Practical tools like DBT skills are essential when emotions feel unmanageable That’s where dialectical behaviour therapy (DBT) steps in — not just as a long-term therapy, but as a reliable method for navigating acute emotional crises. Originally designed to help individuals with borderline personality disorder, DBT has since proven effective for treating a wide range of mental health concerns, including depression, post-traumatic stress disorder (PTSD), bipolar disorder, and eating disorders.
Dialectical behaviour therapy (DBT) teaches four core skill sets: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. While each plays a role in long-term recovery, distress tolerance skills, in particular, are critical during moments of intense emotional pain. Explore DBT-based tools in real time, whether you’re experiencing a panic attack, self-harm urge, or surge of anger.
The S.T.O.P. Skill: Pausing in a Crisis
In the heat of a crisis, your first instinct might be to act impulsively. The S.T.O.P. skill is a four-step method to interrupt these reactions and slow things down:
- Stop: Literally freeze, don’t move a muscle.
- Take a step back: Physically or mentally step away from the situation.
- Observe: Notice what’s happening inside and around you (e.g., “My hands are shaking, my chest feels tight”).
- Proceed mindfully: Choose your next step deliberately. Whether it’s calling a friend, using a different DBT skill, or simply breathing.
This tool is especially helpful for de-escalating emotionally charged situations where the urge to react feels overwhelming.
The T.I.P. Skill: Calming Your Body’s Chemistry
Sometimes, your body needs to calm down before your mind can follow. The T.I.P. skill targets your physical state to reduce the intensity of emotional arousal:
- Temperature: Cool your body using ice packs or a cold shower. This slows your heart rate and activates your parasympathetic nervous system.
- Intense exercise: Do a quick burst of activity, like jumping jacks or running in place — for five minutes to release built-up adrenaline.
- Paced breathing: Try the 4-7-8 breathing method — inhale for 4 seconds, hold for 7, exhale for 8 — to reduce anxiety and promote calm.
T.I.P. is especially useful when you feel physically out of control, like during a panic attack or severe agitation.
The Opposite Action Skill: Defying Emotional Urges
In moments of intense emotion, your brain might urge you to take actions that reinforce suffering — like withdrawing from others, lashing out, or self-harming. Opposite action challenges you to do the exact opposite of what your emotion wants. If depression tempts you to isolate, try texting a friend or stepping outside. And if you feel the urge to self-harm because of shame, consider holding an ice cube or drawing on your skin with a red marker as a safer alternative. Or if you’re angry and want to yell, speak softly or write out your feelings instead. Over time, practising opposite action helps retrain the brain and reinforces emotional resilience.
Building a Personal Crisis Plan with DBT Skills
When you’re in the middle of a crisis, having a written plan can make all the difference. Start by outlining which DBT skills help you most, like S.T.O.P., T.I.P., or opposite action, and keep them somewhere easy to find. You can also create a printable safety plan using templates like this one from eMentalHealth.ca or this guide. CAMH also offers a helpful worksheet. Your plan might include distraction activities like Sudoku, music, or cuddling a pet, along with contact information for people you trust and local crisis lines. Removing triggering items from your environment, like sharp objects or alcohol, can also create a safer space.
When to Seek Professional Help
While DBT skills are powerful tools, there are times when professional intervention is necessary. If you are experiencing suicidal thoughts with a plan or intent, or symptoms of psychosis like hallucinations or delusions, it’s important to seek urgent help. In Canada, you can call or text the 988 Suicide Crisis Helpline for free, 24/7 support. If you’re under 25, the Kids Help Phone is also available. For ongoing care, the Centre for Addiction and Mental Health (CAMH) offers outpatient DBT programs. Family members and caregivers can also find support through Sashbear’s free Family Connections program.
Crisis moments don’t define you — but how you respond to them can shape your path forward. DBT offers hands-on, practical skills that help you interrupt distress and choose healthier coping strategies. Like any new habit, these techniques take time and patience to master, so be kind to yourself as you practise. You’re not alone and there’s always a next step.
Eli’s Place Communications Team
Our Eli’s Place blogs are developed & written by the Eli’s Place Editorial Team — a collaboration between staff and volunteers committed to raising awareness about serious mental illness in Canada. We aim to inform, inspire, and engage with readers who care about mental health and recovery.
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- Eli’s Place Communications Team#molongui-disabled-link
- Eli’s Place Communications Team#molongui-disabled-link
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