When we feel emotionally threatened—whether by conflict, past trauma, or overwhelming stress—our nervous system shifts into survival mode. This threat response (fight, flight, freeze, or fawn) is the body’s way of protecting us, but it can also disrupt our emotional balance and relationships. We may lash out, shut down, or people-please to avoid discomfort, even when these reactions don’t serve our long-term well-being. Dialectical Behavior Therapy (DBT) offers practical skills to help us manage these intense emotions, regulate our nervous system, and respond to challenges with greater awareness and care.
One of DBT’s core components is Mindfulness, which helps us observe our emotions and reactions without immediately acting on them. When we notice ourselves getting triggered, mindfulness encourages us to pause, name what we’re feeling, and engage with the present moment rather than reacting impulsively. This simple shift allows the prefrontal cortex (the thinking part of our brain) to engage, giving us more control over how we respond. By practicing mindfulness regularly, we train our nervous system to recognize that we are safe, reducing emotional reactivity over time. Another essential DBT skill for managing the threat response is Distress Tolerance, which teaches us how to navigate emotional crises without making things worse. Techniques like TIP (Temperature, Intense Exercise, Paced Breathing, and Progressive Muscle Relaxation) can quickly calm an overactivated nervous system, helping us regain a sense of control. By engaging in distress tolerance strategies, we communicate to our body that we are not in immediate danger, allowing us to respond to conflict and stress with greater stability and clarity. In relationships, the Interpersonal Effectiveness skills of DBT help us set boundaries, communicate needs, and navigate conflict without falling into patterns of defensiveness or avoidance. The DEAR MAN technique (Describe, Express, Assert, Reinforce, Mindful, Appear Confident, Negotiate) provides a framework for expressing ourselves clearly while maintaining respect for both our needs and the needs of others. This approach strengthens relational trust and reduces the likelihood of emotional escalation, making it easier to repair and maintain meaningful connections. As we practice DBT skills, we support our nervous system’s natural capacity for healing and regulation. With time and consistency, our ability to pause, self-soothe, and communicate effectively grows, allowing us to move from reactivity to intentionality. Healing from the impacts of a dysregulated threat response is not about perfection but about building resilience through small, steady efforts. The more we practice, the more we reinforce safety within ourselves and our relationships, creating a life where connection, stability, and emotional well-being become the norm rather than the exception. Would you like specific guidance on practicing these skills in your daily life?
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Life can present moments of intense emotional distress where coping feels nearly impossible. During these times, having tools to navigate the storm can make all the difference. Dialectical Behavior Therapy (DBT) offers crisis survival skills that are designed to help you endure and reduce emotional pain in the short term, ensuring safety and stability. In this post, we will explore three essential DBT skills for crisis survival: TIPP, Distraction, and Radical Acceptance. These skills are practical, compassionate, and provide a lifeline during moments of overwhelming distress.
TIPP: Regaining Control Through Your Body When emotions feel out of control, the TIPP skill can help you regulate your body to calm your mind. TIPP stands for Temperature, Intense exercise, Paced breathing, and Progressive muscle relaxation. For instance, placing an ice pack on your forehead or submerging your face in cold water (Temperature) can activate your body’s dive reflex, reducing emotional intensity. Similarly, engaging in a brief but vigorous workout (Intense exercise) can burn off excess energy. Paced breathing and progressive muscle relaxation further help by slowing your heart rate and easing physical tension. TIPP is especially helpful in bringing immediate relief when emotions feel unmanageable. Distraction: Creating Space from the Pain Sometimes, the best way to survive a crisis is to temporarily shift your focus. The Distraction skill encourages you to engage in activities that divert your attention from the distressing situation. This might involve calling a friend, watching a favorite show, organizing your space, or immersing yourself in a creative hobby. The key is to choose something that occupies your mind and prevents you from dwelling on the pain. While distraction doesn’t solve the root problem, it provides the mental space needed to return to the situation with a calmer perspective. Radical Acceptance: Finding Peace in What Is In moments of crisis, fighting against reality can amplify suffering. Radical Acceptance is the practice of fully acknowledging the situation as it is, without judgment or resistance. This doesn’t mean you approve of or like the situation; rather, it’s about recognizing that reality exists, whether or not we agree with it. For example, if you’re dealing with a sudden loss, Radical Acceptance involves saying, “This is painful, and it’s happening.” By letting go of the internal struggle, you can reduce additional layers of emotional pain and begin to focus on what you can control. A Lifeline in the Storm Crisis survival skills like TIPP, Distraction, and Radical Acceptance are not about fixing everything at once—they are about enduring the moment and creating a bridge to stability. These tools remind us that no matter how intense the emotional storm, there are ways to navigate through it. With practice, these skills can become a reliable part of your mental health toolkit, empowering you to face challenges with resilience and hope. Remember, you are not alone, and seeking support from a trusted professional or loved one can further strengthen your path to healing. Building and maintaining healthy relationships is a vital part of a fulfilling life, but it’s not always easy. Dialectical Behavior Therapy (DBT) offers a set of skills specifically designed to improve interpersonal effectiveness, making it easier to navigate conflicts, set boundaries, and nurture meaningful connections. In this post, we will explore three essential DBT skills—DEAR MAN, GIVE, and FAST—that can transform the way you relate to others. These skills are practical, empowering, and rooted in empathy, offering hope for creating stronger, more satisfying relationships.
