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.

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.
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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.

In the wake of trauma, amidst the pain and challenges, there exists a profound opportunity for growth and resilience known as post-traumatic growth (PTG). This transformative process involves finding meaning, cultivating resilience, and experiencing personal growth in the aftermath of adversity. When healing from trauma, it is essential to understand PTG and how it intertwines with the healing of the nervous system.

Post-traumatic growth is not about minimizing the impact of trauma or dismissing the pain it causes. Instead, it acknowledges that trauma can catalyze profound inner change and transformation. Through PTG, individuals may develop a deeper appreciation for life, experience increased personal strength, forge deeper connections with others, and discover new possibilities for growth and fulfillment.

Central to the process of post-traumatic growth is the healing of the nervous system. Trauma can dysregulate the autonomic nervous system, leaving individuals in a state of chronic stress, hypervigilance, or dissociation. However, through interventions such as trauma-informed therapy, mindfulness practices, and somatic experiencing, it's possible to restore balance and resilience to the nervous system. These approaches help individuals regulate their stress responses, release stored trauma from the body, and cultivate a greater sense of safety and well-being.

Fostering post-traumatic growth requires a safe and supportive therapeutic environment where individuals feel empowered to explore their experiences and emotions. By validating their struggles and offering tools for healing, therapists can guide clients on a journey of self-discovery and transformation. Through compassionate listening, empathy, and unconditional positive regard, therapists can help individuals navigate the complexities of trauma and embrace the potential for growth and resilience.

While the path to post-traumatic growth may be challenging, it offers hope and possibility for those who have experienced trauma. By embracing the journey of healing, individuals can cultivate resilience, find meaning in their experiences, and ultimately thrive in the face of adversity. For us therapists, it is a privilege to witness the resilience and strength of individuals as they embark on this transformative journey toward post-traumatic growth.

In conclusion, post-traumatic growth is a testament to the human spirit's capacity for resilience and transformation. By understanding the role of the nervous system in trauma healing and creating a supportive therapeutic environment, trauma specialists can facilitate this process of growth and empowerment. Together, we can honor the courage and resilience of trauma survivors as they navigate the path toward healing, growth, and a renewed sense of purpose.

Healing from the effects of trauma can be terribly daunting. In "8 Keys to Safe Trauma Recovery," author Babette Rothschild invites us to navigate trauma healing with wisdom and compassion, offering a roadmap to reclaiming safety, empowerment, and wholeness. Therapists in our practice often recommend this book for clients who are wanting to understand the basics of trauma recovery. Below is a short summary of the 8 keys to safe trauma recovery:

Key 1: Plot Your Course With Mindfulness
Mindfulness is awareness of the present moment, and includes an awareness of emotions, body sensations and cues and more. Using mindfulness to observe our physiological cues can give us vital information to keep us safe and regulated in our post-traumatic life. Inherent in this point is a permission to make choices to keep our bodies and minds regulated, to preserve our peace and safety.

Key 2: Begin with Your Epilogue
This chapter speaks to the importance of noticing that our traumatic experience has ended. Healing can only happen when we know that we are no longer being traumatized and that we made it through the terrible experience. Making these realizations also helps us recognize the internal and external factors that support our ongoing survival.

Key 3: Remembering is NOT Required
Although there is much discussion about this in the mental health community, the author makes the argument that remembering and revisiting traumatic experiences is not required for trauma healing. This argument builds on the skills developed in the first two chapters, stating that developing mindful observation of nervous system cues and using that information to create safety can be enough to heal and move forward. Also inherent in this argument is a question of consent: do you want to revisit your traumatic memories?

Key 4: Stop Flashbacks
Trauma flashbacks are one of the hallmark side-effects of trauma, and they are intrusive and highly disruptive. The author works to reduce and eliminate flashbacks by focusing on the language we use to process them. Are we describing the flashback to ourself in present or past language? Is there a negative or critical message we have internalized when we see our trauma replay in our mind? Moving a flashback from present moment to memory and bringing in compassionate language can make all of the difference for our post-traumatic life.

Key 5: Reconcile Forgiveness and Shame
Oftentimes, healing from a traumatic experience will require us to reconcile our feelings of guilt and shame. The author recommends bringing self-forgiveness and self-compassion to our limitations and sharing about our shame. Both of these gentle practices reduce the lasting impact of shame and guilt.

