STOP

There is a gap between the thing that happens and the thing you do about it. The gap is short. In most people, in most moments, the gap is so short it does not feel like a gap at all — the trigger arrives and the behavior follows in what feels like a single motion. For many of the individuals living through incarceration, that gap wasn’t wide enough for them to critically think, for them to reject their instinct, for them to respond appropriately to the event that landed them in their current situation.

STOP is a skill for widening that gap. Not by much. By enough.

Stopping to think for a second before acting seems like common sense. A no-brainer. We’ve all done it. But that takes conscious effort, active engagement in a thing that is scary, demanding, and unforgiving. We are human (you are, at least…) and therefore most of the time we take the easier solution. Fight or flight kicks in and we just go. Or do. No stop.

In my experience, giving a name to something many times allows me to define something a bit more concretely in my mind as real. I know that it is common sense to not be reactionary, but when you’re going through therapy and discussing times where you did or did not react appropriately, and then naming that thing, it gives it meaning and purpose.

STOP stands for four steps, in order:

Origins of the skill

STOP is one of the crisis survival skills in Dialectical Behavior Therapy, developed by Marsha Linehan at the University of Washington in the late 1980s. ¹ 1 Linehan originally developed DBT as a treatment for borderline personality disorder; its application has since expanded to substance use disorders, eating disorders, PTSD, and a range of conditions characterized by emotional dysregulation. The University of Washington Behavioral Research and Therapy Clinics, where Linehan still teaches, is a thirty-minute drive from where I am writing this.

DBT teaches skills in four modules — Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness — and STOP sits squarely in Distress Tolerance, in the subgroup Linehan calls crisis survival strategies.

A crisis survival skill is for use when the following three things are true at once:

• the distress is acute
• the situation cannot be immediately resolved
• there is a real risk that the next thing you do will make the problem worse

STOP is for that exact intersection. It is not a long-term strategy. It is a tool for the ninety seconds between feeling something and doing something about it.

The skill is published in DBT Skills Training Handouts and Worksheets, Second Edition (Linehan, 2015), and taught in the accompanying DBT Skills Training Manual, Second Edition (Linehan, 2014). ² 2 Both texts are available through Guilford Press. The handouts are designed to be photocopied and used in clinical practice; many of them circulate through correctional rehabilitative programming, often without their original cover sheets. It is one of the few DBT skills simple enough to teach in a single session and short enough to fit on a wallet card.

What each letter actually asks of you

The four letters are easy to memorize. The four letters are not easy to implement. This takes continuous daily practice, patience, and some space to fail.

Stop asks you to interrupt a motor response that has, by the time you notice it, already begun. The skill is being deployed against an impulse that has a head start.

Take a step back asks you to create space in a situation that, by definition, feels like it has none. Crises can and will feel uncontainable. The skill asks you to act as if the situation were containable, before you have any evidence that it is.

Observe asks you to do the one cognitive task — sustained, neutral attention — that emotional flooding makes hardest. Linehan acknowledges this directly: the Observe step depends on basic mindfulness skills, which is why DBT teaches Mindfulness as the foundational module, before Distress Tolerance.

Proceed mindfully asks you, after all of that, to still do something. The skill is not avoidance. The skill is action — but action chosen, not action triggered.

The structure assumes you are the kind of person who has reactions you would prefer to interrupt. Most people, in most situations, do not need STOP. STOP is for the situations where the version of you that shows up first is not the version of you that you want to be the one acting.

STOP is for the situations where the version of you that shows up first is not the version of you that you want to be the one acting.

What it asks of you in places without exits

In the context of prison, that is the time it takes to decide you aren’t offended by the guy from a different “car” who just called you a female dog. Or a punk. That is the time it takes to take a breath, your last bite, and put your tray away after being barked at to “TRAY UP!” fifteen minutes early in the chow hall. That is the time it takes to write a professionally worded kite with a solid complaint of DOC staff behavior instead of a hastily and angrily written one that will never be read. And it’s the time it takes to tell your loved ones how grateful you are that they are on the phone with you at all, instead of yelling at them and then slamming the phone down on the receiver in the day room. These moments save lives, save relationships, and save yourself from a world of unnecessary suffering.

For me, it has helped me to successfully navigate several intense conversations with hostile individuals where had I matched their demeanor out of pettiness I would have ended up in the hospital. If you haven’t figured it out from my writing, or personality, I prefer dark humor and often take shots at low-hanging fruit when it’s dangled in front of me. In prison, there isn’t space for this. Using the STOP skill, especially in the active day rooms where the entire incarcerated population is allowed to co-mingle, is a must.

During the last year, implementing the STOP skill during my transition back into the community has allowed me to remove myself from situations that could have turned uncomfortable, especially when tackling new social situations. Beyond that, it has helped me to defuse cognitive distortions (negative, and mostly untruthful, thoughts) as they appear by disassociating from the distortion in the moment, reframing it logically, and recovering from the harmful impact it could have had on me. Almost as if it was helping me to… tolerate stress.

What the research actually says

Distress tolerance skills, as a class, have been shown to contribute meaningfully to symptom improvement in clinical populations — a 2010 study by Neacsiu, Rizvi, and Linehan found that DBT skills use, including distress tolerance skills like STOP, mediated improvements in suicidality and emotion regulation in patients with borderline personality disorder. The skill is not magic. It does not work every time. What it does, in the aggregate, is shift the ratio of regretted to unregretted actions in the direction the user wants.

That is the entire pitch.

We often do this subconsciously. Now you have a name for it. Naming a thing gives it power. STOP gives you 90 seconds. Use them.

Sources

Marsha Linehan, DBT Skills Training Manual (2nd ed., 2014, Guilford Press) — canonical published source for the STOP skill; the four-module structure of DBT (Mindfulness, Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness); STOP’s placement within Distress Tolerance, in the crisis survival skills subgroup.

Marsha Linehan, DBT Skills Training Handouts and Worksheets (2nd ed., 2015, Guilford Press) — photocopyable client-facing companion to the Manual; the version of the STOP handout that circulates in clinical practice and rehabilitative programming.

Neacsiu, Rizvi, & Linehan (2010), “Dialectical behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder,” Behaviour Research and Therapy, 48(9), 832–839 — finding that DBT skills use mediated improvements in suicidality and emotion regulation in patients with borderline personality disorder.

University of Washington Behavioral Research and Therapy Clinics — Linehan founded and continues to direct the BRTC at UW, where DBT was developed and where she still teaches. depts.washington.edu/brtc