Dialectical Behavior Therapy (DBT) teaches you distress tolerance skills to help you deal with crisis situations.
The first distress tolerance skill taught in DBT is called STOP.
We will go into what the STOP skill is and how to use it, but first, let’s look at how DBT defines a crisis.
What is a crisis
A crisis in DBT is a very stressful situation that can’t immediately be changed.
You have to figure out how to just get through the situation without making things worse.
How to make a crisis worse
Doing something you are trying not to do:
When crisis hits, you may do something you later regret.
Doing that thing gives you immediate relief, but creates more problems down the road.
Not doing something you need to do:
When you need to do something, but you’re overwhelmed by emotions – that’s a crisis, too.
Avoiding what needs to be done creates more problems.
DBT’s STOP skill – a Distress Tolerance Skill
Distress tolerance skills help you survive a crisis without doing something you are trying not to do, or avoiding doing something you need to do.
STOP is one tool to help you ride out a crisis.
What is the STOP skill?
STOP is an easy to remember mnemonic.
Let’s look at what each letter stands for:
Freeze in your tracks. Don’t move. Try visualizing a red STOP sign in front of you.
Don’t react when your emotions are hot and filled with energy.
Don’t let your emotions control you.
T: Take a step back.
You can do this in your mind or you can physically take a step back. This helps you unglue yourself from the intensity of the urge to react.
Once you’ve taken a step back, notice how you’re breathing. You may be holding your breath or breathing shallowly. Try to take a few slow, deep breaths.
O: Observe what’s going on both inside of you and around you.
If there are other people around you, notice what they’re doing or saying.
Notice what you’re thinking and feeling.
When you’re in a crisis, it is easy to zoom in and only see a tiny bit of a bigger picture – but then you only have one slice of information. You need to be able to see the whole picture (zoom out) to figure out the best course of action.
P: Proceed Mindfully.
Will reacting impulsively really get you what you want in the long run?
The STOP skill in action:
First, let’s look at how you can use the STOP skill to help you not engage in behavior you’ll later regret.
Your partner tells you they need some space. They are going to stay at a friend’s house for a while to think things over.
You’re so upset and scared when you hear this news that you want to yell at them.
Or beg them not to leave.
- S: Stop! Don’t say or do anything.
- T: Take a step back. Actually step away from your partner. Notice how you’re breathing. Try to take some deep breaths.
- O: Observe what’s going on inside and outside. Observe your thoughts and feelings. Are you scared your relationship is going to end? Observe what your partner is doing. Are they waiting expectantly for your response? Observe your surroundings, like a camera zooming out to take in the whole scene. Is the sun coming in through the window? Is your cat curled up on your couch?
- P: Proceed mindfully. Consult your wise mind. Does your wise mind tell you to start screaming at your partner or begging them not to go? Ask your wise mind how you want to feel about yourself tomorrow.
Now, let’s look at how you can use the STOP skill to help you not avoid doing something you need to do.
You have a deadline for a work project approaching. If you don’t complete the project, it will create major problems at work.
You’re mad at yourself for procrastinating and scared of losing your job.
You’re so overwhelmed by your emotions that you can’t think straight and the hours are ticking by.
- S: Stop in your tracks. Whatever you’re doing, stop immediately. If you’re in front of your computer, put your hands down.
- T: Take a step back by getting up and walking away from your computer or desk. Maybe go outside for a moment. Notice how you’re breathing. See if you can take some deep breaths.
- O: Observe the situation. What’s going on inside you? Outside you? Notice judgmental or worrying thoughts. Observe your body, too. Are your shoulders hunched? Is your jaw clenched? Notice your surroundings.
- P: Proceed mindfully. Ask your wise mind what the best course of action is. Does your wise mind tell you to spend the next few hours avoiding your project or getting to work? Ask your wise mind what the next right step is for you.
The STOP skill…
…is great to use in the heat of the moment to stop yourself from doing something you’ll regret later. But it’s not a way of life, nor is it necessarily meant to make you feel better.
You know the skill is working if you survived the crisis without doing something (or not doing something) that made things worse.