Distress tolerance skills from Dialectical Behavior Therapy (DBT) help you survive self-harm crisis without making things worse.
TIPP Skills for Acute Self-Harm
Temperature: Cold water on face activates the dive reflex, rapidly reducing self-harm intensity
Intense exercise: 20 minutes of vigorous exercise discharges self-harm physiological activation
Paced breathing: Slow the breath (especially exhale) to activate parasympathetic system
Progressive muscle relaxation: Systematic tension-release reduces self-harm physical symptoms
ACCEPTS Skills for Riding Out Self-Harm
Activities that engage attention away from self-harm Contributing to others shifts focus from self-harm Comparisons that provide perspective on self-harm Emotions opposite to self-harm — deliberately generated Pushing away self-harm temporarily when you can't act on it now Thoughts that replace self-harm rumination Sensations that provide strong alternative input
When Distress Tolerance Is the Right Skill for Self-Harm
Use distress tolerance when self-harm is intense but the situation can't change right now. The goal is surviving without making things worse — not solving self-harm.