90. Crisis Survival 101: Coping Skills, SUDs Scores, + My Recommendations
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Today's solo episode is all about crisis survival! In this episode we dive deep into how to survive a crisis—whether that's extreme anxiety, anger, depression, urges, or something else! I cover what qualifies something as a crisis, SUDs scores, creating a safety plan, DBT survival skills (STOP, asking for help, ride the wave, TIPP, ACCEPTS + IMPROVE, and more), coping with general distress vs. specific situations, and what’s worked for me!
Mentioned In The Episode…
+ Crisis Survival/Safety Plan Template
+ ALL of the DBT Crisis Survival Skills Worksheets
+ National Hotlines (via APA)
+ Mental Health America Hotlines + Resources
SHOP GUEST RECOMMENDATIONS: https://amzn.to/3A69GOC
Episode Sponsors
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🍓This week's episode is brought to you by Sakara. Sakara is a nutrition company that focuses on overall wellness, starting with what you eat. Use code XOSADIE at checkout for 20% off your first order!
About She Persisted (formerly Nevertheless, She Persisted)
After a year and a half of intensive treatment for severe depression and anxiety, 18-year-old Sadie recounts her journey by interviewing family members, professionals, and fellow teens to offer self-improvement tips, DBT education, and personal experiences. She Persisted is the reminder that someone else has been there too and your inspiration to live your life worth living.
a note: this is an automated transcription so please ignore any accidental misspellings!
Sadie: Welcome to she persisted. I'm your host Sadie Sutton. Every Friday, I post interviews about mental health, dialectical behavioral therapy and teenage life. These episodes break down my mental health journey, teach skills to help you cope with life and showcase testimonials from individuals, including teens, just like you, whether you've struggled yourself or just want to improve your mental fitness.
This podcast is your inspiration to live a life you love and keep persisting.
Hello. Hello. And welcome back to another episode of sheep resisted. We have another solo episode and I'm really excited because you guys have been really liking the solo episodes. They're some of my most downloaded, you guys are always DM-ing and saying that you appreciated the content.
And so that makes me happy because I love sharing little tips and tricks that I learned along the way. And it's really cool that you guys are loving to hear those. So today we are talking all about crisis survival skills. So crisis survival skills are the skills that you use when you're out like a nine out of 10 for emotions, you are struggling to cope.
So if you're having a really bad panic attack, if you are a super, super depressed, if you're super angry, those moments is when you use crisis survival skills to really survive through the moment. So the first thing that we have to touch on is that you always have a choice, whether you want to cope through a situation or just like sit with it, or you can make it worse.
So you always have the decision to use coping skills to decide, to try and make the situation better, to try and get through it. And you are. Always have the decision, whether you want to cultivate that willingness, or if you want to stay in that willful Headspace. So that's the first thing we have to mention.
The next thing I want to cover is what makes a crisis and when to use these skills, because crisis survival skills are amazing. They are what get you through difficult moments. They are what help you survive emotions that feel extremely painful and tough and overwhelming. But if we use them too much, they really lose their effectiveness.
So a crisis, like I said, is when you were at like an eight or a nine or nine out of 10 for emotional distress. And there was a couple of things within the DBT and therapy world that can kind of quantify this one is a SUD score. And so stud stand for subjective units of distress. So. Like it says in the name it's very subjective.
It'll be different for everyone. So what might be like a 10 for me might be like a seven for you and vice versa. So there is this really great thing. It sounds a little bit cheesy, but it's very helpful to think about and do this activity, but it's a feelings from their monitor. And so it's like from zero to 10 and zero, you are.
Cool. You're collected. You are doing great. And at 10, you are at your, your lowest, you are struggling to use skills to cope. You're extremely overwhelmed. You are extremely distressed. And that, that looks different for everyone. And so what I did when I was doing DBT for one of the first times was I went through this thermometer and I kind of labeled what each of the numbers looked like for me and what it looks like as far as using coping skills.
So, like I said, 10. Couldn't you skills couldn't cope was really struggling with so distressed that I couldn't even think about the possibility of what skills I would use and how to implement them. I was really struggling with that willingness and the ability to implement. And so at a nine crisis, survival skills are really helpful to implement. Most skills would be effective at an eight. It was more things like deep breathing. When it's a sex, it's more like self soothing. So the, the lower I got with distress, the less intensive coping skills I needed. And then I also kind of quantified what it looked like.
Presentation-wise. So a 10 would be like a really bad panic attack and not able to communicate that I needed help. Whereas in nine, maybe I was still struggling with a lot of anxiety having a panic attack, but I could at least ask for help or I could use some skills. And then a seven was having anxiety, but not a full blown panic attack.
