A version of this article was also published at Psychology Today.
Panic, rage, lust, depression, humiliation, joy... Strong emotions make us feel like doing things URGENTLY. When we are super emotional, we usually feel a lot of intense physical agitation that we desperately want to escape. Even pleasant emotions can come with intense urges to act ineffectively. Sadly, compulsions often cause us problems.
If you're a sensitive person, then you probably struggle with some form of impulsivity. Many people specifically come to DBT in order to reduce impulsive behaviors. Luckily, DBT was designed to help with this exact issue! The very first DBT skill covered in the distress tolerance module is the STOP skill, and it's purpose is to help you not act impulsively when in emotional crises.
STOP is an acronym for a set of skills, and it stands for: Stop, Take a step back, Observe, and Proceed Mindfully.
DBT's best advice for stopping impulsive behaviors is to stop??? Great.
While the STOP skill is necessary and effective for reducing impulsive behaviors, I've often had clients feel invalidated when I teach it... If they could just "stop" when in emotion mind, they wouldn't be in DBT! (So they say.) The acronym is great or whatever, but how the f--- are they supposed to actually stop?
Actually stopping is the hard part. For sure. So, in response to this feedback, I often introduce another DBT skill whenever I teach STOP: Cope Ahead.
The Cope Ahead Skill
Cope Ahead is a DBT skill from the emotion regulation module. It's purpose is to increase our emotional resilience by preparing us for difficult situations ahead of time.
To Cope Ahead, we first identify a potential future situation that we expect to be emotionally painful, stressful, or triggering. We then craft a coping plan for how we can skillfully respond to the situation. Finally, we then repeatedly visualize ourselves coping effectively with the situation, according to the coping plan we created.
Research shows that practicing a new skill in our imagination actually activates the same neural pathways in our brains as when we practice a new skill in physical reality. In this way, with repeated metal practice, we're more likely to automatically respond the way we want to respond during future situations. So, Cope Ahead doesn't just prep us for emotional emergencies; it actually increases the likelihood we will act skillfully in those situations.
Pretty amazing, right? And really powerful, particularly for those moments when it feels like there's no "pause" between emotion and action. In emotion mind, when we're feeling emotions strongly, it can feel like there's literally no time to stop and make a skillful decision. That's why I suggest Coping Ahead for STOP. By being more "in control" during mental practice, you have the opportunity to create that pause for mindful action (and stopping).
How to Cope Ahead for STOP
To Cope Ahead for STOP, follow the normal steps for both Cope Ahead and STOP, as described in the DBT skills book. (I also provide the combined steps in my book!)
Below, I'll provide some specific examples of what your STOP could entail. Keep in mind that these are just suggestions! You should create your plan according to your specific impulsive urges and triggering situations, as well as your personal needs and preferences.
1. Identify the triggering situation.
Is there a situation or category of situations that usually triggers your impulsive behaviors? STOP Cope Ahead starts with describing that situation in detail. (Note: it definitely could be triggering for you to think about the stressful situation--possibly as triggering as actually living it! So, have your distress tolerance skills ready to use before/as you write! I recommend TIP skills, self-soothing, Distraction with physical sensations, in particular.)
Think about:
What specifically do you normally have urges to do (or not do) that is impulsive, harmful, or unskillful for you?
What things happen in the typical situation? What triggers you? Where are you? Who is there? What do they do (or not do)? What do you do (or not do)?
What emotions are you feeling?
What physical sensations are you feeling?
What thoughts are you thinking?
What is the specific emotion, sensation, or belief that comes right before your urges?
If there are a couple types of situations that trigger you, you will want to go through these steps separately for each of the situations. Cope Ahead is most effective when it's most specific!
If there is not a "typical" triggering situation, or it's hard to come up with details, that's OK. Just write down what you know. You need to at least identify:
What is your impulsive urge? What are you trying to avoid doing in the future?
What is the primary driver of your impulsive urge? Which specific emotion, physical sensation, or thought makes you want to do the impulsive thing?
Very often, as described above, impulsive behaviors come from that physiological agitation and sense of urgency or pressure. So, look out for what makes you feel that urgency! It's one of the main things you'll want to Cope Ahead for.
2. Identify how you'd practice Stop in the future triggering situation.
At this first step in STOP, you're just trying to stop, to pause and to not react. How could you do that? Common tricks/techniques:
Say "stop!" out loud to yourself, or yell it to yourself in your head.
Hold your hand out in a "stop" gesture.
Clap your hands together loudly.
Picture a stop sign in your mind.
Look at a stop sign. (I've had multiple clients find it useful to put a picture of a stop sign in the locations where they often experience impulsive urges!)
