I originally wrote this up in a document for a friend of mine as a sort of "what I learned in therapy" document. When I'd finished it, it occurred to me that most of it would be useful for other folks too. I removed anything that might identify people, chucked into a few groups, and now I'm chucking it up here for anyone who needs it.
I've also continued work on the document version of this page. It now includes information on trauma, dissociation, anxiety, depression, and more in addition to the skills listed here. It also has ideas for shadow work and journaling. Feel free to download that if you'd like- it's there for people to use!
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- Anxiety is a cycle. You feel afraid, so you avoid things. That teaches your brain that the things you avoided are actual threats, reinforcing the fear and making you more afraid next time. The only way out is to do the thing despite the fear. Do it anyway. It'll be scary and shitty, but it'll gradually train your brain out of the anxiety. Run straight at the fear. Tolerate it for as long as you can stand it, then push a little longer before letting yourself stop.
- If you can do something about the cause of your anxiety (if there is one), then do it. If you can't do anything about it, then why are you worrying about something you can't do anything about? Realizing that can help let it go.
- Take deep breaths. They press on the vagus nerve in your chest, which calms your nervous system down. Do it for longer than you think you need to.
- Variation on deep breaths: imagine breathing in calm white light. Imagine it flowing through you and pushing out the fear.
- Imagine letting your anxious thoughts float away in a river or other visual metaphor. Really let them float away- don't hang onto them. It's okay. They'll come back if you need them. If they do come back, try letting them go one more time. If that doesn't work, see if you can figure out where they're coming from.
- Remember that all emotions are temporary, even the ones that stick around for a while. Everything before has passed by. This will pass too.
- Read up on how exposure therapy actually works. See if you can use elements of it in your own life.
- Talk to the fear. Assume it means well. Reassure it if you can. Make compromises if you need to. Ask it what it needs from you and find a way to show it that the world is safer now than it was in the past. Imagine your fear as a creature or shape. Feel where it is in your body. Imagine hugging it or offering it comfort.
- Imagine your happy place as vividly as possible, sense by sense. Immerse in it. Keep the deep breaths going. Focus on how that place feels. Optional: slowly tap on your knees, alternating sides EMDR-style.
- Using your right hand, trace from the corner of your left eyebrow to the back of your ear, the hinge of your jaw, and down to your collarbone in one smooth line. If you can do your left hand on your right side at the same time, all the better. Do this 10-15 times. Sounds weird, but it can work (apparently it stimulates a few nerves involved in calming a panic response).
- Place one hand on your chest and the other on your stomach. Apply comfortable pressure. Stay like that for as much time as you have.
- Do literally any movement or exercise that you can do. It tricks your body into thinking you escaped the threat. Wave your arms around wildly. Bicycle your legs slowly in the air. Wiggle or roll around. Squeeze a pillow really hard. Anything goes if it uses your muscles.
- Do something mentally demanding. Brains can't do logic and emotion well at the same time. Thinking of rhyming words, doing math, rotating shapes in your head… if it makes you work to think logically, it’s good.
- Comfort yourself. Cuddle with a plushie or blanket.
- Fake it until you make it. Hold your body like you're confident and not afraid. Straight back, shoulders back, hands on your hips or arms folded. Stay like that for a while.
- Let the fear out with a stressful game or similar. Point it at something and use that to let it out.
- You have the ability to handle this even if you don't feel that way. There's always a way to get through something.
- Make sure your needs are met. It's very hard to be happy if you have unmet needs (mental and emotional needs included).
- Do not isolate yourself. You need people more than ever. If you're feeling the urge to cut yourself off, reach out instead. It's a sign you need social contact with others.
- Likewise, do something. Even if you have no motivation or reward, engage in something that made you happy in the past. Do it even if it feels blah. Keep doing it. Don't stop because it feels blah. Make it your hobby anyway. The more you can make yourself do, the better. Even tiny steps are something if you can keep them up.
- Get out of the house if you can. Go places. Even sitting on the porch for 15 minutes counts. Changing literally any scenery helps.
