Surviving A Crisis: Dialectical Behavior Therapy (DBT) Distress Tolerance Skills

Overview of DBT Crisis Survival Skills

DBT Crisis Survival Skills are specific techniques in Dialectical Behavior Therapy aimed at managing immediate emotional crises. They are intended to help individuals withstand a crisis without resorting to self-destructive behaviors.

Key DBT Skills:

  • Distracting: Redirecting attention away from distressing emotions.
  • Self-Soothing: Using the five senses to calm oneself during intense emotional experiences.
  • IMPROVE the Moment: Techniques to make the present moment more tolerable.
  • Pros and Cons: Assessing the positive and negative outcomes of a situation or action.
  • TIPP: A method that includes Temperature change, Intense exercise, Paced breathing, and Progressive muscle relaxation to manage acute stress.
  • These skills are part of a broader DBT approach designed to enhance emotional regulation and resilience during challenging times.

Dialectical Behavior Therapy (DBT) is a therapeutic approach that combines cognitive-behavioral techniques with mindfulness practices. It's particularly effective in managing acute stress and crisis situations. DBT equips individuals with essential skills to navigate through emotional turmoil and stress without resorting to harmful behaviors. These skills, central to DBT's framework, are critical in helping individuals maintain stability and make reasoned choices during intense emotional experiences.

CBT in Crisis Management

In moments of crisis, where emotions run high and situations feel overwhelming, CBT provides a beacon of structure and practicality. CBT's approach to crisis management is rooted in its foundational principles of addressing thought patterns and behaviors that can escalate stress and anxiety. Here's a closer look at how CBT principles are applied during crisis situations to help navigate through the turmoil effectively:

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  • Managing Negative Thought Patterns: Crises often trigger a surge of negative thoughts. CBT techniques help in identifying these thoughts and understanding how they influence emotions and behaviors. By recognizing and addressing these thoughts, individuals can prevent them from escalating the crisis.
  • Reframing Perspective: CBT aids in reframing a crisis situation from an insurmountable problem to a challenge that can be managed or overcome. This shift in perspective can reduce feelings of hopelessness and helplessness that often accompany crises.
  • Enhancing Coping Skills: CBT equips individuals with practical skills to cope with the stress of a crisis. This includes techniques like relaxation, mindfulness, and effective problem-solving. These skills can help in reducing anxiety and improving the ability to think clearly and make decisions.
  • Behavioral Techniques: Actions influence emotions. CBT encourages engaging in activities that can provide a sense of control and normalcy, even in a crisis. This might involve maintaining a routine, engaging in physical exercise, or pursuing hobbies.

What are Distress Tolerance Skills?

In DBT, there are several crisis survival skills that can be incredibly effective in managing acute stress and emotional upheaval. Each skill offers a unique approach to navigating challenging moments and can be applied in various real-life situations.


Distracting is a skill that involves shifting your focus away from distressing emotions or thoughts to more neutral or positive activities. This skill is especially useful when intense emotions feel overwhelming, and immediate relief is needed. You might watch a favorite movie, engage in a hobby, or call a friend. The key is to find an activity that is absorbing enough to provide a temporary reprieve from distress.


Self-soothing is about calming and nurturing yourself using your five senses. For instance, taking a warm bath, listening to soothing music, or enjoying a favorite scent can help relax your mind and body. This skill is particularly helpful when you're feeling anxious, agitated, or upset, as it provides a way to comfort yourself in a healthy, non-destructive manner.


The IMPROVE technique is a multifaceted approach to making the present moment more bearable. It includes Imagery (visualizing a peaceful scene), Meaning (finding a sense of purpose in the distress), Prayer or spirituality for support, Relaxation techniques, One thing at a time (focusing on the present task), taking a mental Vacation, and Encouragement (positive self-talk). This skill can be beneficial in situations where you feel stuck or helpless, as it offers various ways to positively alter your current state of mind.

Pros and Cons

Pros and Cons is a decision-making tool that involves weighing the positive and negative outcomes of a situation or action. This skill is particularly useful when facing tough decisions during a crisis, as it helps to evaluate the potential consequences of different choices.


TIPP involves physiological techniques to quickly reduce emotional arousal. It stands for Temperature change (like holding an ice pack), Intense exercise (to burn off energy), Paced breathing (to calm the nervous system), and Progressive muscle relaxation (to release physical tension). These methods are particularly effective in situations where you need to quickly reduce high levels of emotional or physical arousal.

Professional therapy plays a pivotal role in the effective application of Dialectical Behavior Therapy (DBT) skills, enhancing the value of self-help strategies. A therapist specializing in DBT provides essential support by customizing skills to fit individual needs and challenges. This personalization ensures that you can apply these skills more effectively in your unique circumstances.

Applying DBT Crisis Survival Skills, such as 'Distracting with Wise Mind ACCEPTS,' requires careful consideration to ensure they are used effectively and to prevent overreliance. These skills are designed for specific situations where immediate coping strategies are needed to manage acute emotional distress.

When to Apply DBT Skills

The primary guideline for using DBT Crisis Survival Skills is to reserve them for situations where you're experiencing intense emotional pain that cannot be immediately resolved. This might include instances of severe anxiety, overwhelming stress, or emotional responses that could lead to harmful behaviors. The key is to use these skills as a temporary measure to navigate through the crisis, rather than as a long-term solution.

Consider the context in which these skills are applied. They are most beneficial when used in situations where the emotional response is disproportionate to the actual event or when you're unable to address the issue immediately. For example, using these skills can be helpful during a panic attack or in a high-stress situation where immediate action is required.

Professional Help: The Role of Therapy in DBT Skill Application

In therapy, you also benefit from a structured environment that's conducive to learning and practicing DBT skills. Regular sessions allow for a systematic introduction to skills, ongoing practice, and necessary adjustments based on feedback. This structure is key to mastering and effectively integrating DBT skills into daily life.

Therapy provides a safe space for exploring complex and sensitive emotions. The therapeutic relationship offers a non-judgmental and supportive setting for delving into personal challenges, which is crucial for emotional growth and resilience. Additionally, therapists can incorporate DBT skills into a comprehensive mental health treatment plan, ensuring a holistic approach to your emotional well-being.

Overall, while self-help methods are useful, the guidance and support of a professional therapist significantly enhance the application and effectiveness of DBT skills. This professional involvement is crucial for a deeper, more meaningful engagement with the therapy and for achieving long-term mental health benefits.


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