Pavlov Meets Mindfulness: Integrating Classical Conditioning into DBT Skill Building

For therapies based in classical conditioning to work, the therapist and client must first identify specific traumas and triggers. While this step sounds straightforward, trauma-based behaviors are often so automatic or rationalized afterward, that clients may have trouble labeling them without assistance. Therefore, a first step can be to use DBT skills to identify triggers and trace them back to their origins. 

Mindfulness is a core skill in DBT, allowing clients to become aware of their own thoughts and feelings without acting on them. It can be broken down into components, each of which can facilitate trauma relief by leveraging classical conditioning.

• Observe
  The most fundamental form of mindfulness in DBT is to simply observe one’s thoughts and feelings without labeling or responding to them. This is easier said than done at first, but clients can be trained over time to watch their own mental processes as if they were passengers in a vehicle. This lays the groundwork for additional mindfulness skills and other work in DBT.
  
  In this mode, it’s common for clients to surface painful memories. By learning to not cling to those feelings and thought patterns, the client begins the classical conditioning work of disassociating certain feelings from trauma in the present moment.
• Describe
  This next step in DBT’s mindfulness framework brings in a verbal component. Clients describe what is happening around them in objective terms, and do the same for their own emotions. Clients can use this step to become aware of their own internal processes, and to identify emotions that don’t “fit” a particular situation, such as feeling afraid when there is nothing to fear. This part of the process can help uncover targets for classical conditioning work.
• Participate
  In this form of mindfulness, the client performs an activity with full awareness, without multitasking, letting their mind wander, or going on autopilot. This exercise teaches the client that they can be mindful and active at the same time. It also creates an opportunity to interrupt certain mental patterns that the client slips into in certain settings.

As the client becomes more skilled in each of these areas, they develop more awareness of their own mind and the ability to avoid getting  swept away by certain emotional patterns. This first phase lays the groundwork for using classical conditioning and DBT to address trauma.

Combining DBT and classical conditioning principles can help clients unlearn trauma-based responses and replace them with more adaptive patterns. Trauma often creates powerful conditioned associations between neutral cues (such as a voice tone, body posture, or social situation) and intense emotional or physiological responses like fear, shame, or anger. These responses can be so immediate that clients may not fully understand what’s triggering them. Using classical conditioning as a lens, therapists can help clients recognize these learned associations and use DBT skills to weaken or replace them with new, safer responses through repeated, supported practice.

Several DBT skills are particularly effective in this process:

• TIPP is a set of techniques that address emotions at the physiological level. Cold temperatures, which can take the form of splashing cold water on the face, a cold pack over the eyes, or a cold shower, can have a rapid calming effect. Intense Exercise can burn off excess adrenaline and jittery feelings after a stressful event. Paced Breathing, with long, slow exhales is another tried and true calming method, and Progressive Muscle Relaxation helps clients settle down and identify where they are holding stress in their bodies. By employing these distress tolerance in the face of trauma-associated stimuli, clients can develop new associations and interrupt their classically conditioned emotional response. This also gives them a renewed sense of control over their triggers.
• Check the Facts encourages clients to slow down and examine whether their emotional response matches the current situation, helping to distinguish between present-moment reality and past conditioning. 
• As the client takes more control over their classical conditioning triggers, they can work to take Opposite Action. When a trauma cue elicits an emotion like fear or anger that no longer serves the client, this skill teaches them to act contrary to the urge, which can recondition the emotional link over time.
• To build general feelings of positivity that can buffer the client against the stormy winds of trauma, they can practice ABC: Accumulate positive emotions through uplifting experiences, Build mastery that will increase confidence, and Cope ahead of challenging situations that can be anticipated.

Classical conditioning is a familiar and enduring model connecting lived experience and physiological reactions. While it provides certain core concepts that relate to undoing trauma, many clients will find it challenging to use in the absence of other tools. DBT provides excellent scaffolding for clients to shift their physiological responses. Used together, DBT and classical conditioning can help clients identify their triggers, then systematically deprive them of their power

Training:

Live: 2025 Cohort | Comprehensive Dialectical Behavioral Therapy (DBT)

Introduction to Dialectical Behavioral Therapy (DBT)

Blog Posts:

Understanding Behaviorism

Getting Rid of a Behavior You Don’t Like

Discover How Behaviorism and DBT Combine for Effective Self-Soothing and Crisis Reduction

What is DBT & How Does it Work?

eBook:

Dialectical Behavioral Therapy