Key 6: Take Smaller Steps for Bigger Leaps
This chapter speaks to the overwhelm so many feel toward trauma recovery. The author validates the common desire to rush through trauma recovery and, in doing so, taking big steps that end up creating more distress and overwhelm. She advocates for small steps that work to keep trauma survivors feeling safe and regulated, which actually serves to establish nervous system trust and healing.

Key 7: Get Moving
Trauma reverberates throughout our physical bodies, and because of this, physical activity can have a lot of potential to heal our physical selves. Physical activity not only moves us out of the nervous system freeze response, but building strength and endurance can also provide a sense of physical empowerment and even safety. Each individual heals from different types of movement, so this concept also provides an invitation to explore what types of movement are right for each trauma survivor.

Key 8: Make Lemonade
This chapter highlights the benefits of finding the growth opportunities that exist in our post-traumatic life experiences. While no traumatic experience is primarily beneficial, we may be able to find ripple effects in our lives that leave us in a more resilient, wholehearted or healed state of being.

Conclusion: Embracing Gentleness and Safety for Trauma Recovery
Babette Rothschild reminds us that a slow, gentle and common-sense approach to trauma healing is possible. Her 8 Keys invite the trauma survivor to collaborate and even lead the healing journey. May we walk this path together, empowered by the keys to safe trauma recovery, and emerge stronger, wiser, and more resilient than ever before.

In the ups and downs of our lived experience, our nervous system translates and stores the impact of what we experience. Trauma disrupts the delicate balance of our nervous system, leaving behind discordant echoes that reverberate through our bodies, minds, and spirits. Today, we explore a healing journey informed by Polyvagal Theory, illuminating the pathways to safety and healing after trauma.
The Polyvagal Perspective on Trauma
Polyvagal Theory, pioneered by Dr. Stephen Porges, offers a revolutionary lens through which to understand the impact of trauma on the nervous system. At its core lies the recognition that our autonomic nervous system – comprised of the sympathetic and parasympathetic branches – plays a pivotal role in regulating our responses to threat and safety.
Trauma hijacks the autonomic nervous system, propelling us into states of hyperarousal or hypoarousal. Hyperarousal, characterized by the activation of the sympathetic "fight or flight" response, plunges us into a state of vigilance and reactivity. Conversely, hypoarousal triggers the parasympathetic "freeze" response, leading to dissociation and disconnection from our internal landscape.
The Quest for Nervous System Safety
In the aftermath of trauma, reestablishing physical, emotional and relational safety becomes top priority– not just as a concept but as a physiological imperative. Nervous system safety transcends mere physical refuge; it encompasses the restoration of neurophysiological equilibrium, allowing us to navigate the world with a sense of calm and connection.
Central to Polyvagal Theory is the concept of ventral vagal engagement – a state of social engagement and connection fostered by the parasympathetic nervous system. Cultivating ventral vagal pathways is essential for re-establishing safety after trauma, facilitating intimacy, trust, and attunement in our relationships.
In the realm of Polyvagal Theory, healing unfolds within the crucible of safe and supportive relationships. Co-regulation – the reciprocal exchange of physiological and emotional cues – serves as the cornerstone of healing, offering a roadmap for navigating the complexities of interpersonal connection with grace and compassion.
Embodied Resilience and Empowerment
Resilience, from a Polyvagal perspective, is not merely a psychological construct; it's an embodied state of being. Embodied resilience entails attuning to the wisdom of our bodies, harnessing the innate capacity for self-regulation, and integrating our experiences into the tapestry of our being with gentleness and acceptance.
Empowerment begins with understanding. Polyvagal literacy equips us with the knowledge and insight to navigate the terrain of trauma with clarity and agency. It invites us to become fluent in the language of our nervous system, attuning to its cues and messages with curiosity and compassion.
Nurturing Hope Through Nervous System Awareness
In the vast expanse of trauma's aftermath, hope emerges as a guiding light – a beacon of possibility beckoning us towards healing and wholeness. Polyvagal awareness infuses hope with substance, grounding it in the neurophysiological realities of our embodied experience and illuminating the path towards transformation.
In closing, the journey of healing after trauma, as illuminated by Polyvagal Theory, is a testament to the resilience of the human spirit and the transformative power of connection. May we remember that healing is not just a destination but a sacred unfolding – a journey of rediscovery, reclamation, and profound self-compassion.
So, to all those embarking on this nervous system healing path, know that you are not alone. Within the wisdom of your nervous system lies the map to healing and wholeness. And as you navigate the terrain of trauma with courage and grace, may you find solace in the knowledge that safety, connection, and resilience are not just within reach – they are your birthright.
Embrace the journey, dear reader, for within its twists and turns lies the promise of a life reclaimed, a spirit renewed, and a heart restored to its truest rhythm. And it is our privilege to provide guidance, safety and relational support on the path of healing and restoration. 