DEAR MAN: Asking for What You Need One of the most common challenges in relationships is effectively expressing our needs without damaging the relationship. DEAR MAN is a structured DBT skill designed to help you assert yourself while maintaining respect for the other person. The acronym stands for Describe, Express, Assert, Reinforce, stay Mindful, Appear confident, and Negotiate. For example, if you need a partner to help more with household chores, you might say, “I’ve been feeling overwhelmed (Express) because the chores are piling up (Describe). Could we create a schedule to divide them more evenly? (Assert)” This approach fosters clarity and collaboration, ensuring your needs are heard while respecting the other person’s perspective. GIVE: Strengthening Relationships with Empathy While it’s important to express your own needs, nurturing relationships also requires showing care and understanding. The GIVE skill focuses on creating and maintaining positive interactions. GIVE stands for Gentle, Interested, Validate, and Easy manner. For instance, when a friend shares a problem, you might respond gently (“I’m here for you”), show interest (“Tell me more about how you’re feeling”), validate their emotions (“It makes sense you’d feel that way”), and use an easy manner, such as smiling or offering humor when appropriate. GIVE helps create an atmosphere of trust and support, strengthening the bond between you and others. FAST: Maintaining Self-Respect in Relationships Healthy relationships require balance—not only considering the needs of others but also preserving your own self-respect. The FAST skill emphasizes staying true to your values while interacting with others. FAST stands for Fair, Apologies (limited to when necessary), Stick to your values, and Truthful. For example, if a colleague pressures you to take on extra work that you cannot manage, you might say, “I want to help, but I need to stick to my current commitments (Stick to your values). Thank you for understanding.” By using FAST, you ensure that your self-respect remains intact while navigating relational challenges. A Path Toward Stronger Connections Improving relationships takes effort, patience, and the right tools. DBT skills like DEAR MAN, GIVE, and FAST provide actionable strategies to enhance communication, build trust, and maintain self-respect. These skills remind us that relationships thrive on mutual understanding, empathy, and healthy boundaries. Whether you’re resolving a conflict, deepening a friendship, or setting limits, these DBT skills offer a compassionate and hopeful framework for success. With practice, you can create the meaningful and fulfilling connections you deserve. Navigating trauma triggers can be an overwhelming and disorienting experience, but Dialectical Behavior Therapy (DBT) offers effective tools to help individuals regain a sense of safety and control. DBT, developed by psychologist Dr. Marsha Linehan, is a therapy designed to balance acceptance and change, making it particularly helpful for those managing intense emotional responses. In this post, we will explore three DBT skills—Grounding, Opposite Action, and Self-Soothe—that can be transformative in navigating trauma triggers. These skills are practical, adaptable, and offer a pathway to resilience and healing.
