The STOP skill is used in the very first seconds of a crisis urge — before you do anything else. It creates a pause between the emotional trigger and your response, giving you space to choose skillfully rather than react automatically.

• SStop. Don't act. Freeze in place. Do not move a muscle. Your emotion is not an emergency — yet.
• TTake a step back. Physically step back if you can. Take a breath. Separate yourself from the intensity of the moment.
• OObserve. Notice what is happening inside you and around you. What are you feeling? What triggered this? What does the situation actually look like?
• PProceed mindfully. Ask: what is my goal here? What is the most effective thing I can do right now? Then act from that place — not from the emotion.

ACCEPTS is an acronym for ways to distract yourself during a crisis. These aren't avoidance — they're short-term survival tools to get through intense moments.

• AActivities — Do something engaging: clean, cook, play a game, work out, or any hobby
• CContributing — Help someone else; volunteer, text a friend, do something kind
• CComparisons — Compare to a harder time you survived, or to others in more difficult situations
• EEmotions — Create a different emotion with a movie, music, or reading
• PPushing Away — Mentally set the problem aside temporarily; you can return to it later
• TThoughts — Replace with counting, puzzles, or reciting something
• SSensations — Use intense but safe sensation: cold, heat, strong flavor, texture

TIPP works by directly targeting your nervous system's physiological state — particularly useful when emotion mind has completely taken over.

• TTemperature: Hold ice, splash cold water on your face, run cold water over your wrists, or fill a bowl with cold water and ice and dunk your face for up to 30 seconds. Activates the dive reflex, rapidly slowing heart rate. (Avoid if you have a heart condition.)
• IIntense Exercise: Run, jump, do burpees — match the intensity of your emotion with your body. Burn it off.
• PPaced Breathing: Exhale longer than your inhale. Try 4-count in, 6-count out.
• PProgressive Relaxation: Tense each muscle group for 5 seconds, then release. Work from feet to face.

Radical acceptance doesn't mean you approve of what happened — it means you stop fighting against reality. Fighting reality causes suffering on top of pain.

• 1Observe that you are fighting reality ("I'm telling myself this shouldn't be happening")
• 2Remind yourself: this is what happened. It is already real, regardless of your wishes.
• 3Notice what refusing to accept is costing you emotionally.
• 4Practice acceptance in your body: relax clenched fists, unclench your jaw, breathe.
• 5Use a coping statement: "This is what is. I can tolerate this moment."

Self-soothing uses sensory experience to calm your nervous system. Have a personal "self-soothe kit" ready for crisis moments.

• 👁️Vision: Candles, nature, art, photos of people/places you love
• 👂Hearing: Calming music, nature sounds, rain, a favorite podcast
• 👃Smell: Lotion, essential oils, baking, fresh air
• 👅Taste: Herbal tea, a favorite food eaten mindfully, something sour or sweet
• 🤚Touch: Soft blanket, warm bath, petting an animal, massage

In crisis, list the short and long-term pros and cons of tolerating the distress vs. giving in to the crisis behavior. This engages your rational mind even during emotional flooding.

• 1Pros of tolerating distress: what happens if I resist acting on the urge?
• 2Cons of tolerating distress: what am I giving up by not acting?
• 3Pros of acting on crisis behavior: short-term relief, etc.
• 4Cons of acting: long-term costs to relationships, goals, self-respect

IMPROVE is used when you're in a painful situation you cannot immediately change. Rather than escaping it, you shift your relationship to the moment itself. Use one or several strategies together.

• IImagery — Imagine a safe, peaceful place in vivid detail. Or picture the situation going well.
• MMeaning — Find or create a reason for the suffering. What might this moment be teaching you?
• PPrayer — Connect with something larger than yourself — whether spiritual, secular, or simply the universe.
• RRelaxation — Use muscle relaxation, warm bath, deep breathing, or any body-based calming practice.
• OOne thing in the moment — Focus completely on just this one moment. Not the past or future.
• VVacation — Give yourself a brief mental or physical break from the problem. Even 10 minutes.
• EEncouragement — Cheerlead yourself. "I can get through this." "This feeling will pass." "I've survived hard things."

DEAR MAN is the core skill for making requests or saying no. The first four letters help you communicate clearly; the last three help you stay effective even when pushed back on.

• DDescribe the situation with just the facts
• EExpress your feelings with "I" statements
• AAssert what you want or don't want, clearly
• RReinforce — explain why it benefits them too
• MMindful — stay focused on your goal; ignore attacks/distractions
• AAppear confident — tone, posture, eye contact
• NNegotiate — offer alternatives, be willing to give a little

Use GIVE when maintaining the relationship matters as much as getting what you want. It keeps the interaction warm and non-threatening.