And a five was just kind of, we were, we were chilled. We're not at our best, but there was no need to like cope actively with an emotion that came up. So like I said, this is really different for everyone. Maybe you struggle with really intense and distressing. Anger. So quantifying what the different levels of anger looks like and what skills work at different, but what different levels could be really helpful for you.
And the reason we do these things is that when we get in that really emotional state, when we get in fight or flight mode, we are not able to logically think through things. It's just how our body reacts. It's our emotions function in a way that they optimize for the quick, no thinking emotional reaction to keep us alive, to save us.
And so we can't logic through and be like pros and cons here at. What is the coping skill I should use when I'm having a panic attack and can't think straight. So we do this beforehand, when we're in those moments that are really distressing, we can just immediately know what to do instead of like really trying to unpack and figure out what the best course of action is.
Okay. So there's a couple more things to mention about when to use crisis survival skills and when they can be really helpful. So some ways to know that you're in a crisis situation, and again, this is kind of subjective it's based on your level of emotional distress.
So you know, you're in a crisis situation when it's highly stressful, it's short term, this is not like long ongoing stress about a school project. There are ways to cope with that. But again, we talked about how crisis survival skills are for the short term so that they don't lose their effectiveness.
And the last thing about being in a crisis is that it creates intense pressure to resolve the crisis right now, again like the school project thing it's due in two weeks. There's not like that immediate, like you need to get rid of the stressor immediately because it's causing so much pain and distress.
So we're using crisis survival skills. When you have a really intense feeling of pain that cannot be helped quickly you want to act on your emotions, but that will only make things worse. Emotion, mind threatens to overwhelm you, but you need to stay skillful and effective. And I really want to add the caveat there of, again, you feel like you, you need to stay skillful.
We always have that choice. You are feeling overwhelmed and yet there are certain demands or expectations that must be met. So say you're going through the school day and the expectation is to go to your class, but you're having a panic attack. So you're going to cope through to hopefully try and be able to go to the class.
And lastly, your, your emotional arousal is really extreme, but the problem can't be solved immediately. There's not a quick fix. You need to kind of cope through the emotions and be able to sit with the discomfort of the situation. So, like I said, there's a lot of reasons that we don't use crisis survival skills every single day for every single emotion that arises.
And that's because they lose their effectiveness over the long-term. We want to reserve these for one, we're really struggling that we have a way to help ourselves in that, in those painful moments. So we're not going to use crisis survival skills for everyday problems. I'm solving all of the problems that life throws at us and, and making your life worth living.
So a lot of the crisis, survival skills or activities. That are good distractors or they're enjoyable. It's things like spending time with a friend calling a loved one maybe it is drawing or doing your nails or doing a self care net, like those kinds of things. And so to make your life worth living, you're not just constantly coping through things 24 7 you're of course, building in activities you enjoy.
But the idea is to get them reserve these for when you really need them.
So one of my favorite coping ahead, things that you can put in place that really sets you up for success is called a safety plan. And this was something that I relied heavily on when I was doing DBT. It was something that was always a standard of care.
Whenever I would start working with a new therapist or a certain amount of time went by. We would set up a safety plan together in session. And so what a safety plan is, is it is a basically it's an outline of what you're going to do when you are feeling emotionally unsafe, overwhelmed, distressed that really high intensity that we just talked about.
So I will post like a template on my website for this episode, as well as on Instagram, but I'm going to walk you through it. The first thing that you want to outline are the warning signs. So this situations, thoughts, feelings, body sensations, and behaviors, that signal that a crisis might be developing.
And so for me, when I filled the. This was in 2017. This was a long time ago. You guys but it's my real worksheet. I talked about the cognitive physical and, and combined signals. So cognitively my thoughts were racing. I was worried about like judgment from other people. I was hyper aware of what was going on around me.
And I was starting to have like a little bit of the physical symptoms of a panic attacks. Like my heart rate was increasing. My breathing was increasing on physically. I was like starting to get a little shaky. I was having. Breathing. And then combined, I was feeling really frozen by a moment motions.
I was too scared to really move and I was just feeling very consumed by my fears. So that was warning science. The next thing that you want to outline is the internal coping strategies you can use. So things that you can do by yourself to take your mind off of what you're experiencing. So that could be distracting, could be a relaxation technique.
It could be a physical activity. There's a lot of options here. And so I, again, kind of broke this down into what would work to cope with a cognitive warning sign versus physical versus combined. So for when I was really overwhelmed, like my thoughts were spiraling, I could use distraction. I could self-soothe I could use the tips.
Go. Dive into, or I could ride the wave of the emotion physically. I could use pretty much all of my, my skills and my, and my toolbox regarding distress tolerance. So I could use deep breathing. I could do an ice bath and again, riding the wave was something that was really helpful for me. And combined warning signs.