Grounding: Anchoring Yourself in the Present Moment Trauma triggers often pull us into the past, making it difficult to stay connected to the present. Grounding techniques serve as anchors to the "now," helping you to focus on what is real and immediate. A simple yet powerful grounding exercise is the "5-4-3-2-1" method: identify five things you can see, four you can touch, three you can hear, two you can smell, and one you can taste. This exercise gently redirects your attention to your current surroundings, reducing the intensity of the emotional response. Grounding not only interrupts the cycle of reactivity but also reinforces your sense of safety and presence. Remember, you are not in the past—you are here, and you are safe. Opposite Action: Choosing Empowerment Over Avoidance When faced with a trauma trigger, the natural response might be to avoid or withdraw. While this instinct is understandable, it can sometimes reinforce feelings of fear and helplessness. Opposite Action, a DBT skill, involves intentionally engaging in behaviors that counteract these urges. For example, if a trigger makes you want to isolate, you might choose to call a supportive friend or take a walk in a safe, public place. This skill requires practice and courage, but it can gradually weaken the power of the trigger and strengthen your sense of agency. By challenging avoidance, you’re affirming that you are stronger than your fears and capable of reclaiming your life. Self-Soothe: Nurturing Yourself with Compassion Triggers can leave you feeling raw and vulnerable, which is why the Self-Soothe skill is so vital. This DBT skill encourages you to engage your senses in comforting, nurturing activities. Consider lighting a scented candle, wrapping yourself in a soft blanket, or listening to calming music. The goal is to create an environment that fosters relaxation and safety. By treating yourself with kindness and care, you’re sending a powerful message to your nervous system: it’s okay to relax, and you deserve comfort. Self-soothing not only eases the immediate distress but also builds a foundation of self-compassion that supports long-term healing. A Path Toward Healing The journey through trauma is not linear, and it’s natural to encounter moments of struggle along the way. However, integrating DBT skills like Grounding, Opposite Action, and Self-Soothe can equip you with tools to navigate even the most challenging triggers. Each skill is a step toward reclaiming your power, rebuilding your resilience, and reconnecting with your sense of self. Healing is not about erasing the past but learning to live fully in the present, and these skills provide a hopeful and actionable pathway to do just that. Remember, you are not alone in this journey, and support is always available to help you move forward. Depression and the freeze response to trauma can share a variety of overlapping symptoms, which can sometimes make it challenging to distinguish between the two. Both conditions can lead to low energy, a sense of emotional numbness, and difficulty with motivation. However, while depression often develops gradually, stemming from a complex mix of genetic, environmental, and emotional factors, the freeze response is a specific reaction to trauma. In this state, the nervous system essentially “shuts down” as a protective mechanism, making a person feel frozen, helpless, or disconnected. Understanding these differences can help people find more tailored approaches to healing, as both require specific kinds of care and support.
The freeze response is part of the body’s natural “fight, flight, or freeze” reaction, which is governed by the autonomic nervous system. When faced with trauma, the sympathetic nervous system (responsible for the body’s fight-or-flight response) may initially prepare the body to react, but if the threat feels too overwhelming, the parasympathetic nervous system can kick in, causing the body to freeze. This response helps a person feel “safe” by essentially numbing sensations, slowing reactions, and suppressing emotions. In trauma survivors, this freeze state can sometimes persist long after the initial trauma, creating symptoms that overlap with depression, such as low energy, numbness, and emotional detachment. While it’s challenging, recovery from both depression and trauma is possible with the right support. Trauma-focused therapies, such as EMDR, IFS or somatic therapies, can help individuals release their bodies from the freeze response and reconnect with themselves. At the same time, treatments for depression, such as dialectic behavioral therapy (DBT) or mindfulness, can help rebuild a sense of purpose and energy. Working with a mental health professional can clarify the underlying causes of these symptoms and open pathways to healing. Remember, feeling “stuck” is not a permanent state—healing is achievable, and with compassion and the right tools, it’s possible to reclaim a life of resilience and hope. Mindfulness is a powerful tool in supporting anxiety, as it helps shift focus away from anxious thoughts and toward the present moment. When anxiety strikes, our minds often race into the future, anticipating worst-case scenarios or reliving past stresses. Mindfulness, however, invites us to pause, notice, and observe our current experience without judgment. This practice creates a sense of space between us and our anxiety, offering relief from the constant cycle of worry. Simple techniques like mindful breathing, where you focus on the sensation of air entering and leaving your lungs, can calm both your mind and body, signaling to your nervous system that it’s safe to relax.
