Crisis

Endure and soothe yourself

For moments when a problem cannot be solved right now and what is needed first is inner soothing, comfort, or a more bearable moment.

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entries
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roles
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Clusters

What this is about

This situation becomes central in DBT when pain, emptiness, or inner distress cannot be solved quickly and the first task is therefore not change but tolerability. In Linehan's manual, Self-Soothing and Improving the Moment sit side by side here: one works through the five senses and immediate comfort, the other through imagery, meaning, prayer, relaxing actions, one thing in the moment, brief vacation, and encouragement.

Clinically, the key distinction from acute crisis is that not every painful moment needs a full alarm response; sometimes it needs soothing, containment, and a more bearable present moment. The most common mistake is trying to make unsolvable pain disappear immediately and thereby creating even more pressure, avoidance, or self-harm.

What happens in the body

Body reactions, typical impulses in an exceptional state, and escalation course as orientation for first stabilizing steps.

  • Body in exceptional stateInner distress, pressure in the chest, sensory openness, body tension, need for shelter or comfort, restlessness that is hard to regulate
  • Typical impulsesRun away, numb out, fix everything immediately, get stuck, look for comfort, hide, or do anything that makes the moment easier to bear
  • Escalation courseNot every painful moment can be changed immediately. In those cases, skills help make the present moment more tolerable without tipping into escalation, avoidance, or self-harm.

First entry (1)

The most direct first step for this situation.

SkillPrioritized firstDistress Tolerance

Self-Soothing

When reassurance, body regulation or a non-punitive form of self-care are needed before problem solving, emotion regulation or interpersonal skills.

Also in: Mindfulness · Emotion Regulation

Open entry

Orient (2)

Helps frame the situation and gain an overview.

QuestionPrioritized first

Is This Self-Soothing or Improving the Moment?

When sensory-physical calming and broader IMPROVE strategies easily blur together.

Also in: Distress Tolerance

Open entry
Skill bundlePrioritized firstDistress Tolerance

STOP Skill

If before any further analysis, communication or regulation, the reflexive further reaction must first be stopped.

Also in: Emotion Regulation · Interpersonal Effectiveness

Open entry

Apply (2)

Concrete exercises and skills for the situation.

SkillPrioritized firstDistress Tolerance

Improving the Moment

If the secondary overload of the moment should be reduced so that perseverance, thinking and later skill use become possible again.

Also in: Mindfulness · Emotion Regulation

Open entry
ExercisePrioritized firstDistress Tolerance

Safe-Place Visualization

When, in times of stress or fear, a quickly accessible inner counter-image to threats and excessive demands needs to be created.

Also in: Emotion Regulation

Open entry

Stabilize (3)

Supports calming and regulation in the situation.

Skill bundlePrioritized firstDistress Tolerance

TIP Skills

When what is needed is not primary understanding or talking, but rather quick, body-oriented crisis regulation.

Also in: Emotion Regulation

Open entry
ExercisePrioritized firstDistress Tolerance

Cue-Controlled Relaxation

When not only general relaxation is needed, but also the fastest possible, trained approach to calming down in stressful situations.

Also in: Emotion Regulation

Open entry
ComponentPrioritized firstDistress Tolerance

TIP: Paced Breathing

When acute tension requires immediate, close-to-the-body and discreet regulation.

Also in: Emotion Regulation

Open entry