When you are feeling at the peak of anger, depression, and / or anxiety, you may have high urge to make quick and rash decisions. At this time you may choose to:
End a relationship
Engage in self harm or substance use
Send a message or say something that you don't really mean
Quit / Leave a job
Purchase something that is not within your budget
Restrict food or binge / purge
Engage in negative self talk
Throw, break, or hit something
When the difficult moment passes, you may be questioning why you did this behavior and feel even more guilt or shame following this action.
Crisis Survival skills are techniques / strategies that you can use at the peak points of distress. If you can get past this moment of wanting to act, you will be in a much better position to engage in a way that reflects your values and your long term goals.
Some of the crisis survival skills are as follows:
STOP skill
S - Stop (literally pause yourself before acting)
T - Take a step back
O - Observe available options
P- Proceed mindfully and within your values
Using Temperature
Splashing cold water in your face
In Minnesota, going outside into the cold winter weather for a moment
Putting your head in the freezer to feel the cold for 30 seconds
Taking a cold shower
Holding an ice cube or frozen orange for 30 seconds
Temperature techniques shock your system and bring you back to the present moment.
Paced Breathing
Mindfully breath in for 6 seconds, hold for 5 seconds, and release for 5 seconds. Continue this breathing technique 5 times.
Square Breathing
Breath in for 4 seconds, hold for 4 seconds, breath out for 4 seconds and hold for 4 seconds. Do this 4 times.
Distractions
Finding a distraction to get whatever is on your mind off of your mind for 5-30 minutes.
Watch a favorite TV show
Play a video game
Listen to a favorite song that calms you down
Go for a walk
Look at Memes on your phone or play a short game
Do a YouTube Drawing Tutorial. (My daughter and I did this one earlier today! See below)
Example of YouTube drawing Tutorial ^^
Self Sooth
Find things that sooth one of your senses. For the sense of touch some ideas may be:
Pet an animal
Put on a favorite lotion
Ask for a hug from a safe person in your life
Play with a fidgit
Attend to relationships
This skill consists of spending time with those that are supportive and helpful to us.
Call someone that you know who may be helpful when you are experiencing high distress. You may use this person as a distraction and ask them how their day is going.
These are just a couple of the crisis survival skills in Dialectical Behavior Therapy. We use these to assist in getting through the challenging moment without making ineffective / harmful decisions. When we are ready, we can approach the conflict or stressful situation in a more effective and value based way.
These skills take practice. Remember that even the attempt of the skills is progress. It is still progress even if we resort back to the ineffective behavior listed above.
Crisis Survival Skills are common DBT techniques created by Marsha Linehan in her DBT Skills Manual (Linehan, 2015).
Love these examples Sam! Thanks!