4 Essential DBT Skills: Crisis Survival Kit

When you’re in the middle of a crisis it feels like your brain’s “alarm system” has taken over. This can make it difficult to think logically which can present its own set of challenges. For children, teens, and young adults who are still developing their emotion regulation abilities, this can be intensified. By learning and practicing essential DBT skills, you can create a toolkit of resources to help you effectively manage challenging situations.

Dialectical Behavior Therapy (DBT) is a gold-standard treatment that teaches people valuable skill sets that can be used for managing intense emotions. When our emotions are intense, it can feel difficult to maintain a level head. Our state of mind largely influences the way we feel, act, and react to any given situation. By practicing DBT skills and using tools from your crisis survival kit, you can learn how to access your Wise Mind and find a balance between emotion and reason. This can help you act more effectively and work through a challenging situation.

Building Your DBT Crisis Survival Kit

You can think of a DBT crisis survival kit as a set of tools, skills, and strategies to help you manage challenging emotions. The goal isn’t to stop the emotions— the goal is to work through the moment without making things worse. Creating a pre-assembled toolkit of items, reminders, skill sets, and other resources can help you easily access the support you need in a challenging moment.

When your emotions are feeling intense this kit can be like a “break glass in case of emergency” box. If your emotions are too intense for you to practice sound decision making, you can fall back on these strategies:

Your crisis survival kit can exist as a physical binder for you to study and reference. This could also include a box of physical tokens that help you relieve stress or bring joy. Or, it could be a digital folder on your phone or computer that functions as a skills resource bank.

What you include in your toolkit is up to you! It can include printouts of DBT skills, screenshots of kind messages from friends, or a playlist of songs that help you feel more relaxed. Apps like Calm or DBT Coach can also be helpful resources to include in your toolkit so that you have a variety of different resources to access when you need them.

DBT Skill Sets for Crisis Survival

There are dozens of different skill sets taught in DBT. Some that you may have heard of are DEAR MAN, FAST, Opposite Action, and Radical Acceptance. Each DBT skill set has its own unique set of uses and benefits. When it comes to essential DBT skills to help you effectively navigate a crisis situation, here are the highlights of a few skill sets you may want to refer back to:

DBT TIPP Skill

The DBT TIPP skill is a distress tolerance strategy that can help you manage strong emotions during moments when you are particularly overwhelmed. By using these tools, you can help change your body chemistry and physically relax yourself to overcome feelings of distress. Some ways you can do this include:

• Temperature. When feeling overwhelmed or in crisis, you may experience an increased heart rate. You will want to try and decrease your heart rate, which can be done by decreasing your temperature.
• Intense Exercise. Intense emotions can lead to a lot of pent-up energy. This can be dispelled and put to good use by engaging in rigorous physical activity.
• Paced Breathing. The rate of your breathing may also increase in moments of distress. This is also connected to your heart rate, and an increase in both can contribute to the feeling of being overwhelmed.
• Progressive Muscle Relaxation. Stress can leave us with the sensation of physical tension, which can be released through controlled tensing and relaxation of the muscles.

For more information about the DBT TIPP skill, the DBT TIPP Skills: Improving Distress Tolerance article offers detailed examples to help you learn how you can apply this strategy.

DBT STOP Skill

The DBT STOP skill can help prevent you from taking impulsive actions. Our judgement and decision making abilities can be clouded when experiencing intense emotions. The STOP skill helps you assess the situation and give yourself an opportunity to take more mindful actions:

• Stop. Don’t move a muscle.
• Take a step back by either physically or mentally removing yourself from the situation.
• Observe. What is happening inside and outside of you?
• Proceed mindfully. Ask yourself, “What will make this better, not worse?”

Self-Soothe DBT Skills

When experiencing a situation that causes intense emotions, it is helpful to find a way to quickly relax using different body senses. Self-soothing DBT skills for distress tolerance can help you during those moments when you feel especially overwhelmed. Some examples of how you can engage each of your senses include:

• Vision. Look at a photo of a pet.
• Hearing. Listen to one specific song.
• Smell. Light a candle or smell a citrus fruit.
• Taste. Eat something sour or minty.
• Touch. Wrap yourself in a heavy blanket.

For additional examples of how you can practice these sensory strategies, the Self-Soothe DBT Skills: Sensory Strategies for Distress Tolerance shares more ways that you can apply this skill in your own life.

