Crisis skills in DBT are skills to get you through the moment of crisis without circumstances becoming worse. These skills are used in situations such as urges to self-harm, thoughts of suicide, panic, dissociation, and impulsivity, to name a few. The hope is to encourage a self-regulated response rather than an overreaction.
The STOP Skill
The STOP Skill is an acronym for the following steps: Stop, Take a step back, Observe, Proceed Mindfully. Mindfulness is at the heart of DBT’s practices and teachings. The STOP Skill seeks to support the idea of mindfulness by limiting reactions and encouraging responses. This skill is best practiced in the midst of extreme anger, frustration, and impulsivity, amongst other strong emotions.
Pros & Cons
The second DBT skill is pros and cons. This is not the same as conducting a cost benefit analysis. This skill differs from what you may think of when hearing “pros and cons”. These pros and cons are specific to one’s reaction to distress in the moment. It asks what is the pro of tolerating distress adaptively versus the con of giving into low distress tolerance. This skill is helpful when initially met with adversity as it can guide decisions on the next steps and responsiveness thereafter.
TIPP Your Body Chemistry
DBT TIPP skills are distress tolerance skills that intend to change your body’s central nervous system response. Our central nervous system is broken into the sympathetic, or fight-flight-freeze-fawn system and our parasympathetic, “cool” or homeostatic system. The parasympathetic is where our body is functioning most adaptively. TIPP skills hope to bring us back to parasympathetic homeostasis and bring our distress level down significantly.
Distract With ACCEPTS
ACCEPTS Skills are methods of distracting from triggering stimuli. The acronym stands for Activities, Contributions, Comparisons, Emotions, Pushing Away, Thoughts, and Sensations. When pros and cons or problem-solving feel difficult or overwhelming, allow yourself time to distract.
Self-Soothing With the 5 Senses
Self-soothing using the 54321 method supports bringing you back to what is really in front of you. This skill is best practiced when feeling overwhelmed to the point of dissociation and/or having racing thoughts.
IMPROVE the Moment
IMPROVE the moment is a set of skills that involves challenging one’s negative beliefs and emotional response through body-focused relaxation and affirmation. If a person intends to improve themselves and their circumstances, then they can put this skill into practice. It is best practiced when low distress tolerance signs are occurring, such as self-harming urges.
