Continuing our series on DBT skills, in this blog we will review the States of Mind Framework and discuss Wise Mind.
As a refresh, Dialectical Behavior Therapy (DBT) is an evidence-based psychotherapy that focuses on building practical skills for emotion regulation, distress tolerance, mindfulness, and interpersonal effectiveness. DBT emphasizes balancing acceptance and change, helping individuals acknowledge what is hard in the moment while still choosing behaviors that support long-term health and recovery.
Check out the other articles in this series highlighting our team’s favorite skills/tools we have learned from our weekly DBT training:
https://lauracipullo.com/blog/using-dbt-opposite-action-in-nutrition-care/
https://lauracipullo.com/blog/using-the-dear-man-skill-in-nutrition/
In nutrition counseling, clients often get stuck between two extremes:
- eating purely based on emotion, or
- eating purely based on rules and nutrition “logic.”
The DBT States of Mind framework offers a simple, compassionate way to understand what is driving food decisions in the moment, and how to move toward more flexible, sustainable eating.
The three States of Mind
DBT describes three ways of processing situations outlined by the following figure from the DBT Skills Handbook
Emotion Mind
In Emotion Mind, decisions are driven primarily by feelings.
In nutrition work, this often sounds like:
- “I feel out of control, so I might as well keep eating.”
- “I feel guilty, so I shouldn’t eat dinner.”
- “I’m anxious about carbs, so I can’t have pasta.”
Emotion Mind is not wrong. Emotions carry important information. But when emotions are the only driver, eating choices often become reactive.
Reasonable Mind
In Reasonable Mind, decisions are driven primarily by logic, rules, and information.
In nutrition counseling, this may show up as:
- rigid calorie or macro tracking
- strict food rules
- eating (or not eating) because “the plan says so”
- ignoring hunger because the numbers say intake should already be enough
Reasonable Mind brings valuable structure and nutrition knowledge, but it can disconnect clients from their bodies and emotional context.
Meeting in the middle: Wise Mind
Wise Mind is the integration of Emotion Mind and Reasonable Mind.
From a nutrition perspective, Wise Mind includes:
- nutrition science and clinical guidance
- lived experience
- hunger, fullness, and energy cues
- emotional and situational context
- personal values and goals
Wise Mind is not perfect eating. It is flexible, informed, and responsive.
Why this is powerful in food and body work
Many clients feel stuck between two extremes:
- eating purely based on emotion
or - eating purely based on rules and control
The States of Mind framework normalizes both—and then gently points toward a third option.
This helps shift the clinical focus from:
“Was this the right food?” to: “What state of mind is guiding this choice right now?”
How this may look in session:
A client says:
“I’m afraid to eat pasta because I know I’ll feel guilty afterward.”
You might explore:
- Emotion mind:
“I’m scared of weight gain and loss of control.” - Reasonable mind:
“Pasta is a carbohydrate source. Carbohydrates are the body’s main fuel source.”
A Wise Mind choice might sound like:
“I can include pasta in a balanced meal and notice how my body feels afterward—without needing to restrict or compensate.”
Why this matters for our nutrient work, particularly clients with disordered eating
Disordered eating often trains people to:
- distrust emotion (including hunger and desire), and
- over-rely on Reasonable Mind in the form of rigid rules and plans.
When restriction becomes unsustainable, eating may swing in the opposite direction and become driven almost entirely by Emotion Mind.
Teaching the States of Mind helps clients:
- notice these shifts in real time,
- understand why eating feels so polarized,
- begin practicing decisions that are informed by both the body and nutrition science.
The DBT States of Mind skill helps clients move away from:
- rule-based eating
- fear-based restriction
- reactive food decisions
and toward eating that is emotionally aware, body-informed, and grounded in evidence-based nutrition.
When paired with skills like Check the Facts and Opposite Action, States of Mind becomes a powerful tool for helping clients build trust in both their bodies and the information guiding their care.