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. 

 Written by Christian Swan on March 16, 2017

I still remember my exact location and can nearly return to the sensations I felt in my body the moment I got the text message. I remember reading the words, "active shooter," from my husband who was in his office on that sunny day in June. While my husband returned home safely that evening, there is no arguing that he suffered a major traumatic incident. 

In the days and weeks that followed, my husband and I received an overwhelming amount of support. Our phones were overloaded with text messages and calls from loved ones, and we even received a few free meals. I was very thankful for the community we had at the time, and yet noticed a common thread in all of the support we were receiving. "How is your husband? Is he doing better?" people would ask me. I would answer their questions, and they felt relieved to hear that my husband was healing well. However, I was still suffering, and I struggled to advocate for the support I needed at the time. 

As the loved one of a survivor of trauma, I also became a survivor of secondary/vicarious trauma. Secondary trauma occurs as a result of secondary exposure to traumatic content. When our loved ones are impacted by trauma, we want to listen to their story and help in any way possible. And yet, it is too easily to overlook the effects their stories have on our own bodies. These effects can manifest themselves in various ways, from sleep disturbance to irritability to excessive fear and worry. 
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Do you have a loved one who recently survived a traumatic event? Perhaps you are feeling overwhelmed and excessively tired as you seek to provide care. You may also find yourself struggling to find meaningful ways to support your loved one. Below are some ways that you can support yourself during this time:
   1.) Honor your experience as a secondary survivor of trauma. Often, secondary survivors feel guilty when they become overwhelmed by their loved one's story. It is too easy to say, "I need to stop feeling badly because the trauma didn't happen directly to me." Instead, consider the effects that these stories are having on your body and take time to name your own traumatic experiencing. 
    2.) Seek activities that nourish you. Some ideas may be getting outside, practicing yoga or meditation, going to a concert, calling a close friend, or taking  a nap. What activities help you feel refreshed? Pursue them.
    3.) Consider professional counseling. Taking time to focus on your own experience will not only help you to heal but will also give you more freedom to care for your loved one. 

"Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life." 
- Judith Herman, Trauma and Recovery

When you hear the word, "trauma," what comes to mind? Growing up, I placed trauma in a category of things I only heard about on the news. Events like plane crashes, robbery at gunpoint, or natural disasters made sense to me. Of course they were big and terrible and traumatic--the news said so! However, as I got older, I realized that there was much more grey area about what was actually considered trauma or not. Some trauma is publicized, but other times thoughts about it can become so difficult that even one's closest friends do not know about it. Furthermore, trauma to one person may not be considered trauma to another. In these cases, is it still considered trauma? 
While some trauma can take a very clear and pervasive form, like in the cases I mentioned above, it can also be more subtle and even happen over a period of time. Often, individuals do not seek out the counseling treatment they need because they do not feel like their experiences were "bad enough." If you are wondering if you have experienced trauma and should consider counseling, I recommend asking yourself two questions. 

First, do you have experiences in your life that you would define as traumatic? I'm not asking whether your aunt or the newspaper or your Facebook feed calls it traumatic. Instead, I want to know how YOU feel about your experiences. If you have experienced an event in your life that you define as traumatic and want to talk about it, I would urge you to consider calling a counselor. You may be surprised by how healing it is to have your story of trauma validated by an objective individual. 

Perhaps you are certain you have experienced trauma, but still do not know if you should consider counseling. In that case, my second question to you is this: are you having difficulties in life that you did not have before the trauma occurred? For example, you may find that you struggle to sleep through the night, have an increased/decreased appetite, or have difficulty completing tasks efficiently at work or school. Or maybe the experience of the trauma has become so pervasive that you can't seem to stop thinking about it. By seeing a counselor, you can begin to develop coping skills that will reduce your post-traumatic symptoms and help you feel more functional in your daily life. 

If you can answer yes to one or both of these questions, it may be time to consider reaching out for trauma therapy. Healing is possible when you are willing to commit the time to properly honor your story in the context of a safe relationship. 

Written by Christian Swan on March 09, 2017