That for me, I remember being like the, the perfect storm. Like that's when things got really overwhelming and really difficult to cope with. So I wrote down for that is to catch before the crisis arises and to ask for help and, and call my therapist for skills coaching. The next step is to write down three people in social settings that provide distractions.
This might be like super obvious. You're like, why would I need to write this down? But again, we're going above and beyond to make it easier for us to cope with situations that are super painful and overwhelming. So I wrote down three of my friends and I also mentioned like going outside and getting outside of the situation and you can literally even.
Phone numbers. If for some reason you're like, what have, I can't remember what if I don't have my phone with me? So you're making this really easy for yourself when you're struggling. And then step four is people that you could ask for help. So maybe this is a school counselor, a parent, a family friend a friend, a therapist until you're writing down their names and a phone number, if applicable and step five is professionals or agencies that you can contact during a crisis.
So for me, I wrote down my therapist, I wrote down my psychiatrist and I wrote down a school teacher that I had a really great relationship with. And the key here is really. We've talked about this before, but if you're really struggling and you're going to a teen, you might get that validation. You might get that support, but teens are not meant to deal with overwhelmingly complex mental health issues.
They shouldn't be expected to deal with that. They're not equipped. And so having professional resources that you can lean on is huge. So I will of course put some blinks and resources in the show notes, but there are a ton of different like local. Crisis lines based on your city. There are state ones.
So the California youth crisis line is 1-800-843-FIVE 2 0 0. Who's the national suicide prevention line, which is wanting 200, 2 7 3 talk. The crisis text line is 7 4 1 7 4 1. There are a ton of websites where you can get support virtually. And so that can be a huge to getting support when you're struggling, but it's not necessarily effective to go to a friend. And then step six is to make the environment safe. And that means emotionally and physically. So for me, I wrote down having a, a coat box, which we'll talk about next. I'm surrounding myself with, with people and taking breaks and really giving myself the grace to like, get through the moment and not feel the pressure to like, just like sit it out and run the clock out.
And then the last thing, this is more specific to DBT when you're circling with suicidal ideation. But the last thing to outline is the one thing that is most important to me and worth living for. And that is different for everyone. And 2017, I wrote down the future, which is super vague. But I think still chill stands true.
But what is that thing that keeps you going, that keeps you motivated that reminds you that it's worth it to cultivate that willingness and to cope through an emotion. So write that down, leave that as a reminder for yourself for when you're struggling.
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The next thing which I did just briefly touch on is a Coke box. And so this is a box that you would dedicate with all coping skills that you can use when you're in crisis mode.
So we're going back to this idea of making things really easy for ourselves. We don't want to be struggling to think about like what to cope with or, or what what skills do I have access to what would work when I'm feeling anxiety versus anger versus sadness, et cetera. And so it coat box makes it really easy to have all your skills accessible and there, when you need them, you have your resources literally at your fingertips and it can be a great resource. And it's also a fun activity to do. And so. Another thing to add here is that you could have like a coat box at home, but maybe you have like a little pouch you keep in your backpack for school.
And so an example of things that you put in your coat box or your coping box, I was thinking like books. If there's a book that you really love to read, that really is a great distractor. One of my favorite things to put in mind was really kind of notes. So if you have like birthday notes that you save or.
Thank you note that a friend wrote to you, those reminders that people care about you and love you as a great thing to include phone numbers, a list of people. Again, you can put your safety plan in your coat box. People you can contact when you're really distressed of people that are good to talk to or distract you with some snacks that you enjoy.
So you'd like, like a certain time of type of candy and then reminders of activities, distractors and coping skills. So some ideas that I had was putting like a bag of microwave popcorn in your Coke box, which is a reminder of like watching a movie or a TV show and do a night to distract yourself. Maybe doing your nails is very calming, distracting.
It is for me. So maybe you put nail Polish in there or face masks or you love listening to music when you're really distressed. So put a headphones in there. And then another thing which I think is super helpful is there are these amazing lists of 100 coping skills. It's super random things like going on a walk or asking for help, or it's seriously, there's like anything and everything you could ever think of.
It's a hundred coping skills at your fingertips. Quite literally, so like squeezing ice or doing a puzzle cooking dinner with your family, counting to a hundred, playing a sport unplugging from electronics. Like there's literally so many different things that you might not have immediately thought of. So printing that out and keeping it near coat box is a great resource to use when you're struggling.
And so like said, like I said, You can also make this like a travel option for your backpack. If you struggle with panic attacks at school, put together a little bag of what works for you. So the tips go, which we'll talk about. Maybe you have one of those first aid packs where you like pop it and then it gets cold.
