DBT Skills: STOP a Crisis

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Dialectical behavior therapy (DBT) is an evidence-based, therapeutic approach. Its main goals are to teach people how to live in the moment, develop healthy ways of coping with stress, regulate their emotions, and improve their relationships with others. One tool in DBT is particularly helpful in times of crisis, and uses the acronym STOP (Stop, Take a step back, Observe, and Proceed mindfully). When we are in crisis, it may be hard to cope with overwhelming emotions, and we may act in ways that are more harmful than helpful. By learning and practicing the acronym STOP, we can help ourselves “survive the crisis”, and STOP ourselves from making the situation worse.

When to Use STOP

• We want to act impulsively or out of emotion (e.g. yell at our partner; use a substance; engage in self harm; etc.)
• We feel emotionally overwhelmed, and still need to act skillfully (e.g. starting to feel a panic attack in a social situation; feeling filled with grief, and still needing to finish a project; experiencing a crying spell, and still needing to take care of a pet or child)
• We feel an intense physical pain that can’t be stopped (e.g. chronic illness or pain)
• We are experiencing extreme arousal (e.g. feeling overstimulated; a trauma response is triggered; we have intrusive thoughts; etc.)

STOP Skill

Stop

• Whenever you notice a crisis arising, stop whatever you are doing
• Choose not to react, or act on an urge

Take a step back

• Take a deep breath, noticing the inhale and the exhale
• Take a temporary break from the situation if possible, to give yourself some space mentally and/or physically

Observe

• Check in with your body and notice any emotions or sensations that are present
• Check in with your environment and notice what is going on around you
• Observe any thoughts or judgements that may be coming up, with a sense of curiosity

Proceed mindfully

• Act with awareness rather than impulse or emotion, and mindfully consider all of the external and internal factors
• Be intentional with your next actions, and ensure they align with your goals and values

Reflection

• What are some common situations that you may find yourself in a crisis?
• What are the early warning signs that a crisis may occur (i.e. people, places, thoughts, emotions, urges, etc.)?
• What are some negative outcomes that have occurred when you didn’t STOP?
• What are some positive outcomes that might occur if you did STOP?
• How will you remember or remind yourself to STOP in the future?

Additional Resources

• DBT: Distress Tolerance Skills
• DBT: Interpersonal Effectiveness
• DBT Skills: Opposite Action
• DBT Skills: Soothing Anxiety
• DBT Skills: TIPP for Emotional Crisis
• Everyday Mindfulness
• Finding Unity
• Mindfulness Basics
• Self-Soothing Activities

References

• Linehan, M., M., (2014). DBT Training Manual. New York, NY: The Guilford Press.