Anxiety Distress Tolerance: DBT Skills for Surviving Crisis

DBT distress tolerance skills for managing intense Anxiety — TIPP, ACCEPTS, and crisis survival.

Distress tolerance skills from Dialectical Behavior Therapy (DBT) help you survive anxiety crisis without making things worse.

TIPP Skills for Acute Anxiety

Temperature: Cold water on face activates the dive reflex, rapidly reducing anxiety intensity

Intense exercise: 20 minutes of vigorous exercise discharges anxiety physiological activation

Paced breathing: Slow the breath (especially exhale) to activate parasympathetic system

Progressive muscle relaxation: Systematic tension-release reduces anxiety physical symptoms

ACCEPTS Skills for Riding Out Anxiety

Activities that engage attention away from anxiety Contributing to others shifts focus from anxiety Comparisons that provide perspective on anxiety Emotions opposite to anxiety — deliberately generated Pushing away anxiety temporarily when you can't act on it now Thoughts that replace anxiety rumination Sensations that provide strong alternative input

When Distress Tolerance Is the Right Skill for Anxiety

Use distress tolerance when anxiety is intense but the situation can't change right now. The goal is surviving without making things worse — not solving anxiety.

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