That was one thing that I like to carry with me and was super helpful. Again, I think headphones are a great small option, a little like lollipop or a piece of candy. I think the notes are a great idea. Your list of people to contact. Or even the list of what you're going to do to cope through things are all super like travel, friendly and effective.
So the next thing that I want to touch on is similar to the safety plan, but it's a less, it's less of a safety planet. And it's more of a general coping ahead plan. So for this, what you do is you write out on paper, you can type it up also, but you're getting super specific on common scenarios, emotions, urges, and thoughts that are triggering.
So maybe when you have a test coming up in school, you have a panic attack in the bathroom with certain thought patterns going off. Write that down. And then you're going to go through and write exactly how you're going to cope through that situation. If you have a certain thought spiral about like body image, for example, for example, what exactly are you going to do to ride the wave of that distress and cope through it?
Same thing for anger sadness. And you don't have to write down every single possible scenario, but kind of talking about the big ones that create a lot of difficulty for you. And really present with a barrier or coping can be really helpful.
So here we're going to do a little DBT education about some skills that are universally helpful to high-intensity distressing emotions. Also pretty much all these skills are from the distress tolerance module. We are tolerant in distress. And so one of the first like core skills, it's like the building blocks of the distress tolerance module is the stop scale.
So it's kind of self-explanatory, but it can be difficult to remember to deal. And these really distressing situations, which is a common threat. So it's an acronym you're going to stop, take a step back, observe and proceed mindfully. So when you're stopping, you are not immediately reacting to emotions. You are physically freezing. And. You you're aware of the fact that emotions sometimes make us act without thinking. So you are staying in control and you are physically, mentally stopping in this crisis. You are then going to take a step back from the situation.
You're going to take a break. You're going to let it go. You're going to take a deep breath. And you're going to really push away that urge to act impulsively based on what your emotions are telling you.
For observing, you're going to notice what is going on both internally and extra layers. That's like thoughts, emotions, urges, and then externally behaviors, interactions, situations. So what is the situation? What are your thoughts and feelings? What are other people saying or doing? And lastly, the most important part of the stop skill is proceeding.
So you were acting with awareness and deciding what to do. You're considering your thoughts and feelings, the situation, and other people's thoughts and feelings. And so you're going to think about your goal for this situation. Are you going to prioritize self-respect and our personal effectiveness coping effectively?
What is it that you want out of this? And you're going to ask your wise mind will act certain actions, certain solutions make this situation better or worse. So that's the stop skill. You can use it for any highly intense emotion.
And you can use is for anxiety. You can use this for extreme sadness. You could use this in an argument for anger, for guilt, any emotions where you're at like a seven to 10, or even like a sex. If you're like, I just think I could benefit from taking a break.
Use the stop scale. The next hill, that can be somewhat difficult to implement when you're in this super high distress. But once you get down to a six or a seven can be super helpful is the pros and cons scale. So you're using this when you have to decide between two courses of action. And we talked about cultivating willingness to coping through situation, and that in itself is like a mini pros and cons.
You are evaluating whether it would benefit you to use coping skills or sit in the situation. Or make it worse. And a really common situation to you is pros and cons in as, when you have a really strong urge or you are like deciding whether to confront someone or you are thinking about. Coping with something in a certain way. Like maybe you're like, I really think I could benefit from advocating for an extension on this assignment.
That's giving me a panic attack or you're like, I think I should go to a counselor right now and get support rather than going right back to class. Do a little pros and cons. And so what makes the DBT. Pros and cons a little bit unique is that it's like a four box approach. So you are doing the pros of acting on crisis urges, pros of resisting crisis surges, cons of acting on crisis urges and cons of resisting crisis urges.
So write those out, give a sentence of a couple of bullet points for each, really think about it. And so before an overwhelming crisis hits, you want to write out your pros and cons, you want to bring those thoughts and your conclusion with you and really reminders of, of them rehearse them over and over.
Remind yourself what your wise mind is telling you. Even if your emotion mind is like, kind of trying to sway you.
And when you really are struggling with, with an urge to act in a certain way, it can be really helpful to imagine the positive consequences of resisting that urge can be helpful to think and picture the negative consequences of giving into those bad crisis behaviors. And lastly, remembering past consequences when you have acted on crisis urges.
So if in the past you have avoided a situation that makes you really anxious. What were the consequences there? Maybe you were more anxious next time you encountered that situation. So think about that consequence and what could possibly happen in the future. If you continue to engage in that avoidance.
The next skill that really universally can be super helpful is asking for help. And this can come in certain forms. Again, we talked about professional resources and crisis lions, crisis tax lines. People you can call talking to a therapist, asking for help from a counselor or your parents from a friend.
But this is huge when you are feeling overwhelmed, even if you just want to ask for help in the form of a distraction, or to have someone sit with you or just be around you asking for help can be really helpful to feel less alone in navigating what you're going through.