Remember, for Cope Ahead, you want to know what it would look like to Stop. You want to be able to visualize specifics as a part of your mental practice later.
3. Identify how you'd Take a Step Back.
This STOP step is asking you move away from the trigger or away from your impulsive behavior, ideally in a way that actually creates physical distance! So, as an example, if you're having urges to binge-eat, you could walk out of the kitchen. Some other ideas:
Step or jump away from something or someone.
Turn your body or head away from something, or close your eyes.
Sit or lie down, or stand up.
Shut your laptop or turn off your phone.
Toss a tempting object across the room (without damaging anything!).
Cross your arms, clasp your hands, sit on your hands, or put them behind your back.
Tightly shut your mouth, or cover your mouth with your hand.
Take a deep breath.
4. Identify how you'd Observe.
It's always helpful to mindfully observe any situation before acting, in order to be most effective. This step is figuring out how you would do that in your triggering situation. You may practice some mindfulness "What" skills quickly, or you may do a practice that's a bit more involved... Up to your situation and your needs! Some ideas:
Observe your breath, practice paced breathing, or stretch your body.
Observe and describe the facts of the situation.
Label your emotions, sensations, or urges.
Use Check the Facts.
Practice self-validation.
5. Identify how you'd Proceed Mindfully.
At some point, you'll have to move forward and probably respond to the trigger. How would you like to respond, without engaging in impulsive behaviors? Perhaps you'd use one or multiple of the following skills:
Review a Pros and Cons worksheet for your current impulsive urge.
Use TIP skills to regulate your nervous system and decrease the physiological agitation/urgency.
Use a distress tolerance kit or other distress tolerance skills to cope.
Practice a Wise Mind exercise.
Use Opposite Action or Problem Solving to try to reduce painful emotions.
Use DEAR MAN GIVE FAST skills to assert needs or limits to someone effectively.
Whether you will use coping skills to tolerate and respond to intense emotions, or you use skills to respond directly to the trigger itself in a more effective way, this step is about participating effectively, whatever that means!
6. Identify your ideal outcome for the crisis situation.
What would it look like for this crisis to end exactly as you wanted it to? What would it look like for you to act totally skillfully? What would you want to happen? What would you want to do? How would you want to feel? Possibilities include:
Coping without hurting yourself or someone else.
Communicating your needs clearly, assertively, and kindly.
Increasing intimacy or connection with someone.
Doing something pleasurable, fun, or relaxing.
Self-validating or standing up for yourself in a way you're completely proud of.
Feeling relief, happiness, pride, warmth, or hope.
Just like in step one, be as specific as you can be at this step! You want to be able to fully visualize your ideal outcome.
7. Practice your coping plan in your head.
If you haven't already, write out your STOP coping plan clearly and concisely. Now, imagine the triggering situation happening and you following your coping plan perfectly.
If you are able to visualize things in your mind, do so; literally play through in your mind what it would be like to successfully handle the situation, practice STOP, and avoid acting on your impulsive urges.
If you can't visualize, or have trouble focusing, you also can repeatedly write or read your cope ahead plan to yourself, or you can record yourself reading it out loud and repeatedly listen to the recording.
Repeated mental rehearsal is the important part for making skillful behaviors your default reaction, rather than impulsive behaviors.
8. Physically prepare for crisis, reward yourself, and re-evaluate as needed.
If you identified anything in the above steps that you can actually physically prepare ahead of time, make sure you do so! If you plan to use TIP skills, do you have the ice pack or bowl you'd use ready in your freezer? If you plan to use Pros and Cons, do you have them written out already? Would it help you to put your written-out STOP Cope Ahead Plan into your distress tolerance kit, on your phone, or somewhere else you could easily access it? Do you want to put up a stop sign photo anywhere? Do you want to share your plan with a trusted friend or therapist?
Once you set yourself up for success, make sure you take some time to reward yourself. This is hard work! Specifically, make sure you practice TIP skills, self-soothing, or relaxation techniques after mentally rehearsing. In the same way that mental practice is like real-life practice, imagining stressful situations can evoke the same emotions that experiencing stressful situations can. So, be kind to yourself. Rest and reward a ton.
Finally, don't be too discouraged if you still act impulsively after rehearsing your STOP Cope Ahead Plan. That's pretty normal. Behavior change is hard! If you engage in your impulsive behavior, my best recommendation is to review it (like through chain analysis). What happened? How did you follow your cope ahead plan (or not)? What did your original coping plan forget, miss, or underestimate? Review and refine your plan. Over time, this refinement will act like further practice and help you reduce impulsive behaviors. You got this!
Have questions or ideas about this post? Or want to share your STOP tricks with others? Please comment below or reach out to me on social media! You also can find my Instagram post on this topic here.
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