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DBT Therapy Ottawa: Skills for Strong Emotions and Hard Moments
Some feelings arrive so quickly that there seems to be no space between the emotion and what happens next. You might send a message you later regret, shut down during a hard conversation, pull away from someone you care about or feel unable to focus on anything except the distress. Dialectical behaviour therapy, often called DBT, offers practical skills for slowing the moment down.
Therapy with Empathy offers DBT-informed individual therapy for adults and teens. Meet with Jessica in person at our Wellington West office or through secure video anywhere in Ontario. Sessions are available in English and French, subject to current availability.
When emotions take over the whole moment
You can understand your reaction and still struggle to change it while it is happening.
You may know what you want to do when you are calm. You want to pause, speak clearly, stay present or leave the conversation without making things worse. But when the emotion rises, the plan can disappear. Your body moves into action before your thinking mind has caught up.
For some people, the reaction moves outward. You raise your voice, send several messages, demand an answer or say something sharp. The action may make sense as an attempt to be heard or protected. Later, you may feel guilt, worry about the relationship or wonder why the moment became so large.
For other people, the reaction moves inward. You become quiet, numb or disconnected. You agree to something you do not want, avoid the conversation or criticize yourself for having needs. The outside may look calm while the inside feels crowded and painful.
You might also feel trapped between two choices. You want closeness and space. You want to accept yourself and make a change. You want to honour the emotion without letting it make every decision. These needs can seem like opposites, even when both are true.
DBT-informed therapy gives you a place to understand the pattern without reducing you to it. You learn skills for noticing what is happening, getting through intense moments, caring for emotions and communicating more effectively. The work is practical, but it also makes room for context, relationships and the reasons a response developed.
- “My feelings go from zero to one hundred.”
- “I know what to do, but I cannot use it in the moment.”
- “I shut down when a conversation gets hard.”
- “I say yes, then feel angry and resentful.”
- “I react quickly and regret it later.”
- “I need reassurance, but it never lasts.”
- “I cannot think clearly when I am upset.”
- “I want to respond differently without ignoring my feelings.”
DBT explained in plain language
What is dialectical behaviour therapy?
Dialectical behaviour therapy is a structured approach that combines acceptance and change. It teaches skills for paying attention, tolerating distress, understanding emotions and communicating in relationships. DBT was designed for people who experience intense emotions, but its skills can be useful for many concerns and life situations.
Acceptance and change can both be true
A dialectic holds two ideas at the same time. You can accept that a feeling is real and still choose not to act on every urge. You can understand why a response developed and decide that it is no longer helping. You can care about another person and set a boundary with them.
This approach can reduce the pressure to choose between judging yourself and giving up on change. Your therapist helps you validate what is happening while also looking for a next step that protects your goals, values and relationships.
DBT turns ideas into skills you can practise
Knowing that you should calm down is not the same as knowing what to do when your heart is racing and your thoughts are moving fast. DBT breaks broad advice into specific skills. You may practise grounding, observing an urge, checking the facts, asking clearly for what you need or tolerating a feeling without making the situation harder.
Skills are not used to erase emotions. They help create enough space for you to choose what happens next. You and your therapist can adapt them to your age, culture, relationships, daily responsibilities and the situations that are most difficult for you.
Skills you can learn and practise
The four main groups of DBT skills
DBT skills are often organized into four groups. You do not need to learn every skill at once. Therapy can begin with the area that best matches the problem in front of you and build from there.
Notice the moment before choosing what comes next
Mindfulness means paying attention to what is happening now with less judgment. You may notice a thought, body sensation, emotion or urge without immediately treating it as a command. This can help you separate the facts of a situation from the story your mind is adding and return your attention to the task or conversation in front of you.
Get through a hard moment without making it harder
Distress tolerance skills are for moments when a problem cannot be solved right away. They can help you pause, ground yourself and ride out an urge long enough to make a deliberate choice. The aim is not to approve of the situation. It is to protect you from actions that may add more pain while you decide what is possible.
Understand what an emotion is telling you
Emotion regulation skills help you name emotions, notice what makes them stronger and understand the action each feeling urges you to take. You can learn to check whether the emotion fits the facts, care for needs that make you more vulnerable and choose a response that supports your longer-term goals.
