a session, including intake, consent to treat, telehealth consent, release of information, the PHQ-9 and the GAD-7. The client fills them in online and the answers wait with the session. TranqBay doesn't score them.
The worksheet lives on this page. Send your client the link, or print it.

At practice.tranqbay.health you can look at a practice website's "My approach" and "Services" sections, where you'd describe DBT-informed work, and the booking page a client would use.

Frequently asked questions about opposite action

What is the opposite action skill?

An emotion regulation skill from dialectical behavior therapy. When an emotion doesn't fit the facts, or acting on it wouldn't help, you do the opposite of what it's urging, all the way, so the emotion has a chance to settle.

What are the steps of opposite action?

Name the emotion, check the facts, name the urge, ask whether acting on the urge would help, choose the opposite action, do it all the way, and repeat until the emotion comes down.

What is an example of opposite action?

Someone who has been avoiding friends out of shame after losing a job calls one friend and tells them plainly, head up, without a long apology. Someone afraid of highway driving after a minor accident drives one exit on a quiet morning, then two. There are examples for seven emotions above.

When should you not use opposite action?

When the emotion fits the facts and acting on it helps; when approaching something would put the client in danger; during a suicidal or self-harm crisis; when the emotion is too intense to think; and for trauma reminders outside a trauma-focused plan.

Is opposite action the same as suppressing or faking a feeling?

No. Suppressing means pushing the feeling away, and faking means pretending it isn't there. Opposite action starts by naming and accepting the emotion, then changes the action that would keep it going. A forced smile over clenched fists isn't opposite action; that's why it has to be all the way.

Is opposite action the same as exposure therapy?

For fear, they work on the same principle: approach instead of avoid, and stay. Opposite action applies that idea to other emotions as well, such as shame, sadness and anger. Planned exposure for a trauma or an anxiety disorder still needs a structured protocol.

How long does opposite action take to work?

Sometimes a few minutes, often longer. A well-practiced emotion may not change the first time, and fear can rise before it drops. Rate the emotion before and after each try, and look at the trend across a week or two.

Does opposite action work for anxiety and anger?

In one small lab study, a single round of acting opposite didn't reduce anxiety or anger more than acting in line with them, though it did for sadness and guilt or shame. The authors suggest that anxiety may need repeated practice, as in exposure, and that acting on anger may feel rewarding to some people. Clinically, repetition and checking the facts carefully matter most for these two.

Is there an opposite action worksheet PDF?

This page works as one. Print this page or save it as a PDF from your browser's print window, and set the page range to the worksheet pages if you only want the client sheet. For a shorter log, see Worksheet 6 on our DBT worksheets page.

Can I photocopy Linehan's opposite action handouts?

Linehan's handouts and worksheets are copyrighted and published by Guilford Press in DBT Skills Training Handouts and Worksheets, which Guilford describes as reproducible. The license printed in the book sets out who may copy them and for what, so read it before you copy anything. Posting them on a website or a shared drive is a different matter from giving a copy to your own client. A worksheet in your own words, like the one on this page, avoids the question.

Before your next session

Pick one client whose avoidance, withdrawal or hiding keeps an emotion going. Print the worksheet, check the facts together on one situation from their week, rehearse the opposite in the room, and look at the practice log at the start of your next session.

If you're building a practice around skills-based work, see how TranqBay works for private practice: you can look at the practice website designs where you'd describe your DBT-informed work, and the booking page your clients would use to book the session where you review their practice. If you're deciding whether to join, this page explains how joining TranqBay works.

Sources

11 sources

Books 3Research 3digital.lib.washington.edu 1academic.oup.com 1dbt-lbc.org 1thehotline.org 1988 Lifeline 1

Books and publishers3

Research3

Updated October 25, 2026. Found it useful? Send it to a colleague.