Some emotions arrive like a wave. One moment you're fine, and the next you're shaking with anger, flooded with panic or sinking into despair. In those moments, "just calm down" is useless advice. What helps is having a few simple tools you can reach for fast. Dialectical behaviour therapy, or DBT, is full of them. This guide walks you through three DBT skills you can start using today: TIPP, STOP and opposite action.
These skills work best with practice. Try them first on a calmer day, so they're ready when you really need them.
What is DBT?
Dialectical behaviour therapy was developed by psychologist Marsha Linehan in the late 1980s. It's a type of cognitive behavioural therapy that blends practical change skills with mindfulness and acceptance. "Dialectical" means holding two ideas at once. In DBT, the big one is: "I accept myself as I am, and I want to change."
DBT was first created to help people with very intense emotions, self-harm and suicidal thoughts. Today, its skills help many people who feel their emotions are too big, too fast or too hard to control.
The four DBT skill areas
DBT skills are grouped into four areas:
Mindfulness. Paying attention to the present moment, without judging it.
Distress tolerance. Getting through a crisis without making it worse.
Emotion regulation. Understanding your emotions and changing the ones that aren't helping.
Interpersonal effectiveness. Asking for what you need, saying no and keeping relationships healthy.
TIPP and STOP come from distress tolerance. Opposite action comes from emotion regulation.
TIPP, DBT skills for when emotions are sky-high
When your emotions are at their peak, your thinking brain goes offline. TIPP works through your body instead, to bring your nervous system down fast. TIPP stands for:
T is for temperature
Cold water can calm your body quickly. Hold your breath and put your face in a bowl of cold water for about 30 seconds, or hold a cold pack or a bag of ice over your eyes and cheeks. This can trigger your body's natural "dive response," which slows your heart rate.
I is for intense exercise
Burn off the energy that strong emotions build up. Do something hard for a short burst: run up the stairs, do jumping jacks or go for a fast walk. Even a few minutes can help.
P is for paced breathing
Slow your breathing down, with the out-breath longer than the in-breath. For example, breathe in for a count of four and out for a count of six. Keep going for a minute or two.
P is for paired muscle relaxation
While you breathe in, tense a group of muscles, such as your hands or shoulders. As you breathe out, let them go and notice the difference. Move slowly through your body.
A safety note
Cold water lowers your heart rate quickly, and intense exercise raises it. Check with your doctor before using these skills if you have a heart condition or other medical condition, a low heart rate, an eating disorder or if you take beta-blockers.
STOP, the skill for the moment before you react
Many regrets happen in the second between feeling something and acting on it. STOP helps you pause in that gap. It stands for:
Stop. Freeze. Don't move, speak or type. Stay still for a moment.
Take a step back. Step away from the situation, even just in your mind. Take a breath.
Observe. Notice what's happening inside you and around you. What are you feeling? What are the facts?
Proceed mindfully. Ask yourself, "What action would help me here?" Then choose that, instead of acting on the urge.
STOP is useful before sending an angry text, snapping at someone you love or doing something you'll regret later.
Opposite action, for when a feeling doesn't fit the facts
Every emotion comes with an urge. Fear pushes you to avoid. Anger pushes you to attack. Sadness pushes you to withdraw. Sometimes those urges help. But when an emotion doesn't fit the facts, or acting on it would make things worse, opposite action can change how you feel.
Here's how to use it:
Name the emotion. "I feel ashamed."
Check the facts. Does this emotion, and how strong it is, fit what's actually happening?
Notice the urge. "I want to hide and cancel my plans."
Ask if acting on it will help. Will hiding make things better or worse?
Do the opposite, all the way. Go to your plans. Stand tall, make eye contact and speak in a steady voice.
Repeat. Opposite action often takes a few tries before the emotion shifts.
Some examples:
Fear that doesn't fit the facts: approach what you've been avoiding, a little at a time.
Anger that doesn't fit the facts: gently step away, or do something kind instead of attacking.
Sadness: get active, reach out to someone and do things that give you a sense of mastery.
"All the way" matters. If you go to the party but spend it frowning in a corner, your body still gets the message that you're in danger.
How to practise DBT skills so they work in a crisis
A skill you've never tried is hard to use when you're upset. Practice builds the path in your brain ahead of time.
Practise when you're calm. Try paced breathing while waiting for the kettle, or STOP before replying to an ordinary email.
Start with low stakes. Use opposite action on a small worry before a big one.
Make a skills card. Write your favourite skills on a card or in your phone, so you don't have to remember them when you're flooded.
Rate your distress. Before and after a skill, rate how upset you feel from 0 to 10. This shows you what helps most.
Expect some misses. A skill that doesn't work one day may work the next. Keep trying.
Over time, many people find they reach for a skill almost without thinking.
Other helpful DBT skills
TIPP, STOP and opposite action are just the start. A few other DBT skills people often find helpful:
Self-soothe with your five senses. Use comforting sights, sounds, smells, tastes and textures.
Wise mind. Find the balance between your emotional mind and your reasonable mind.
DEAR MAN. A step-by-step way to ask for what you want: describe, express, assert, reinforce, stay mindful, appear confident and negotiate.
When skills aren't enough on their own
Skills can make a big difference, but they're easier to learn and use with support. A therapist can help you choose which skills fit your life, practise them and figure out what to do when they don't work.
Full DBT programs often include individual therapy and a weekly skills group. At Transformation Counselling, we don't run groups. Our therapists use DBT in individual counselling, so you can learn and practise these skills one-on-one. Learn more on our DBT counselling page.
If you're struggling with urges to hurt yourself, you're not alone. Our therapy for self-harm offers caring, practical support.
If you need help right now
If you are thinking about suicide or feel unsafe, please reach out right away. Call or text 9-8-8 any time. In Waterloo Region, Here 24/7 is 1-844-437-3247. In Ottawa, call the Mental Health Crisis Line at 613-722-6914 (ages 16 and up), or YSB's youth crisis line at 613-260-2360. In an emergency, call 911.
Frequently asked questions
Is DBT only for borderline personality disorder?
No. DBT was first developed for people with very intense emotions, including those with borderline personality disorder. Today, DBT skills help people with many struggles, like anger, anxiety, self-harm and relationship conflict.
How long does it take to learn DBT skills?
You can start using a skill like STOP today. Getting comfortable with a range of skills takes practice over weeks and months.
Can I learn DBT skills online?
Yes. We offer counselling in person in Waterloo, Kitchener, Cambridge and Ottawa, and online across Ontario. No doctor's referral is needed.
Take the first step
You don't have to be at the mercy of your emotions. Book a free 15-minute consultation to find a therapist who uses DBT skills. Evening and weekend appointments are available.