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Crisis Survival Kit: Coping With Extreme Emotions

DBT pioneer, Dr. Melanie Harned, teaches how to equip your clients with a toolkit to help them overcome their most crippling moments of emotional overwhelm.

So with our crisis survival skills, we have two main goals. One is going to be to tolerate really extreme emotions, crisis situations without doing anything to make that worse. So the second part of that is that we also wanna help clients learn some skills that will bring down their physiological arousal that is gonna be really high in the context of, you know, crisis and extreme emotion situations. So we have a set of skills we call the tip skills that are really designed to change your body's reaction really quickly. I think of these as kind of similar to somebody who might take a benzodiazepine, for example. They're sort of like a fast acting medication almost that just changes your body's physiology in a quick way to help you get through a crisis situation. So there's four skills within our tip skills. One is going to be about temperature is the t, intense exercise is the I, paced breathing, and paired muscle relaxation. There's actually two p's. The one thing I like to do with clients is to put all the crisis survival skills together and help them think about how to make an actual kit called the crisis survival kit of a variety of different ways they can pull from the distracting skills, self soothing skills, tip skills, improve the moment, anything that sort of seems helpful to them, and get some actual physical items located together in some place where they'll be able to readily pull on that when they need it in a crisis, when urges are high to engage in some kind of impulsive behavior. So when building any kind of crisis survival kit, I think it's really important to involve the client as much as you can in generating ideas about things they think that would work for them, that would be readily available to them where they're living or out in the world, where they're going to be. And in that process, it's not unusual for clients to generate some ideas that we might think are not maybe the most effective ways that they would want them to be distracting or self soothing. So we'll also make sure that we kind of evaluate the effectiveness of some of these solutions before arriving together on a plan of what they're going to work on putting together in this kit.