Crisis Survival Strategies

Skills for tolerating painful events and emotions when you cannot make things better right away

Distract with "Wise Mind ACCEPTS

  • Activities (keep busy)
    • Distress Tolerance helps you to feel better, and as you feel better and productive, your self esteem rises and endorphin’s are released.
    • When you do physical activity, you can get a good feeling because chemicals release when we exert ourselves.
    • Do something physical like exercise, hobbies, cleaning, go to community events, call or visit a friend, play computer games, go walking, work, play, participate in sports, go out to a meal, have decaf coffee or tea, go fishing, chop wood, do gardening, play pinball.
    • Do whatever works for you.
  • Contributing (get your mind off yourself)
    • Contribute to someone, do volunteer work; give something to someone else, make something nice for someone else, do a surprising, thoughtful thing.
  • Comparisons (could be worse...)
    • Watch disaster movies, watch soap operas, visit an ER waiting room, or a hospital waiting room, compare yourself to people coping the same as you or less well than you.
  • Emotions (do something that makes you feel differently)
    • (Opposite Emotions): Be sure what you do will create the opposite emotion to what you are feeling.
    • You could watch comedies like "I Love Lucy" or "Carol Burnett" or watch emotional movies or listen to emotional music.
    • Read emotional books or stories
  • Pushing away (block out thoughts and feelings)
    • use this skill last - as a tuning out):
    • Push the situation away by leaving it for a while, leave the situation mentally.
    • Build an imaginary wall between yourself and the situation or push the situation away by blocking it out of your mind.
    • Censor ruminating.
    • Refuse to think about the painful aspects of the situation.
    • Put the pain on a shelf. Box it up and put it away for a while.
  • Thoughts (distracting thoughts)
    • (other thoughts):
    • Count to 10;
    • count colors in a painting or tree or out the window.
    • Do anything, work puzzles, watch TV, read.
  • Senses (be aware of your senses)
    • other intense sensations):
    • Hold ice in your hand, squeeze a rubber ball very hard, take a hot shower, listen to loud music, sex, snap a rubber band on your wrist, suck on a lemon.

Self-Soothe with the Five Senses

  • Vision (e.g., imagine a beautiful beach)
    • Buy one beautiful flower, make one space in a room pretty, light a candle and watch the flame. Set a pretty place at the table, using your best things for a meal. Go to a museum with beautiful art. Go sit in the lobby of a beautiful old hotel. Look at nature around you. Go out in the middle of the night and watch the stars. Walk in a pretty part of the town. Fix your nails so they look pretty. Look at beautiful pictures in a book. Go to a ballet or other dance performance, or watch one on TV. Be mindful of each sight that passes in front of you, not lingering on any.
  • Hearing (e.g., listen to a favourite song)
    • Listen to beautiful or soothing music, or to invigorating and exciting music. Pay attention to sounds of nature like waves, birds rainfall, rustling leaves. Sing your favorite songs, hum a soothing tune, learn to play an instrument. Call 800 or other information numbers to hear a human voice. Be mindful of any sounds that come your way, letting them go in one ear and out the other.
  • Smell (e.g., essential oil, baking)
    • Use your favorite perfume or lotions, or try them on in the store, spray fragrance in the air, light a scented candle. Put lemon oil on your furniture. Put potpourris in a bowl in your room. Boil cinnamon, bake cookies, cake or bread. Smell the roses. Walk in a wooded area and mindfully breathe in the fresh smells of nature.
  • Taste (e.g., bite of fruit or chocolate)
    • Have a good meal, have a favorite soothing drink, such as herbal tea or hot chocolate (but no alcohol). Treat yourself to a dessert. Put whipped cream on your coffee. Sample flavors at an ice cream store. Suck on a piece of peppermint candy. Chew your favorite gum. Get a little bit of special food you don't usually spend the money on, such as fresh squeezed orange juice or organic vegetables. Really taste the food you eat, eating one thing mindfully and focusing on its taste.
  • Touch (e.g., taking a bath, curling up with a cozy blanket)
    • Experience whatever you are touching, notice that the touch is soothing. Take a bubble bath, put clean sheets on the bed, pet your dog or cat, have a massage, soak your feet, put creamy lotion on your whole body. Put a cold compress on your forehead, sink into a really comfortable chair in a hotel lobby or in your home, put on a silky blouse, dress, or scarf. Try on fur-lined gloves. Brush your hair for a long time. Hug someone.