- Figure out what matters to you in life and make that happen more often. List your top 4-5 values. Then, list out your daily activities. Are those activities in line with your values? If not, what can you change about your day to make them match?
- If you can, shower and/or change clothes. Washing bedding counts too. Rub yourself down with a washcloth if showers aren't an option. Being slightly cleaner in any way helps.
- I seriously can't emphasize "do something" enough. Make things. Read. Write. Talk to someone. Make a giant list of things you like. Pet as many cats as you can. Do literally anything, and make a point of doing it. Keep yourself busy. Sitting around doing nothing but scrolling feeds depression like nothing else. Find a project and chase it.
- Remind yourself that your worth is inherent. There is only ever one you. That alone gives you immense value. Nothing anyone else does can change that. You are valuable.
- You are not evil or bad. You are not actively choosing to harm others. You're doing the best you can for the situation you're in. It's your choices that make you good, not some inherent property. No one is inherently bad or evil, and that includes you.
- People don't hate you. If they hated you, they wouldn't ever talk to you. They're not talking behind your back, either- assuming that everyone around you is that malicious when they've all got their own issues and go out of their way to talk to you despite those is twisted logic. Depression is lying to you. Prove to yourself that it’s lying by remembering as many counterexamples as you can.
- A note: this doesn't apply to genuinely abusive people in your life. Even if they're kind sometimes, it doesn't negate the damage they're doing. If someone is abusing you and refuses to change, then the only thing to be done is getting out of there as soon as you can. It's extremely hard to recover while being abused. Waiting for them to change or trying to fix them isn't worth your sanity.
- You have all the tools you need to get through this. You've survived everything before now. You will survive this.
- Talk back to the negative voice in your head. Be kind to it. Recognize that it's hurting and find ways to help it. Ask it what it needs from you (and don't accept "die" as an answer). Show it why its words hurt you, and what you'd prefer to hear instead. Treat it like an injured child if that helps. Teach it to trust you. Yelling back doesn't work as well as kindness, but it works in a pinch if it's an emergency.
- Don't wallow without good reason. Distract, comfort, counter, etc. but try to move forwards despite the feeling. If you HAVE to wallow, then do so with the goal of really hearing the feeling out and understanding what it needs.
- Assume that you're capable. You CAN do things, and you're the only one that can help yourself. Find ways to improve yourself or work on something that feels productive. Feeling like you're contributing to something or improving yourself is a great counter against depression's feelings of worthlessness and meaninglessness.
- Happy music, favorite movies/books/etc., and anything else that's made you feel good in the past can help counter sadness.
- Think of the people that care about you. Remember times they’ve demonstrated how much they care.
- Obviously, don’t die. That’s priority #1.
- If you believe you will take your own life today and you have a plan to do so, then get help now. Put down the phone, shut down your computer, whatever- get yourself to a hospital or mental healthcare facility right now and tell them that you're planning to kill yourself. The mental healthcare system might be shitty in some places, but it'll keep you alive.
- Suicide is often a "way out" from something overwhelming. These thoughts are a symptom, not the problem itself. Figure out what that problem is. Find a way to either resolve the situation or safely leave it.
- If you're having suicidal thoughts but don't want to act on them, then you may be under too much stress. Suicidal thoughts can be the brain's emergency escape hatch when life is too overwhelming. It's your mind saying it feels cornered and needs a significant break. See if you can find a way to pare back your responsibilities and give yourself space to rest. Find ways to be gentle on yourself.
- If you're in a situation where you genuinely want to die, then something needs to change. Any other measure is worth your life. Do whatever you have to do to keep yourself alive. Don't hurt yourself if you can help it, but radical life changes are absolutely on the table if you're at the point of truly wanting to die.
- If you're being abused and are considering dying because it's too much to bear: staying isn't worth your life. You're thinking about the most extreme way to leave the situation already, and there are so many other ways out of it that don't kill you. Start planning a way out if you can. It might take time, but it's worth it if it keeps you alive. Even being homeless is better than being dead. There are no second chances or takebacks if you die.
