A crisis is any situation where you feel overwhelmed and your usual coping methods aren’t working. You might feel like your emotions are too intense or that your circumstances are too difficult to handle.
Dialectical behavior therapy (DBT) is a type of therapy that can help when you have intense emotions and difficulty with relationships. DBT is an evidence-based treatment, which means that researchers have studied and proven its effectiveness.
This article includes a guide to DBT crisis survival skills. You can also download this information as a DBT crisis survival skills PDF. The guide shares practical tools to help you calm intense emotions and navigate difficult situations.
Understanding DBT and Crisis Situations
Dialectical behavior therapy (DBT) can help people deal with intense emotions. It’s built around a few core ideas:
Core Principles of DBT
- Dialectics: DBT is about finding a balance between accepting yourself and working to change.
- Mindfulness: DBT teaches you to pay attention to the present moment without judging yourself. Mindfulness can help you become more aware of your emotions and thoughts.
- Distress Tolerance: Distress tolerance skills help you cope with difficult emotions without making the situation worse. These skills are crucial for managing crises.
What Constitutes a Crisis?
A crisis can be different things to different people.
- Defining a Personal Crisis: What situations, thoughts, or feelings usually lead to a crisis for you? Identifying your triggers and warning signs can help you prepare.
- Common Crisis Triggers: Relationship conflicts, loss, or overwhelming stress can trigger a crisis.
STOP: A Quick DBT Skill for Emotional Regulation
Sometimes, you just need to hit the brakes on your emotions. That’s where the DBT skill STOP comes in. STOP is an acronym to help you pause and think before you react. It’s an immediate intervention technique you can use anywhere.
- S: Stop. Freeze. Don’t react immediately. It’s important to pause before you say or do something you’ll regret.
- T: Take a step back. If you can, remove yourself from the situation. Physically distancing yourself can give you some perspective and dial down the emotional intensity.
- O: Observe. Notice your thoughts, feelings, and what’s happening in your body. Just observe without judging.
- P: Proceed mindfully. Now, act with intention, not impulsively. Choose a response based on rational thought instead of just reacting emotionally.
Distress Tolerance Skills: Weathering the Storm
Distress tolerance skills are all about getting through tough times without making things worse. They’re like a first-aid kit for your emotions. Here are some key techniques:
ACCEPTS: Distracting from the Pain
When you’re overwhelmed, distraction can be a lifesaver. ACCEPTS is a handy acronym to remember different ways to take your mind off the pain:
- Activities: Get busy! Watch a movie, listen to music, read a book, anything that grabs your attention.
- Contributing: Focus on others. Volunteer, help a friend, or just do something kind.
- Comparisons: Remind yourself that things could be worse. Compare your situation to someone less fortunate, but avoid falling into self-pity.
- Emotions: Do something that triggers a different emotion. Watch a comedy, listen to upbeat music, or spend time with people you enjoy.
- Pushing Away: Temporarily block out negative thoughts. Use mental imagery or thought-stopping techniques.
- Thoughts: Think about something neutral or positive. Recall happy memories or do a mental puzzle.
- Sensations: Engage your senses. Take a warm bath, listen to soothing sounds, or try aromatherapy.
This is all about tapping into your senses to calm yourself down, which can include using essential oil blends for sleep and anxiety relief.
This is all about tapping into your senses to calm yourself down:
- Vision: Look at something calming or beautiful, like nature, art, or photos of loved ones.
- Hearing: Listen to soothing music or sounds, like nature sounds, classical music, or guided meditations.
- Smell: Use aromatherapy with scents like lavender or chamomile.
- Taste: Savor a favorite food or drink, really paying attention to the flavors.
- Touch: Wrap yourself in a soft blanket, cuddle with a pet, or take a warm bath.
IMPROVE the Moment: Making Things a Little Better
Sometimes, you can’t completely escape the pain, but you can make the moment a little more bearable. IMPROVE is another helpful acronym:
- Imagery: Picture a peaceful scene. Create a mental sanctuary where you feel safe and calm.
- Meaning: Find purpose in the situation. What can you learn from this? How can you grow?
- Prayer: Connect with your spirituality. Pray, meditate, or engage in spiritual rituals.
- Relaxation: Practice relaxation techniques like deep breathing, progressive muscle relaxation, or yoga.
- One thing at a time: Focus on the present moment. Break overwhelming tasks into smaller, manageable steps.
- Vacation: Take a mental or physical break. Daydream, go for a walk, or plan a short trip.