And then the next skill that I want to bring up is one of my all time favorites. You guys have probably heard me talk about it. A lot of times I've actually seen a surprising amount of people talking about it on both TechTalk and Instagram reels, which makes me so happy, but it is the tip scale. And so tip skills, change your body chemistry.
They reduced extreme emotion. Presentations and emotion mind really quickly. And so it's an acronym that stands for temperature, intense exercise, paced, breathing, and paired muscle relaxation. And this is really helpful for anxiety. It's helpful for anger, extreme sadness, just that really seven to 10 Ray, and really like eight to 10 of levels of distress tip will really bring that down a couple of notches and allow you to cope in other ways.
So. And be T we are tipping the temperature of your face with cold water, and this allows you to calm down really quickly. So what you're going to do. So what you're going to do is you are going to hold your breath and you are going to put your face in a bowl of cold water, or you can hold the cold packs.
We talked about the little ones that you get in a first aid kit. You could put ice in a little The bag on your eyes and your cheeks. And so you're going to hold it for 30 seconds and you want the water to be above 50 degrees. We're not trying to give ourselves frostbite here. But you are trying to activate your mammalian diving reflex.
So as humans, we obviously cannot breathe under water. So our bodies have a system to regulate our breathing and our heart rate. When we come into contact with waters that we don't have access carbon dioxide in our systems and drought. So if you were diving into a cold lake, what your body would do to compensate for that is it would lower your heart rate.
It would lower your breathing rates. So that. Excessively producing carbon dioxide and you can hold your breath for longer. So the same thing works. When you dip your face into a bowl of ice water, you are heart rate, your breathing rate decreases. And along with that, the physical symptoms of distress that you're experiencing, this isn't one of those coping skills that is the most universally.
Easily accessible. Like if you were in a class having a panic attack, you're not going to be like, oh, let me just pull out my bowl of ice water. Like I get it. But there are different ways you can implement this. Maybe you use like a cold, like paper towel under your eyes. Like that can help even if you're not getting the full benefit.
But if you're at home per se and you have access to this, it's a game changer. I highly, highly, highly recommend. We used to do them all the time. When I was at residential, it was like one of the go-to things. They had so many ice packs, they had so many bowls and washcloth. And so whenever someone was having a panic attack, they'd be like, all right, time for a nice dive, let's get the bull.
And it's because it's so effective and it's, it's, it works. You can't be like, well, no, I'm going to mentally. I have my mammalian diving reflex work. Like that's just not how that happens. So that's the first part of the tip scale. The next is intense exercise. And so what this does is it calms your body down when it's really wrapped up and aroused by emotion.
So you're engaging in intense exercise, even if it's just for a short period of time and you are expanding your body's stored up physical energy by running, you could be speed walking, jumping, I'm lifting weights. I find that things like. Really like high intensity workout. So like squats, mine, squats.
Aren't a great example. Burpees. Maybe you're doing the whole bit of a kick boxing moment running, doing sprints on anything that's super physically intense is great for this. And the idea here is that it not only expends, that sort of energy, that you're holding from distress, but your body can't maintain a physical arousal from exercise for like 12 hours straight.
Like your body's not going to do that. So what your body's going to do is it's going to lower your heart rate after the workout. It's going to lower your breathing rate after the workout to try and go back to its homeostasis. And with that, it takes away some of that emotional distress that's presenting in physical.
So the P to the tip skill is for pace breathing and paired muscle relaxation. So pace breathing, you're a pacing, your breathing by slowing it down. And so you're breathing deeply. You're slowing your pace of inhaling and exhaling way down from what it's at when you're experiencing an intense emotion. So like five or six breaths per minute.
I like to do like a. In Hale of like three counts, pause and then exhale for four. It's really great to have your exhale be more slow than your breathing in. And so like five seconds in seven seconds out, whatever works for your lungs, everyone's lungs are different, but kind of along aiding the breath and having your exhale be longer than the inhale is.
And you can do this for as long as possible, as long as you need to. So maybe it's for like two minutes, maybe it's for five minutes, whatever you need. This is a great skill and this is one that can be used at any point in time in almost any environment. And the same thing is true with paired muscle relaxation.
So you are calming down by pairing your muscle relaxation with breathing out. So while doing your deep breathing, you are tensing your muscles with that Jake, your fist, your shoulders, your whole body on your inhale, and you're really being mindful of that tension in your body. And then as you're breathing out, you're relaxing, you're letting go of the tension in observing how there's the difference.
So when we're having like anger or anxiety, Clench our fists, we kind of tense up and so intentionally further like tensing those muscles and then releasing them can really let go of a lot of that tension and can be really powerful and effectives. That's the tip scale. It's an amazing way to change your body chemistry.