- Distract yourself in the short-term and/or ride the urge. Change your environment and do something that makes you feel better or stops you from thinking about it. Do not hurt yourself unless there's literally no other option. Go outside and wander if you have to.
- If you feel safe doing so, go for a walk. This is especially helpful if the thoughts are focused on a specific object; go outside and get away from the object.
- Tell someone. Get help.
- Call or text your local suicide hotline.
- Don't expect your friends to actively convince you to live (that's too much of a load for any one person to bear), but go to them for company and support. Just spending time with people that care about you can help a lot.
- Recognize that you can have thoughts without acting on them. Thoughts often happen randomly and outside of our control. Brains are electrified Jell-O that make every connection they possibly can, even the unhelpful ones. One thought can trigger another without any effort on your part. You’re not to blame for having thoughts you don’t want, and those thoughts don’t say much about you as a person. They’re thoughts. Thoughts happen. It’s okay. Try to learn to let them pass by instead of clinging onto them.
- Urges are not actions. Every time that you can ride out the urge without doing anything is a time you retrain your brain to cope with the urge without acting.
- Delay the urge. Tell yourself that you're going to wait five minutes before doing anything. When those five minutes are up, tell yourself to wait another five. Keep doing it until the urge lets up. If five minutes are too long, try one minute, or even thirty seconds. Make the intervals as small as you need them.
- Ride or "surf" the urge. Notice it and be curious about it, but don't try to change it or make it go away. Don't act on it, either. Just notice it and try to be interested in it. It'll probably be uncomfortable, but that's okay. Take deep breaths and remind yourself that it will pass. If you can sit with it like this, it should pass within half an hour or so.
- If you're struggling to stop cutting, scratching, or similarly injuring yourself physically:
- Draw on the sites where you want to harm yourself. Hurting yourself there would mean ruining the drawing. If you can't draw, try writing poetry or other meaningful phrases on the area.
- Similarly, use red marker to draw on your skin instead of harming. It can be as simple as scribbling on the area. This gives the visual impression of injury without actually being an injury.
- Snap a rubber band on your wrist or otherwise replace the pain with something safer.
- Go for a walk or otherwise exercise. This gives you an endorphin rush just like self-harm does.
- Mental/emotional self-harm exists; for example, exposing yourself to triggers or deeply upsetting things with the goal of making yourself feel worse is self-harm.
- Learn what your self-harm triggers are. Address them if you can; don't avoid them unless you have no other choice, but find ways to deal with them or prevent them. If you tend to harm when you're lonely, then plan to spend time with friends often.
- If possible and safe, address the reasons behind your self-harm. Self-esteem issues, a desire for control, body dysmorphia, wanting an outlet for unbearable emotional pain... there are all sorts of reasons, and there's no way I can list them all. Find your reasons and tackle those. It's easiest to solve problems at their source.
- Name 5 things you can see, 4 you can hear, 3 you can touch, 2 you can smell, and 1 you can taste.
- Name everything in a category (trees, cat breeds, colors, etc.). Random trivia works too.
- Name facts about yourself. "My name is [x]. I'm [x] years old. I'm at [place] right now. It's [time]. The year is... The month is... The day is... I live with [x]." Etc.
- Count things around you. Floor tiles, bricks, specks on the wall, etc.
- Find a strong texture and touch it a lot. Same works for smells, sounds, etc. Sour candies work great. The goal is stimulating your senses to ground yourself.
- Move around. Find ways to feel your body.
- Focus your attention on the present moment as much as possible. Your thoughts, feelings, body, everything in the immediate moment. If you get distracted, gently bring your attention back to now.
- Face the thing causing you to dissociate. Yes, even if it's unpleasant. Turn towards it and hear what it has to say. Let yourself feel that hurt. You might not be able to do that in the moment, but you can do it after the fact.
- The only way to reduce dissociation is to turn towards distress and discomfort. Let yourself feel it and learn to stay present through it. Sit with feelings and gradually teach yourself to tolerate them. Look into "distress tolerance".
- Step back from the situation if you can. Conflict is almost never solved in anger.
- Deep breaths.
