Emergency Resources

Use this when the feeling is too big to think through. Thinking comes after. Pick one of the four, do it, then answer the questions.

⚠️ Cold water on the face drops your heart rate fast, and intense exercise raises it. Check with your doctor before using these steps if you have a heart or medical condition, a lowered heart rate from a medicine, take a beta-blocker, are allergic to cold, or have an eating disorder. (Linehan, Distress Tolerance Handouts 6 and 6a.)

How big is it right now, 0–10?

Which one am I doing? (T · I · P · P — pick one)

• T — Temperature: holding your breath, put your face in a bowl of cold water, or hold a cold pack (or a zip-lock bag of cold water) on your eyes and cheeks. Hold for 30 seconds. Keep the water above 50°F. Works best sitting quietly.
• I — Intense exercise: even just for a short while — running, walking fast, jumping, lifting weights — to spend the energy the emotion has built up.
• P — Paced breathing: breathe deeply into your belly and slow right down, to about five or six breaths a minute. Breathe out more slowly than you breathe in — for example, 5 seconds in and 7 seconds out.
• P — Paired muscle relaxation: breathing deeply into your belly, tense your muscles (not so much that they cramp) and notice the tension. Breathing out, say "Relax" in your mind and let the tension go. Notice the difference.

What I did, and for how long:

How big is it now, 0–10?

What is the one next thing I'll do? (not solve it all — just the next thing)

After: how strong is it now, 0–10?

Use this in the seconds before acting on an urge. It is short on purpose.

• Before: how strong is this, 0–10?

S — Stop. Freeze. Don't move, don't send, don't say it.

• T — Take a step back. Leave the room, put the phone down, breathe out slowly.
• O — Observe. What's happening inside you, and around you?
• P — Proceed mindfully. What action fits what you actually want? Ask Wise Mind: which actions will make this better or worse?

What was I about to do?

What am I noticing in my body and my thoughts?

What do I actually want out of this — a day from now?

What will I do instead, right now?

After: how strong is it now, 0–10?

Pick one thing per sense and actually do it. Kindness toward your body counts.

Before: how strong is this, 0–10?

Sight — something good to look at:

Sound — something calming to hear:

Smell — something I like the smell of:

Taste — something to taste slowly:

Touch — something soft, warm, or steady:

How am I now, 0–10?