And one of my favorite things about the tip scale and DBT is that you can't be like, well, that's not going to work. Like maybe if one person listening to really intense rock and roll is what calms them down when they're having anxiety. That might not work for everyone. That's an example of something that's super subjective, but stimulating your mammalian, diving reflex, doing the temperature.
Part of the tip scale is going to work. It's going to decrease your heart rate is going to decrease your breathing rate. And, and that's something I love about DBT is it's not like, well, I hope this works. Like let's see, it's like, it will work. You will get through this situation. You will be able to cope and you will feel better.
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So the, the last cope ahead plan scaled that I want to give you that is universally helpful across situations is distraction. And self-soothing distraction can be an amazing coping skill and technique because it allows you to kind of take a break from those painful emotions those distressing thoughts and feelings, but the key is to not just be constantly distracting when we're avoiding our emotions, they come back and bigger, more overwhelming forms, which is.
Why these crisis survival skills are great for crisis, but not 24 7 life. And that's completely true for distraction skills. So there are some great acronyms. The first one is accepts. And so that stands for activities, contributing comparisons, emotions, pushing away, thoughts and sensations. So with activities you could distract by.
Focusing your attention on a task that you need to get done. Maybe you're someone that likes to cleaning really calm to use. You're going to like clean a room. Maybe you're going to go on a walk. Maybe you are playing a sport. Maybe you're going to watch a video, go out to a meal with a friend, call a friend, listen to music, play cards.
Puzzle like you name it, do an activity that is distracting and gets you out of your head. And again, takes you away from this painful emotion and situation contributing. So doing volunteer, work, helping a friend or family member, surprising someone with someone, nice doing something thoughtful just sending someone a message and be like, hi, I'm thinking about you today.
And I miss you. And I hope things are going well. Comparison. So comparing. Your current sensation, your core and emotions with when you felt differently at a different time. So maybe you're putting these in perspective. You're like, you know what, like I'm doing a lot better of a job coping with this situation than I was six months ago.
Or maybe it's like, remember how great I felt 10 minutes ago. Let's get back to that point. Another fun thing to do here is like watching a reality show, comparing your, your emotions, your coping, all those things can be kind of a fun activity. And again, putting things in perspective and then kind of checking ourselves because we get so wrapped up in our own heads, our own experiences, what we're normalizing, comparing can be really effective.
And there's a caveat there. I like comparison is the thief of joy. We know that constantly comparing is not effective, but when you're in crisis mode, comparing yourself your, to a previous emotional state of yours or another person's can be effective to kind of again, round yourself and bring yourself back to the situation.
The next part of accepts is emotion. So you are watching emotional TV show. So maybe like you're feeling really anxious. So you're going to invoke joy by watching like the office, because that makes you laugh and, and makes you feel great. Some other ideas are like scary movies.
Watching a comedy may be there's like really soothing music. So you're shifting your mood using like external Stimuli would be the right word, probably, but like books, stories, letters, TV, music, movies, you name it next part of the ESOP scale is pushing away. And this is again, one where it's like helpful in the moment, not a long-term solution. So you are like mentally taking a break from struggling with this. So like, if you're having like really bad anxiety about how a situation is going to play out, you can bet.
Yup. I'm done thinking about this for right now. I'm going to put this in the corner and I'm going to revisit it later, but for. We're done. And so you are leaving the situation mentally. You are kind of ignoring that problem for the moment. And again, you're going to revisit it, but you are decreasing your distress surrounding the issue.
The next part of the accept scale is thoughts. So this is using like internal, mental coping skills. So maybe it's counting to 10 counting colors that you see around you, repeating words or a song in your mind, maybe doing a puzzle, watching a TV, watching TV reading, to really trying to like, get your thoughts, to think of something different.
Another great, like grounding skill here is doing link five things. You can see four things, you can hear three things, you can touch two things, you can smell. One thing you can taste and like kind of finding those things around the room.
Again, it's really breaking up the distressing thought patterns. And, and shifting your thoughts. And the last part of the accept scale is sensation. So. It's it's really invoking your senses, whether that's like holding ice and squeezing ice, which can be really great for urges or taking a hot shower, taking a cold shower, whatever works for you.
Maybe it is. This is going out in the rain or the snow that. The most universally effective depending on your climate. But listening to super loud music and, and really again, grounding and getting outside of your, your body, getting outside of your mind and breaking up the, that distress. That's the except scale.
And similarly is the improved scale.
So improve is for improving the moment. And so you are using imagery, meaning prayer, relaxation, one thing in the moment, vacation and encouragement. And these are less distractions, but more ways to, again, improve the moment, get through the moment and, and cope in that intense, difficult situation.