Ask, say no and protect the relationship
Interpersonal effectiveness skills support clearer communication. You can practise asking for what you need, setting a limit, keeping your self-respect and deciding what matters most in a conversation. The goal is not to control how another person responds. It is to communicate in a way that reflects your needs and values.
A practical and flexible approach
What can DBT-informed therapy help you work on?
Strong emotions and impulsive reactions
Anger, fear, sadness or shame can arrive with a strong urge to act. DBT skills can help you recognize early signs, pause before acting and choose a response that fits the facts and your goals. You can also look at what makes emotions more intense and build routines that support steadier coping.
Distress, overwhelm and shutdown
When stress becomes intense, you may feel unable to think, move or communicate. DBT-informed therapy can help you practise ways to stay connected to the present and get through the next part of the moment. These skills are not a replacement for urgent crisis services, but they can strengthen everyday coping and preparation.
People-pleasing, boundaries and conflict
You may stay quiet to avoid conflict, agree when you want to say no or become intense when you fear you are not being heard. DBT skills can help you prepare a clear request, set a boundary and stay connected to your values while making room for the other person’s response.
Teen stress, relationships and identity
Teens can face strong emotions alongside school pressure, friendship changes, family conflict and questions about identity. DBT skills can give a teen concrete language for what is happening and options for responding. Sessions also make room for the environment around the teen rather than treating them as the whole problem.
What you can work on
DBT Therapy Ottawa: Skills You Can Bring Into Daily Life
DBT-informed therapy is not about becoming calm all the time. It is about building a wider set of choices for moments when emotions, urges or relationships feel difficult. You and your therapist decide which skills are relevant and practise using them in situations that matter to you.
- Notice early signs that an emotion is getting stronger
- Pause between an urge and the action you take
- Use grounding when your mind feels flooded or far away
- Get through distress without adding a new problem
- Name emotions and understand the needs underneath them
- Check whether an emotional reaction fits the current facts
- Reduce black-and-white thinking during stressful moments
- Ask clearly for what you need without losing your voice
- Say no while protecting your self-respect
- Repair after conflict instead of avoiding it or escalating it
DBT skills across different stages of life
DBT-informed individual therapy for adults and teens
DBT-informed therapy for adults
Adults may use DBT skills to work on emotional overwhelm, relationship stress, people-pleasing, guilt, anxiety, self-doubt and difficult conversations. Sessions can focus on a recent situation, the emotion and urge that appeared, what you did next and what you would like to try differently.
The approach can be especially useful when insight alone has not changed the pattern. You may already understand why you react in a certain way. Therapy helps turn that understanding into small, repeatable actions. The skill is adapted to your real schedule, relationships and responsibilities rather than taught as a rule you must follow perfectly.
DBT-informed therapy for teens
With teens, DBT skills can be connected to school, friendships, family life, identity and online communication. A teen may practise noticing an emotional wave, pausing before sending a message, asking for help, setting a boundary or getting through a stressful evening without making the situation harder.
The therapist explains privacy and its limits, including how caregiver involvement will be handled. Caregivers may be included when it supports safety or the teen’s goals, but therapy also needs enough privacy for honest conversation. The exact plan is discussed with the teen and caregiver.
What sessions can look like
Starting DBT-informed therapy in Ottawa
You do not need to know the four skill groups before you begin. Start with a moment that keeps becoming difficult. Your therapist can help you slow it down, understand what happened and choose one skill to practise.
Notice the current pattern
You and your therapist look at a recent example. What happened before the emotion rose? What did you feel in your body? What thoughts and urges appeared? What did you do next? The purpose is to understand the chain of events, not to judge you for having a reaction.
Learn and practise one skill
Your therapist may introduce a mindfulness, distress tolerance, emotion regulation or interpersonal skill that fits the moment. You can practise it together, ask questions and change the language so it feels natural. The focus stays on something specific enough to remember and use.
Review what happened and adapt
Between sessions, you may try the skill in a small real-life situation. When you return, you review what helped, what got in the way and what needs to change. A skill not working immediately is information, not failure. The plan can be adjusted to better match you and the situation.