From the perspective of nervous system healing, mindfulness plays an essential role in regulating our body's stress response. When we practice mindfulness, we activate the parasympathetic nervous system, sometimes referred to as the “rest and digest” system, which counters the “fight, flight, or freeze” response triggered by anxiety. By engaging in grounding exercises—like noticing the sounds around you, feeling your feet on the ground, or focusing on a single object in your environment—you help soothe an overstimulated nervous system. Over time, these small moments of mindfulness can lead to lasting changes in how your body responds to stress, creating a more resilient and balanced nervous system. Dialectical Behavior Therapy (DBT), a highly effective approach for managing intense emotions, includes mindfulness as a core skill to support anxiety. Two useful DBT techniques are Observe and Describe. When practicing Observe, you simply notice your thoughts, feelings, or sensations without trying to change or judge them. It’s about creating awareness. Describe takes this a step further by naming what you're experiencing. For example, instead of saying, "I am anxious," you might say, "I notice a tightness in my chest and a sense of unease." This creates emotional distance from the anxiety, giving you room to respond calmly rather than react out of fear. By utilizing mindfulness skills to support nervous system healing, you can develop a toolkit that not only manages anxiety but fosters a greater sense of control and hope. Healing is possible, one mindful breath at a time. Healing mental health disorders is a multifaceted journey that requires addressing the diverse and interconnected factors contributing to an individual’s well-being. The bio-psycho-social-spiritual model provides a comprehensive framework for understanding and treating mental health issues, emphasizing the importance of integrating biological, psychological, social, and spiritual dimensions. This holistic approach ensures that treatment is personalized and addresses the unique needs of each individual, fostering a more effective and enduring recovery process.
Biological aspects of healing involve medical interventions such as medication and lifestyle changes that can significantly impact mental health. For instance, medications like antidepressants or antipsychotics can help regulate neurochemical imbalances, providing stability for individuals to engage more fully in their healing journey. Additionally, lifestyle modifications such as movement, mindfulness, and adequate sleep are crucial in supporting overall brain health and reducing symptoms of mental health disorders. These biological interventions are often most effective when combined with other therapeutic approaches. Psychological, social, and spiritual healing are equally vital in the recovery process. Psychological therapies, such as dialectical behavior therapy (DBT), help individuals develop healthier relationship patterns and emotional expression. Trauma, somatic and polyvagal therapies help to regulate the nervous system. Increasing social support, building strong relationships with family and friends and involvement in community activities, provides a sense of belonging and reduces feelings of isolation. Supporting spirituality, whether through religious practices, meditation, or a personal sense of purpose, can offer profound comfort and resilience. By nurturing all these dimensions, individuals can build a robust foundation for healing, creating a life filled with hope, connection, and meaning. Meeting with a skilled and sensitive mental health therapist can support each and/or all of these dimensions of a person’s mental health, diminishing, and sometimes eliminating, the effects of mental health disorders. When discussing Post-Traumatic Stress Disorder (PTSD) with clients in the aftermath of their traumatic experience, we have noticed a recurring experience. Many times, clients who meet criteria for the diagnosis of PTSD understand this to mean that they will always suffer from the effects of their trauma. All too often, we see a shadow sweep over our client’s faces as shame and fear rise in their bodies. We want to help clarify this particular diagnosis with a message of hope. PTSD is not a lifelong chronic condition, rather a description of how our bodies work to restore safety after trauma. Let’s talk about Post Traumatic Stress and how we can use this information to work toward healing.
Post-traumatic stress (PTS) is a natural response to experiencing or witnessing a traumatic event, impacting both mind and body. When confronted with trauma, the body's nervous system initiates a complex cascade of responses aimed at survival. Understanding the neurobiological impact of trauma can shed light on the symptoms individuals may experience, such as hypervigilance, flashbacks, and emotional dysregulation. Understanding PTS must involve the nervous system's role in trauma, which illuminates how our body reacts to perceived threats. Traumatic experiences can dysregulate the autonomic nervous system, leading to a state of hyperarousal or dissociation. This dysregulation can disrupt the body's ability to distinguish between real and perceived danger, resulting in ongoing feelings of fear and vulnerability. By learning about the nervous system processes at play, individuals can gain insight into their symptoms and recognize that they are not signs of weakness but rather adaptive responses to overwhelming circumstances. This knowledge can also inform treatment approaches, emphasizing interventions aimed at regulating the nervous system's stress response. Treatment for PTS often involves therapeutic modalities that target both the mind and body. Polyvagal theory helps to pay attention to nervous system signals and to use this information to create safety in the mind and body. Dialectical Behavior Therapy (DBT) helps individuals become skillful in mindfulness, emotional regulation, interpersonal skills and distress tolerance, while somatic experiencing focuses on releasing stored trauma from the body. Eye Movement Desensitization and Reprocessing (EMDR) and Brainspotting harness the brain's natural healing mechanisms to reprocess traumatic memories and alleviate distress. These approaches