So with imagery, And you were imagining relaxing scenes. You're imagining things are going well, or maybe you're doing imagery of like the hurtful emotions kind of just like draining out of you. And another thing you could do is remember a happy time and imagine yourself in it again in religious sit with that.
So it's kind of like a meditation exercise. Next is meaning. So you are finding purpose and meaning in a painful situation. This can be really difficult in the moment, but for some people that works. Focusing on whatever positive aspects of the painful situation you can find, especially in interpersonal conflicts, when those are really painful for me, I really like to figure out like, okay, long-term like, how is this helping me?
Maybe I am learning to cope more effectively. Maybe I'm being more validating and understanding in my relationships. This is pushing me to grow. This is pushing me to improve. There is purpose here and there, there is some, some benefit that's coming of this. The next part is prayer. So if you are someone that really finds a lot of like calm and peace from praying, this is a great place to use that relaxation, really just doing relaxing activities.
We did talk about that in the accept scale, but maybe it's like taking a bath, doing yoga, breathing deeply, that kind of stuff. On one thing in the moment we are practicing some mindfulness. So you are completely in 100% doing only one thing you're staying in the moment you are being present. Focusing your entire attention on this situation.
Again, you are getting out of your head, the rumination of like thoughts, spirals that go in 12 different directions. We're kind of like curbing that and we're like, Nope, we're just going to be in this moment right now and cope through that. The next one is a brief vacation. So again, it's a little bit of distractions and maybe you're like getting in bad and you're just going to ignore things for 30 minutes and you're going to go back and cope with things.
Maybe you're turning off your phone for a while, or you are doing little like day trip with a friend. And you're just going to go and distract from what's causing a lot of pain. Yeah, I think this is a great one to implement, especially with stress. Again, we don't want to use. Distress tolerance skills all the time.
But if you are feeling super overwhelmed, you feel that distress, maybe it's with school, maybe it's with a work assignment being like, okay, 30 minutes, we're taking a break or doing a mini vacation and then we'll revisit. And the last part of the except scale. Is, the last part of the improved skill is using self encouragement and rethinking the situation.
So you are giving yourself a pep talk. This is one of my favorite skills and something that I use all the time, especially with anxiety. So you're like, I'm I got this. I can stand this. It's going to be okay, this is going to pass this. Isn't going to last forever. And really just getting herself through this situation.
So that's the improved skill. Another thing that can be helpful in distracting is self-soothing. And I know that you have heard about self care everywhere, but the idea with self-soothing is you're using your five senses and this can be another great thing to like, outline what works for you beforehand, but you are breaking it down into like vision, hearing, smell, taste, and touch.
So maybe vision, like you love watching a certain TV show. You like watching this sunset, maybe Going on a walk and observing nature is really calming to you for hearing. Maybe it's listening to a certain kind of music or a podcast or going out in nature and just listening to the quiet and the bird, that kind of thing.
Smell, maybe it's fun things like your favorite perfume or you're going to bake cookies so you can smell those lighting, your favorite candle. You name it. That's what you're going to do. And then taste is another really fun one. So maybe drinking your favorite tea, eating your favorite dessert, really soothing yourself through taste and touch.
Maybe you are petting your dog or you are doing like a self care night and putting on your favorite lotion. Doing the tip scales again, kind of touch, but like a cold compress on your head or laying in your bed. If it's super comfortable or wrapping yourself in a blanket, really just soothing the senses and decreasing that distress.
So those skills, the stop skill president con's asking for help tip and distraction, and self-soothing are universally really effective at decreasing distress. They, a lot of the time will work, especially if you know what works for you and they can be great tips to be aware of and implement across the board.
Really quickly, we're going to get a little bit more micro on anxiety, anger, sadness, and urges, and like what skills and my experience has been really helpful for each of those, because it's different, like things aren't universally going to work. If you are really feeling super sad, drawing on yourself with markers is not going to help, but if you're having a really strong self harm merge that might work so things are different for different emotions and it's helpful to know what works for you.
But for me, when I'm experiencing anxiety, the distraction piece is huge. I really do love the pep talk part of the improve skill. That's something that really helps me get through the moment. I love the tip scale.
I think taking a brief vacation and kind of stopping and taking a step back from the environment. And then going back can be really helpful. I'm a huge proponent of like drinking cold water and using self-soothing to really try and, and decrease those physical sensations of distress, especially with anxiety.
Another huge thing there is riding the wave, remembering that no emotion is constant. No emotion will last forever. And so they, the anxiety will pass the well and be. Observant of like how, at some moments your anxiety increases and then it decreases and then it increases and it decreases and really just leaning into that and sitting with that Anger anger for me, I think is still one that's difficult to cope with.