- Distract yourself. Even spending 5 minutes focusing on a different topic has significant effects on anger levels.
- Ride out the emotion and let it pass.
- Try to see the other person's perspective on the issue even if you disagree with it.
- Change the anger into fuel (like passion or the desire to change).
- Don't engage with rage fuel. It won’t help if you make yourself angrier.
- Recognize that anger is caused by feeling that something is unfair or unjust, or by feeling hurt.
- Don’t punch things. It keeps you angry for longer instead of calming you down.
General maintenance/avoiding problems
- Take care of physical needs. Have you eaten in the last few hours? Drank water? Slept 7+ hours total? Need the bathroom? Moved around at all, even if that's just waving your arms around for a few minutes? You will not be happy if you have unmet needs.
- Take care of mental needs. Are you lonely? Have you accomplished anything today that feels productive? Have you worked on yourself at all? When did you last go outside or see nature? Have you been hugged or touched recently (pets and plushies count)? Do you feel supported by anyone in your life? Are you overloaded or stressed by taking on too much?
- Make and enforce boundaries. Good people will not only respect them, but appreciate them.
- Manage sensory needs. Being understimulated or overstimulated can wreck your mental health.
- If something is uncomfortable or distressing, take care of it as soon as possible. Run straight at it and tackle it before it can fester.
- Avoid black and white thinking. Think of grays and in-betweens. If you find yourself stuck in "it's this OR this", then think of a third option outside that binary.
- Emotions are normal. Every person on this planet has feelings, and every person has felt overwhelmed by them at least once. It’s okay. You’re not bad, wrong, or weird for having big feelings.
- Recognize that discomfort is normal. Life isn't comfortable 90% of the time. It's a struggle. It's okay to feel uncomfortable or upset. Sit with discomfort. Push at the edge of your comfort zone. With practice, your tolerance will increase and what used to be upsetting will be easier to tolerate.
- Practice gratitude. Start your day by thinking of something you’re looking forward to, or with something you’re happy about. End it by thinking of something you’re grateful for. It sounds corny, but it helps.
- If you can, meditate. This doesn’t have to be “sit totally still and think of nothing for hours on end”; that’s not how meditation works anyway. Meditation is about focusing your attention on one thing (your breathing, for example) and letting other thoughts pass by. You will have other thoughts. That’s okay. Notice them, then let them go and gently bring your attention back to your focus. You don’t need to do this for very long, either. Even 5 minutes a day is helpful.
- If you have a trauma history, then learn about polyvagal theory. It helps you understand how trauma affects your brain's responses to life. In particular, look up "window of tolerance" and read about it.
Getting things done
- Break tasks into the smallest steps possible.
- Write those steps down. Use that list and follow it.
- Have someone else tell you to do the thing.
- If you can’t do something, see if there are any obstacles in your way. Change or remove the obstacles.
- Instead of "I need to do the thing," think "I wonder when I'm going to do the thing?" Be curious about when it'll happen. This has gotten me out of bed when nothing else worked to make me move.
- Use distraction to your advantage to get more done instead of fighting it. See also: https://www.structuredprocrastination.com/
- Apologies to ADHD folks. I don't have that experience and can't be of much help there.
A bunch of useful phrases
- Bear witness.
- Do it anyway.
- Bravery is doing things in spite of fear.
- Everyone feels emotions. It’s okay and natural to feel things, intense feelings included.
- There are no bad emotions, only unpleasant ones.
- It’s okay to cry.
- No one has any idea what they’re doing. Folks who seem to have it together are fumbling through life just as much as the rest of us.
- Life is hard. That’s what makes it worth living.
- If it’s worth doing, then it’s worth doing halfway.
- You already have everything you need inside you. You are strong enough.
- Turn towards fear.
- Anxiety is a cycle of avoidance. The only way out is to stop avoiding the source of the anxiety.
- Recovery is a process, not a goal.
- You’re the only one that can help yourself.
- Be gentle on yourself.
- Good things take time and effort.
- Mistakes are opportunities to grow.
- You’ve survived everything life has thrown at you so far. You can survive this too.
- You are loved more than you know.
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