Source: Source: Dialectical Behavior Therapy Skills Handbook, Fulton State Hospital, Jan 2004 Adapted for use from Linehan, M.M. (1993). Skills Training Manual for Treating Borderline Personality Disorder. New York: Guilford Press.

Improve the Moment

  • Imagine (better times, better things, success)
    • Imagine very relaxing scenes or soldiers fighting and winning. Imagine a secret room within yourself, seeing how it is decorated. Go into the room whenever you feel threatened. Close the door on anything that can hurt you. Imagine everything going well. Imagine coping well. Make up a fantasy world that is calming and beautiful and let your mind go with it. Imagine hurtful emotions draining out of you like water out of a pipe.
  • Meaning
    • (create a track record of endurance) Find or create some purpose, meaning or value in physical or emotional pain. Remember, listen to, or read about spiritual values. Focus on whatever positive aspects of a painful situation you can find. Repeat them over and over in your mind. Make lemonade out of lemons.
  • Prayer:
    • (walk and talk out loud or kneel and pray to your higher power, to God, Goddess, whoever) Open your heart to a supreme being with great wisdom, whatever that means to you. It could be God or your own wise mind for instance. Ask for the strength to bear the pain in this moment. Turn things over to God or a higher being.
  • Relaxation
    • Find humor and laugh. Try relaxing each large muscle group, starting with your hands and arms, going to the top of your head, and then working down. Listen to a relaxation tape, exercise hard, take a hot bath, or sit in a hot tub. Drink hot milk, massage your neck and scalp, or your calves and feet, get in a tub filled with very cold or hot water and stay in it as long as you can tolerate. Breathe deeply, half-smile, change your facial expression
  • One thing at a time
    • Focus your entire attention on just what you are doing right now. Keep yourself in the very moment you are in in the present. Focus your entire attention on physical sensations that accompany nonjudgmental tasks. (e.g. walking, washing, doing dishes, cleaning, fixing). Be aware of how your body moves during each task. Do awareness exercises.
  • Vacation
    • Give yourself a brief vacation. For instance, from 2 p.m. to 4 p.m., get in bed and pull the covers over your head for 20 minutes. Rent a motel room at the beach or in the woods for a day or two. Unplug your phone for a day, or let your answering machine screen your calls. Take a 1 hour breather from work that needs to be done. Look at a magazine, bundle up in a chair, eat slowly. Allow yourself to be a kid again - take a break from adulthood.
  • Encouragement
    • Cheer lead yourself. Repeat over and over: “I can stand it. This won't last forever. I will make it out of this. I'm doing the best I can. I can do it. I am OK.
  • Thinking of Pros and Cons
    • Make a list of the pros and cons of tolerating the distress vs. not tolerating the distress - that is, of coping by hurting yourself, abusing alcohol, or drugs, or doing something else impulsive. Focus on long-term goals, the light at the end of the tunnel. Remember times when pain has ended. Think of the positive consequences of tolerating the distress. Imagine in your mind how good you will feel if you achieve your goals, if you don't act impulsively. Think of all of the negative consequences of not tolerating your current distress. Remember what has happened in the past when you have acted impulsively to escape the moment. Ask yourself, “Will this event that is distressing me going to matter in 5 years?”



For help in a crisis, call the 24/7 VI Crisis Line at 1.888.494.3888, visit your local emergency department, or call 911

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