DBT ACCEPTS Skill

DBT ACCEPTS is a set of skills that you can use to temporarily distract yourself from intense, overwhelming emotions when you cannot change the situation immediately:

• Activities. Engage in a task that requires focus. This shifts your attention away from the distress.
• Contributing. Focus your energy on someone or something else. This helps you feel useful and shifts the focus off your own pain.
• Comparisons. Put your situation into perspective. This isn’t about shaming yourself, but about finding a different lens.
• Emotions. Generate a different feeling than your current distress. If you are sad, seek out something lighthearted.
• Pushing Away. Mentally or physically move the problem to the side for a while. This is a “planned” avoidance.
• Thoughts. Fill your brain with neutral thoughts to “crowd out” the negative ones.
• Sensations. Use physical sensations to bring yourself back into your body and out of your head.

For some examples of what the DBT ACCEPTS skills look like in practice, you can refer to the DBT ACCEPTS Skills: How to Survive Life’s Hardships & Build Resilience article for more ideas about how you can use these strategies.

Validating Statements for Crisis Survival

In addition to referencing key DBT skill sets, generating a list of validating statements to reflect on can also be a great strategy to help you get through a challenging moment. Some people may think of these as affirmations or mantras. The validating statements in your crisis survival kit are a powerful tool because they bridge the gap between “I’m losing it” and “I’m okay.” They don’t try to sugarcoat the situation— instead, they acknowledge the pain while reminding you of your strength.

Validating statements can be written on index cards or saved in your phone’s notes app so that you can easily access them when you need some extra support. You could even save specific statements in places where you know you will see them often to help reinforce a more positive mentality throughout the day. A statement could be saved as your phone’s lock screen or wallpaper, written in dry erase on your bathroom mirror, or on an “emergency card” you can keep in your wallet. These tricks can make it even easier to access your validating statements.

Depending on the nature of your crisis situation and how you are feeling in the moment, you can choose a set of validating statements that most resonate with you. Some examples of validating statements you may use in response to particular feelings are included below.

Validating Statements for Feelings of Overwhelm or Panic

• “This feeling is a wave; it has a peak, but it will pass.”

• “I don’t have to figure out my whole life right now. I just have to get through the next five minutes.”

• “My heart is racing because my body is trying to protect me, but I am not in physical danger.”

• “I am safe in this moment, even if my brain is telling me otherwise.”

Validating Statements for Feelings of Anger or Frustration

• “It makes sense that I’m angry right now. This situation is genuinely difficult.”

• “I can feel this anger without letting it drive my actions.”

• “My feelings are valid, but my impulses might not be helpful.”

• “I’m allowed to take up space and feel this way.”

Validating Statements for Feelings of Hopelessness or Sadness

• “I’ve survived 100% of my hardest days so far.”

• “This is a heavy moment, not a permanent life sentence.”

• “I don’t have to be ‘productive’ right now. Existing is enough.”

• “I am doing the best I can with the tools I have in this moment.”

Validating Statements for a “Neutral Reality” Check

• “I can be uncomfortable and still be okay.”

• “Feelings are data, not always facts.”

• “I don’t have to like this situation to accept that it’s happening right now.”

How to Use Your DBT Skills for Crisis Survival

Everyone’s nervous system is wired differently, and DBT skill sets won’t always work the same way for every person in every situation. Curating the tools in your DBT skill crisis survival kit is a process that may take some trial and error. Practice applying different skills to different situations to see what will work best for you and the specific challenges you may face.

When figuring out which DBT skills will be most helpful in your toolkit and how to use them, here are a few things to keep in mind:

• The Vibe Check. Some people need to “calm down” (e.g. slow breathing), while others need to “release” (e.g. punching a pillow or screaming into one). Identify if you are a “fighter” (high energy/anger) or a “flee-er” (anxiety/shutting down) in crisis.
• Trial in Peace. Practice these skills before you are in emotional overload. If you try to practice them when you are already feeling highly overwhelmed it will be more difficult to learn and apply them. DBT skills can be more effective if you practice them in a clearer headspace so that you can more effectively apply them in a crisis situation.
• Low Barrier to Entry. Keep your survival kit somewhere visible or easy to access, such as on your desk, under your bed, or in a specific backpack. If it’s buried in a closet, you won’t use it.

Building an emotional toolkit is one of the best investments you can make in yourself. It’s like training for a marathon— the more you practice these “reps” when things are calm, the more natural they’ll feel when life gets chaotic.

Just remember, be patient with yourself. Some days the skills will decrease intense emotions, and other days they might just help you “tolerate” the pain until it passes. Both are wins.

Additional Support to Apply DBT Skills

Learning, practicing, and applying DBT skills can offer valuable lessons to anyone. It’s important to keep in mind that mastering these skills is a process that will take time and support. If you or your child are struggling with overwhelming emotions or difficulty managing reactions, a skilled DBT psychologist can help you identify goals and start taking steps toward real change. If you want to learn more about how to take that first step, please contact us to learn how we can help.