ADHD and Impulse Control: How DBT Skills Help When Willpower Fails

For a long time, cognitive behavioral therapy (CBT) was considered the gold standard for working with ADHD. And to be clear: CBT is not a bad approach. It has helped many people with structure, planning, and goal-setting. But if you live with ADHD or parent or coach someone who does you may have noticed something frustrating: Knowing what to do is not the same as being able to do it.

This is where impulse control and emotional regulation come in. And this is also where, lately, I’ve found myself drawn more and more to Dialectical Behavior Therapy (DBT). As I’m training as a therapist and learning DBT as my primary method, I keep having moments of recognition: Oh. This is what was missing. Not just for my clients but for me, and for my son.

ADHD and impulse control: not a character flaw

Impulse control problems are one of the core challenges of ADHD, yet they’re often misunderstood. From the outside, impulsivity can look like:

• Saying things you later regret

• Reacting “too strongly” to small triggers

• Interrupting, snapping, quitting, buying, or deciding too fast

• Exploding emotionally or shutting down completely

Inside, though, it often feels very different. Many people with ADHD don’t lack insight. They know the rules. They know the strategies. They’ve read the books, tried the planners, learned the “right” steps. The problem is that impulse control relies heavily on executive functions. And executive functions are exactly what ADHD makes unreliable, especially under emotional stress.

When emotions run high, the prefrontal cortex (the part of the brain responsible for planning, inhibition, and perspective-taking) goes offline. If emotional regulation is already difficult, asking someone to “just use CBT tools” can feel like asking them to swim harder while they’re drowning. That doesn’t mean CBT is wrong. It just means it sometimes asks too much too early.

Why emotional regulation matters first

In ADHD, emotions often come on fast and strong. Anger, frustration, shame, excitement they can all spike quickly, and once they do, the body is already in fight-or-flight mode.

At that point:

• Reasoning is harder

• Following steps is harder

• Delaying reactions is harder

Impulse control problems are often emotion regulation problems in disguise. This is why DBT has felt so relevant to me.

What DBT actually is in simple terms

Dialectical Behavior Therapy was originally developed for people with intense emotional dysregulation. At its core, DBT is about two things being true at the same time:

• You are doing the best you can

• And you can learn skills to do better

DBT doesn’t start with changing thoughts or behaviors. It starts with very concrete, very practical skills that help the nervous system calm down before you’re expected to act wisely.

DBT focuses on four main skill areas:

• Mindfulness

• Emotion regulation

• Distress tolerance

• Interpersonal effectiveness

What I love about DBT, especially for ADHD, is that it doesn’t assume your system is already regulated. It meets you where you are.

Using DBT with myself and with my son

I didn’t come to DBT only as a therapist-in-training. I came to it as a parent. My son and I both have problems with impulse control. That means we both have big emotions, quick reactions, and moments where things escalate faster than either of us wants. Before DBT, those moments often followed the same pattern:
Someone gets triggered → emotions rise → words get sharp → regret follows.

DBT gave us something different: a pause. Not a perfect pause. Not a calm, enlightened pause. But enough space to interrupt the spiral. What surprised me most was how “simple” some of the exercises looked on paper and how powerful they became with practice.

Three DBT skills that help with impulse control

Here are three DBT-based practices that we use regularly and that I often suggest to clients.

1. Temperature change (for intense emotions)

When emotions spike, logic won’t work but the body will. One DBT distress tolerance skill is changing body temperature:

• Splash cold water on your face

• Hold an ice pack

• Step outside into cold air

This activates the dive reflex and helps the nervous system slow down. We’ve used this after arguments, sometimes literally standing at the sink, breathing, resetting before continuing the conversation. It doesn’t solve the problem, but it makes the next step possible.

2. Naming the emotion out loud

DBT places a lot of emphasis on naming what’s happening.

Instead of:
“I’m furious, this is unbearable”

Try:
“I’m noticing a lot of anger right now.”

That small shift creates distance. With my son, we often say things like:
“Looks like anger just showed up.”
Not you are angry, but anger is here.

It reduces shame and gives us both room to respond instead of react.

3. One mindful breath done consistently

Mindfulness in DBT isn’t about emptying your mind. It’s about noticing what is, without judgment.

One practice we use:

• One slow inhale

• One long exhale

• Feel your feet on the floor

That’s it.

At first, it feels almost ridiculous. But over time, that single breath becomes a cue: I don’t have to act right now. Impulse control grows not from force, but from repetition.

Why consistency matters more than perfection

DBT works best when it’s practiced regularly, not only in crisis. That’s true for adults and especially for kids. Some days, the skills work beautifully. Other days, we forget them completely. That’s part of the process. What DBT has taught me, both personally and professionally, is that change happens through practice, not insight alone. And for people with ADHD, that’s deeply compassionate. It acknowledges the reality of our nervous systems instead of fighting them.

A different kind of hope

I don’t see DBT as a replacement for CBT. I see it as a foundation. Once emotions are more regulated, CBT strategies often become much more accessible. Goals feel reachable. Protocols feel doable. For me, DBT has brought more calm into my work, my parenting, and my relationship with myself. It hasn’t made ADHD disappear but it has made impulse control feel less like a personal failure and more like a skill I can keep practicing. And that, for me and my son, has made all the difference.

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