not only address psychological symptoms but also aim to restore balance to the nervous system. Despite the challenges posed by PTS, there is hope for recovery. With the right support and resources, individuals can learn to regulate their nervous system responses, reduce symptoms, establish safety and cultivate resilience. It's essential to approach treatment with compassion and patience, recognizing that healing is a gradual process that unfolds over time. In conclusion, understanding the neurobiological impact of trauma is crucial for navigating post-traumatic stress with compassion and efficacy. By integrating this knowledge into psychoeducation and treatment approaches, we can empower individuals to reclaim agency over their healing journey. Remember, recovery is possible, and there is hope for a brighter future beyond trauma's shadow. Next week’s blog post will be about Post Traumatic Growth. Introducing Radical Acceptance Radical Acceptance is a core skill in Dialectical Behavior Therapy (DBT). This skill falls into the category of Distress Tolerance skills. We reach for this skill when we are navigating something big and hard in our life that is outside of our control or influence. The idea behind Radical Acceptance is that we can work to improve our wellbeing even in the midst of the big and hard things. To appreciate what Radical Acceptance can offer us, we must first understand the difference between pain and suffering. Pain is an inevitable part of being human in our world. We will all experience pain at different times in our life. Suffering, however, is caused when we make choices that make painful circumstances harder for ourselves. Radical Acceptance seeks to accept pain and reduce suffering. When we reduce suffering, we grow in emotional resilience and wellbeing. Understanding Radical Acceptance Radical Acceptance is the act of fully acknowledging and embracing reality without judgment or resistance. In other words, Radical Acceptance is a choice to stop fighting against reality. Likely something is happening in our life that is hard and beyond our ability to change it, and we are left with the decision to accept (radically) or reject the reality of the situation. The radical part of Radical Acceptance speaks to the complete and total nature of our choice to accept reality. Radical Acceptance is not resignation or apathy, rather it is a conscious choice to yield to what is real. Radical Acceptance also does not require our stamp of approval on the difficult circumstances, instead a simple acknowledgement that it exists and that we will stop fighting against it. Suffering comes when we fight against painful events that we don’t have the power to change, and Radical Acceptance offers us a peaceful alternative. Cultivating Radical Acceptance DBT offers us some step-by-step guidance on how to execute the choice to Radically Accept painful circumstances.
We can draw upon other DBT skills as tools to help us in this process. Mindfulness skills help us notice what is happening internally and externally and bring awareness to the present moment. Additionally, mindfulness skills call us to self-compassion and nonjudgmental observation of emotions. We may have an opportunity to reframe negative thoughts about our reality and notice growth opportunities or unexpected benefits. Some nourishing activities like journaling and spending time in nature can help promote acceptance. Often times, Radical Acceptance requires patience and practice, as most painful events will require us to choose acceptance over and over again. Disclaimer: Radical Acceptance is not an excuse for harmful or abusive dynamics, but it may be a starting point for being honest about the harm that exists. May this honesty open doors for healing and support. Written by Allison Harvey
Trauma survivors have gone through something that challenged every part of them, most significantly their sense of safety. Their needs are personal, unique to their personality and circumstances, and often quite delicate. Naming these needs creates space for trauma survivors to feel safe, work toward healing and maintain connection with loved ones. Physical Needs On a very basic level, trauma survivors have a need for safety and security. Through their traumatic incident(s), they learned to be on guard and watchful. Trauma survivors need a physical location where they can let their guard down and rest. Trauma survivors also need access to medical and psychological care—professionals to come alongside them and nurture their physical and emotional self back to health. Trauma survivors also need adequate nutrition and sleep. Tending to these basic needs helps to heal a nervous system that felt a strong lack of safety. Emotional Needs Those who have survived trauma(s) have a strong need for emotional understanding, empathy and validation. When they are ready to share about their story, they need to be received with compassion, support and validation that says “what you are feeling makes sense to me.” Trauma survivors can also be supported with emotional skills that help them navigate trauma triggers and a large emotional burden while they are healing. Social Needs Trauma healing happens within a safe, understanding and supportive relationship(s). Those who have survived trauma need their people to remain open to them. Trauma healing can be messy and indirect, so survivors need compassion and grace to learn to feel safe in relationships again. Survivors may need more accommodations so that they can stay regulated, and this may look like them setting boundaries or asking for certain changes. Connecting with others who are healing from trauma can be very beneficial as well. Psychological Needs Professionals who are supporting trauma survivors should be trauma-informed and have a path toward healing in mind. Psychological care should be gentle and paced by the survivor. Professionals should respect the trauma survivor’s wishes to tell their story or not, knowing that healing can happen either way. Trauma survivors benefit greatly from learning and practicing coping mechanisms and stress management techniques. All of these activities support the survivor to rebuild trust, regain resilience and personal strength. |
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