This just sucks. Like I'm like, oh, I hate this. And I think it's because I've done a lot of coping with anxiety and sadness and urges throughout my life. Whereas anger and, and like guilt and shame. Sometimes when those pops up, it's like, wow, this is Ford. I don't know exactly how to navigate this.
But I think a couple that work for me as the stop skill. Again, huge getting out of the situation, especially if it's an, an interaction can be huge. And I think in the long-term is super helpful. Physical movement. I really love like a little boxing moment or doing sprints or doing a workout, even if it's just like walking around, that can be so helpful to like, kind of let go of some of that distress.
I really love listening to loud music when I'm angry, I'm putting in my headphones and just completely distracting. I think that screaming and crying in a healthy way, when you're feeling anger can be really great. I was watching, what was that movie? It had what was her name? I was watching a movie recently.
I can't remember it, but it's the one about the school shooting it's on HBO max, you saw it all over Tik TOK. It has the girlfriend dance moms. I'm totally blanking, but there's this scene where they go out in nature and they just like scream. This sucks. Like life is hard. This is so annoying. What is going on?
And so for anger, that can be really helpful. I just flip the heck maybe, maybe some less choice words but that can be really helpful and letting those emotions out and then coping through and moving past things, I think ranting to a friend is huge. I like to joke that like I'm a big complainer and not in the way that I'm always like everything socks.
But I, I like to express his emotion. So if I'm really annoyed, I'm going to go to front and be like, what? Like, this is so annoying. I don't understand. And then moving on and coping with the situation. And then another thing that I think is really helpful. I remember doing this a lot when I was a kid, is writing an angry letter, like, especially when I'm angry with my.
Right. These letters are used to write these letters and I think this is so annoying. How could they do this? Blah, blah, blah, blah, blah. And just getting it out as an act that's very therapeutic. And you, you feel less of a need to say your piece to get that out and to make the other person understand you because you have kind of found that self-understanding sadness, I think is a really hard, hard emotion to navigate.
And I think even myself, when I think of sadness, I don't immediately think. Wow. That is a super distressing emotion. Like it's just like a bad feeling. But it's important to remember that sadness can bring a lot of distress that you need to cope through. And so for sadness, opposite action is huge.
Sadness wants us to withdrawal and be alone and cry and isolate and ruminate. So instead kind of getting out of your body and, and your thoughts and going. Hanging out with a friend or watching a funny movie or getting some movement in and really doing the opposite of what the emotion is telling you is huge.
And even at the beginning of that, implementing the stop scale. So you're taking a step back and you're like, this isn't effective. What can I do? And kind of, I think again, pros and cons is really helpful here in being like, okay, what are the pros of sitting with the sadness? What are the cons, how do I want to move forward?
And the last one I want to touch on is urges. I think a lot of these skills, we think about them in terms of emotions, but urges can be a really powerful. And distressing experience to navigate that these skills can work worked for. And a lot of these skills, when I was struggling, I was using for urges with self-harm and suicidal ideation, and they were, they were effective skills to use.
Riding the wave, I think is huge, especially when it comes to urges, kind of noticing when you have a stronger. When it goes away and, and leaning into that app and flow and knowing that nothing is constant. And so the urge will also pass skills that are super helpful for, for self-harm and suicidal ideation is squeezing ice.
I've heard throwing ice had a wall, never tried it, but squeezing ice is huge drawing on herself with markers writing notes down kind of expressing what you're feeling, getting that outside of you, instead of just suppressing, it can be really huge and really helpful and effective. So. I know that's a lot, it's a lot of different information about crisis skills, how to cope with them when you can use skills and a whole lot of different coping skills. But we are setting ourselves up for success. We're trying to do the work beforehand. So when we are in crisis situations, we don't have to figure out how to cope because we already know what works for us.
So. That is the crisis skills, survival episode. I really hope this was helpful. If you have favorite coping skills that you like, or that are useful for you, please send me a DM. Let me know. I love learning new coping skills and passing them along because what works for me might not work for you, my no work for another person.
And so the more ideas you can be aware of, the more likely it is, you will find what works for you. So. To recap that long whirlwind, we talked about crisis survival. We talked about what qualifies this situation as a crisis. And knowing when you should be using your crisis survival skills, we've talked a lot about how to set yourself up for success when it comes to coping.
So knowing your limits, having a plan in place, educating yourself and cultivating willingness to go through a situation. And lastly, how to cope with very specific high intensity emotions and situations. So if you like this episode as. Be sure to leave a review on apple podcasts and Spotify share with a friend or family member.
And if you share on Instagram, make sure to tag me and she persisted podcasts and I will share and give you a little shout out. So yeah, that is this week's episode. I really hope you enjoyed and I will see you next Monday.
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