Distress Tolerance Skills (DBT)

These skills are used to help tolerate highly stressful short-term events, urges and painful emotions when you cannot make things better right away.

Use these skills when acting on your emotions will make things worse, you have intense pain that cannot be helped quickly, you are overwhelmed but demands must be met, arousal is high, but problems cannot be solved immediately.

1.     The STOP Skill

·      STOP (e.g., Stop what you are doing, Freeze, Don’t act on emotion)

·      TAKE a step back (e.g., take a breath, pause, remove yourself from the situation)

·      OBSERVE (e.g., notice what’s going on inside and outside of you, thoughts, feeling, physical sensations)

·      PROCEED MINDFULLY (e.g., Act with awareness, In deciding how to proceed consider your thoughts, feelings, the situation and other people’s feelings, be intentional)

2.     Pros & Cons

·      List PROS & CONS of acting on crisis urge

·      List PROS & CONS of resisting crisis urge

3.     TIP Your Body Chemistry

·      TIP the temperature of your face with cold water (e.g., submerge face into cold water for 20 seconds, put ice packs on face/neck)

·      INTENSE exercise to calm down your body when it’s revved up by emotion (e.g., running, mountain climbers, push ups for 2 minutes at a time).

·      PACED Breathing (e.g., deep inhales through your belly for 4 seconds, hold 7 seconds, exhale for 8 seconds).

·      PAIRED MUSCLE RELAXATION (e.g., when breathing into your belly clench muscles in your body/hands and release tension with each exhale).

4.     DISTRACT with Wise Mind & Accepts

·      ACTIVITIES (e.g., exercise, puzzles, read, spend time with friends).

·      CONTRIBUTING (e.g., volunteer, do something thoughtful, help out).

·      COMPARISONS (e.g., compare how you feel to a time you felt different).

·      EMOTIONS (e.g., listen to emotional music, watch an emotional movie, read an emotional book).

·      PUSHING AWAY (e.g., leave the situation for a while, sleep on it, urge surf).

·      THOUGHTS (e.g., count to 10, count colours in a painting, repeat words to a song, word puzzles).

·      SENSATIONS (e.g., squeeze a rubber ball, hold ice in hands, cold plunge, take a bath).

5.     Self-Soothe With 5-Senses

·      HEARING: Listen to music, sounds in nature.

·      VISION: Look at pictures, soothing images, walk in a pretty part of town.

·      SMELL: Use essential oils for stress, use body cream and shampoos you like the scent of, baking, cooking.

·      TASTE: Eat favourite foods, suck on something sweet, mindfully eat.

·      TOUCH: Take a bath/shower, pet your dog or cat, give yourself a massage, hug someone, wrap yourself up in a blanket.

6.     Improve The Moment

·      IMAGERY: Imagine a soothing image, visualize being somewhere peaceful

·      MEANING: Find purpose/meaning in a painful situation, silver linings.

·      PRAYER: Pray to God, Universe, higher being.

·      RELAXING: Yoga, stretching, take a bath, breathe deeply.

·      ONE THING: Be present, focus on one thing at a time.

·      VACATION: Take a brief vacation from responsibility, take a break from work to do something for yourself.

·      SELF-COMPASSION STATEMENTS: “You are enough”, “It’s a good day to do something challenging”, “This discomfort will pass”.