• GGentle: No attacks, no judgments, no sneering, no threats
• IInterested: Listen and appear interested in the other person's perspective
• VValidate: Acknowledge their feelings and point of view as understandable
• EEasy manner: Use a little humor and lightness; don't be overly intense

FAST is for situations where your self-respect matters most — where you don't want to compromise your values just to please someone or avoid conflict.

• FFair: Be fair to yourself AND the other person
• AApologies (no excessive): Don't apologize for existing or making a request
• SStick to values: Don't compromise what matters to you to keep the peace
• TTruthful: Don't lie, exaggerate, or act helpless to manipulate

Validating someone doesn't mean agreeing with them — it means showing that their feelings make sense given their history and situation.

• 1Pay attention — put down the phone, make eye contact
• 2Accurately reflect back what you heard
• 3Read and name unspoken feelings or thoughts
• 4Validate based on history ("Of course you feel this way given what happened")
• 5Normalize ("Anyone would feel that way")
• 6Radical genuineness — treat them as capable and equal

Emotions are often triggered by interpretations, not just facts. Work through each question to see if your emotional response matches reality — or if it's being amplified by assumptions.

When your emotion doesn't fit the facts (or when acting on it would make things worse), act opposite to what the emotion is telling you to do — all the way.

• 😢Depression/sadness: Act active. Get up, reach out, do something — even if it feels pointless
• 😡Anger: Gently avoid, do something kind, take a break
• 😰Fear: Approach what you fear (safely). Do what you're afraid of doing
• 😳Shame: Share with a safe person; don't hide
• 😒Disgust: Get close to what disgusts you (when appropriate)

Your physical health is the foundation of emotional resilience. Answer yes or no for each area to see your wellbeing score and get suggestions for anything that needs attention.

Positive emotions are not a luxury — they build resilience. This skill is about intentionally increasing positive emotion in your life, not just waiting for it to happen.

• 1Short-term: Do at least one pleasant thing each day. Don't wait until you "deserve" it.
• 2Be mindful of positive moments: When something good happens, pay attention to it. Let it in.
• 3Long-term: Work toward goals and changes that create a life worth living
• 4Attend to relationships: Repair and maintain relationships that bring you joy

Depression and emotional dysregulation erode your sense of competence. Deliberately doing things you're good at — or learning new skills — builds the emotional foundation of self-respect.

• 1Identify activities that make you feel capable, successful, or skilled
• 2Plan to do at least one mastery activity daily
• 3Make it challenging enough to feel meaningful, but achievable

Observe means noticing your experience without immediately trying to change it, analyze it, or put it into words. Just witness what is happening right now.

• 1Notice sensations in your body — temperature, pressure, tingling
• 2Watch your thoughts pass like clouds, without grabbing onto them
• 3Notice emotions as waves of sensation — where do you feel them in your body?
• 4Observe what's happening in the room: sounds, light, space

Describe means applying words to what you observe — but only observable facts, not interpretations. This separates experience from the story we tell about it.

• ✓"I notice tightness in my chest" (not "I'm anxious and something bad will happen")
• ✓"I noticed the thought 'I'm a failure'" (not "I am a failure")
• ✓"My face is hot" (not "I'm embarrassed and everyone is judging me")

Participate is the opposite of being a spectator of your own life. It means becoming one with your experience — fully immersed, without self-consciousness.

• 1Stop observing yourself and just do the activity fully
• 2Dance, sing, talk, or work without stepping outside to judge yourself
• 3Respond skillfully to each moment as it comes, without holding back

Referenced in Linehan's DBT Skills Training Manual as a tool for reducing autonomic arousal before sleep. The extended hold and exhale activate the parasympathetic nervous system and lower heart rate, signaling to the body that it is safe to rest.

• 4Inhale quietly through your nose for 4 counts
• 7Hold your breath for 7 counts
• 8Exhale completely through your mouth for 8 counts — make a whoosh sound

Box breathing (also called square breathing) uses equal timing on all four phases to create a steady, regulated breathing rhythm. Used in DBT as part of the Paced Breathing skill family for reducing physiological tension during distress.

• 4Inhale through your nose for 4 counts
• 4Hold for 4 counts
• 4Exhale slowly for 4 counts
• 4Hold for 4 counts

PMR is included in Linehan's DBT Skills Training Manual as part of the Emotion Regulation and distress tolerance toolkit. It works on the principle that physical tension and emotional distress are interlinked — releasing one reliably reduces the other.

• 1Tense the muscle group firmly but not painfully for 5–7 seconds
• 2Release suddenly and completely
• 3Rest for 20–30 seconds, noticing the warmth and heaviness of relaxation
• 4Move to the next group — always working from feet to face