Getting Through a Crisis the DBT Way: Webinar Recap

If you missed our recent free webinar, “Getting Through a Crisis the DBT Way,” don’t worry. We’re recapping the key takeaways here, and the full recording is available on our YouTube channel. Led by Nicole Roder, LCSW-C, a DBT-LBC certified therapist at Gladstone Psychiatry and Wellness, the session walked attendees through two practical Dialectical Behavior Therapy (DBT) skills for navigating crisis situations: TIP and Cope Ahead.

What Actually Counts as a Crisis in DBT?

We often use the word “crisis” loosely. But in DBT terms, it has a specific meaning: a temporary, highly stressful situation that causes intense emotional pain and can lead to harmful behaviors. The key word is, temporary. A crisis creates an urgent, in-the-moment feeling that something must be resolved right now, even when that isn’t objectively true. The danger is that the behaviors that feel like they’ll bring relief in a crisis (self-harm, substance use, and similar behaviors) are often the very things that cause more harm.

Why Some People Feel Crises More Intensely

The webinar introduced DBT’s biosocial theory, which explains why some people experience much more intense and longer-lasting emotional reactions than others. The theory describes three patterns often seen in people with significant emotional dysregulation:

• A higher emotional baseline — starting from a more activated place even before something happens
• Higher reactivity — a bigger emotional spike in response to the same triggering event
• A slower return to baseline — taking much longer to come back down afterward

These patterns develop over time through the transaction between biology and environment, particularly when a person’s intense emotional reactions are repeatedly invalidated by the people around them. Being told a reaction is “too much” or “not that serious,” over and over, doesn’t make the internal experience feel any less real. Over time, this can push people toward one of two unhelpful extremes: escalating behavior to be taken seriously, or suppressing emotion altogether. Understanding this cycle is often the first step toward breaking it.

DBT Crisis Skill #1: TIP — Changing Your Body Chemistry Fast

TIP is designed for moments when someone is fully in “emotion mind” — too activated to think clearly or access reasoning and logic. It works by shifting the body from a sympathetic (activated) nervous system state into a parasympathetic (calming) one. There are four components:

• Temperature — Briefly lowering face temperature with cold water or an ice pack (while holding your breath and bending at the waist) triggers the body’s dive reflex, rapidly slowing heart rate. *Anyone with a heart condition should check with their doctor before trying this.
• Intense exercise — A burst of vigorous activity for around 20 minutes works off the physical “action urge” that comes with intense emotion.
• Paced breathing — Exhaling longer than inhaling gradually brings the heart rate down; it’s also discreet enough to do anywhere without anyone noticing.
• Paired muscle relaxation — Tensing muscles on the inhale and releasing them on the exhale deepens the calming effect.

TIP works quickly, doesn’t require much conscious effort once practiced, and gives the nervous system a genuine alternative to reaching for a harmful coping behavior.

DBT Crisis Skill #2: Cope Ahead — Planning for Predictable Stress

While TIP helps in the moment, Cope Ahead is a skill for situations you can see coming — a difficult conversation, a family gathering, a hard meeting. It has three steps:

1. Describe the upcoming situation factually and without judgment.
2. Decide in advance which skills you’ll use to get through it.
3. Mentally rehearse the situation, imagining yourself coping effectively — followed by practicing relaxation.

This last step matters more than it might seem. To the brain, vividly imagining a scenario activates many of the same neural pathways as actually experiencing it, which is part of why athletes use visualization to prepare for competition. Rehearsing the effective version of a hard moment, rather than dwelling on how it might go wrong, builds real preparation for when the moment arrives.

About Gladstone’s DBT Program

Gladstone Psychiatry and Wellness is proud to be the first Maryland practice certified by the DBT-Linehan Board of Certification, reflecting full fidelity to the model developed by Dr. Marsha Linehan. Several of our therapists, including program leadership, hold individual DBT-LBC certification as well.

Our comprehensive DBT program is available for adults and adolescents (age 14+) and includes individual therapy, group skills training, and 24-hour phone coaching. The program is a one-year commitment for adults and a six-month commitment for adolescents, beginning with a pre-treatment phase where you and your therapist determine whether DBT is the right fit. Our adolescent program also offers family therapy and parent coaching as needed. We also run a DBT skills group for family and friends of individuals in treatment.

Have Questions or Want to Learn More?

If this recap has you curious about whether DBT could help you or a loved one, we’d love to hear from you. Reach out to our team at [email protected], or visit gladstonepsych.com to learn more about our full range of services, including medication management, TMS, ketamine-assisted psychotherapy, weight management, and Advanced Screening.

Check out our YouTube channel for the full webinar recording, and follow us on social media for more mental health tips and upcoming events.

This blog post is for educational purposes and is not a substitute for individualized clinical care. If you are experiencing a mental health emergency or having thoughts of suicide, please call or text 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room.