- Encouragement: Give yourself positive affirmations. Remind yourself of your strengths and past successes.
Reality Acceptance Skills: Acknowledging the Present
Reality acceptance skills are all about acknowledging what’s happening right now, even when it’s difficult.
Radical Acceptance: Accepting reality as it is, without judgment
Radical acceptance means facing reality head-on, without trying to change it or wish it away. Resisting reality just makes things worse. It’s like fighting the tide – you’re just going to get tired and frustrated.
You can practice radical acceptance through mindfulness and non-judgmental observation. Watch your thoughts and feelings come and go without getting swept away by them. Think of yourself as a detached observer.
Remember, acceptance doesn’t equal approval. You don’t have to like what’s happening to accept it. Acceptance is about acknowledging what is so you can move forward.
Turning the Mind: Choosing to accept reality
Turning the mind is a conscious decision to shift your perspective towards acceptance. It’s about actively choosing to embrace what’s happening, even if you don’t want to.
Identify the benefits of acceptance. What good can come from accepting this situation? Maybe it will reduce your suffering, increase your peace of mind, or give you a greater ability to cope.
Try repeating affirmations of acceptance. Say phrases like “I accept this,” “I can handle this,” or “This is what it is.” These affirmations can help you reinforce your decision to accept reality.
Crisis Planning and Prevention
DBT teaches you to plan ahead for crises. When you have a plan, you’re less likely to feel overwhelmed when difficult emotions or situations arise, and you can find strength. Here’s how to start:
Creating a Crisis Plan
A crisis plan is a step-by-step guide you develop before a crisis happens. This helps you manage future crises more effectively. Your crisis plan should include:
- Identifying personal triggers and warning signs: What specific situations, thoughts, or feelings tell you a crisis is brewing? List them out.
- Listing coping skills and resources: What DBT skills can you use? Include contact information for friends, family, therapists, or crisis lines that can support you.
- Developing a safety plan: If you struggle with self-harm or suicidal thoughts, outline specific steps to ensure your safety and prevent harm. This might include removing access to harmful items or contacting a crisis hotline.
Building a Support System
You don’t have to go through this alone. Building a support system is a key part of crisis prevention:
- Identifying trusted people: Make a list of friends, family members, or therapists you can rely on for support.
- Reaching out for help: Practice asking for what you need. This might mean using assertive communication to express your boundaries or simply saying, “I’m struggling, can we talk?”
- Participating in support groups: Connecting with others who understand what you’re going through can be incredibly helpful. Look for online or in-person DBT support groups.
Frequently Asked Questions
What is the difference between crisis survival skills and reality acceptance skills?
Crisis survival skills in DBT are used during a crisis to help you get through an immediate, overwhelming situation without making things worse. Reality acceptance skills, on the other hand, are used after the crisis has subsided to help you accept the reality of what happened and move forward.
What is the key survival skill in crisis response?
While many skills are valuable, distress tolerance is arguably the key survival skill in a crisis. It’s the ability to withstand intense emotional pain without resorting to harmful or destructive behaviors. This skill set helps you navigate overwhelming feelings and impulses until you can access more effective coping strategies.
How to become better at tolerating distress?
Improving distress tolerance takes practice and patience. Regularly using skills like self-soothing, distraction, radical acceptance, and mindfulness can strengthen your ability to manage difficult emotions. Start small, practice these skills even when you’re not in crisis, and be kind to yourself during the process. It’s also helpful to identify your triggers and develop a plan for managing them.
What are crisis survival skills in DBT?
Crisis survival skills in DBT encompass a range of techniques designed to help individuals cope with intense emotional pain and prevent impulsive behaviors. These skills include distraction (activities, contributing, comparisons, emotions, sensations), self-soothing (using your senses to comfort yourself), improving the moment (imagery, meaning, prayer, relaxation, one thing in the moment, vacation), and thinking of pros and cons of acting on urges.
Summary
DBT crisis survival skills are most effective when you practice them regularly. Think of it like learning to play an instrument. The more you practice, the better you get, and the more naturally you’ll be able to use those skills when you need them most.
These DBT skills are tools that can empower you and build your resilience. They can help you take control of your emotions and improve your overall well-being, even when you’re feeling overwhelmed.
If you’re struggling to manage intense emotions or navigate difficult situations, it’s always a good idea to seek professional help. A therapist trained in DBT can provide further support and guidance as you develop these crucial coping skills.