Meet the therapist
DBT-informed therapist in Ottawa and online across Ontario
Jessica offers individual therapy that draws on DBT skills. Read her profile to learn more about the people she works with, languages, other approaches and current appointment options.
Jessica Muziramakenga
Registered Psychotherapist (Qualifying), CRPO #19000
Jessica works with adults and teens. She uses DBT skills to support people navigating strong emotions, anxiety, guilt, people-pleasing, boundaries and hard conversations. She offers therapy in English and French, in person and online, subject to current availability.
Read Jessica’s ProfileMeet in person or online
DBT-informed therapy from a Registered Psychotherapist
In-person sessions are available at our Wellington West office in Ottawa. Secure virtual therapy is available to clients located anywhere in Ontario. Jessica offers appointments in English and French.
Jessica is currently accepting new adult and teen clients, subject to current appointment availability. Review her therapist profile to learn about her areas of focus, approaches and appointment options.
Suite 202
1355 Wellington Street West
Ottawa, Ontario K1Y 3C2
Nearby parking is available. The office can also be reached by public transit, with LRT access through the surrounding transit network.
Common questions
Frequently asked questions about DBT-informed therapy
What is dialectical behaviour therapy?
Dialectical behaviour therapy, or DBT, is a structured approach that combines acceptance and change. It teaches practical skills for mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Therapy with Empathy uses DBT skills within individual psychotherapy.
What are the four groups of DBT skills?
The four main groups are mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Mindfulness helps you notice the present moment. Distress tolerance supports you through hard moments. Emotion regulation helps you understand and respond to feelings. Interpersonal effectiveness supports clearer communication, requests and boundaries.
Is this a comprehensive DBT program?
No. Therapy with Empathy offers DBT-informed individual psychotherapy. We do not offer a comprehensive DBT program with a separate weekly skills group, between-session phone coaching and a therapist consultation team. If you need a comprehensive program, ask the therapist whether another service may be a better fit.
What can DBT-informed therapy help with?
DBT skills may help with strong emotions, distress, impulsive reactions, shutdown, relationship stress, people-pleasing, boundaries, anxiety, guilt and difficult conversations. Whether the approach fits depends on your needs, goals, preferences and the therapist’s clinical judgment.
Is DBT only for borderline personality disorder?
No. DBT was developed for people with complex and intense emotional needs, but its skills are now used with many concerns. A therapist can help you decide whether DBT-informed work fits your goals or whether another approach or level of support would be more appropriate.
Can teens use DBT skills?
Yes. DBT skills can be adapted for teens facing strong emotions, school stress, friendship changes, family conflict and difficult communication. The therapist explains privacy and its limits and discusses how caregiver involvement will be handled.
What happens in a DBT-informed session?
You may review a recent difficult situation, notice the chain of events that led to your response and identify a skill that could help. The therapist may explain and practise the skill with you. Later, you review what happened when you tried it and adapt the plan.
Will I have homework between sessions?
You may be invited to notice a pattern or practise a skill between sessions because skills become easier through repetition. The plan should be realistic and connected to your goals. If a worksheet or practice does not fit, you and your therapist can adjust it.
Do you offer online DBT-informed therapy?
Yes. Secure virtual DBT-informed individual therapy is available to clients located anywhere in Ontario. In-person appointments are available at our office in Wellington West, Ottawa.
Is DBT-informed therapy available in French?
Yes. Jessica offers therapy in English and French. Review her profile or booking options to confirm current availability.
Do I need a referral?
No. You do not need a doctor’s referral to contact Therapy with Empathy or book psychotherapy. Your insurance plan can have its own requirements, so check with your insurer if you plan to submit receipts.
Is DBT-informed therapy covered by insurance?
Many extended health plans cover services from a Registered Psychotherapist or Registered Psychotherapist (Qualifying). Coverage varies. Ask your insurer whether your plan covers Jessica’s exact designation, how much coverage you have and whether a referral is required.
Start with one conversation
You do not have to wait for another hard moment to start learning new skills
Book a free 20-minute phone consultation to ask questions, talk briefly about what brings you to therapy and see whether Jessica’s approach feels like a fit.