When an urge surges, pause before you decide

What is the STOP skill?

The STOP skill comes from dialectical behaviour therapy (DBT), developed by the psychologist Marsha Linehan. DBT includes a skills training for handling intense emotions, and STOP is one of its skills for getting through an emotional peak: leaving a few seconds' gap between an urge and an action.

The four letters stand for four moves: Stop, Take a step back, Observe, Proceed mindfully. It isn't about squashing the feeling, or never responding; it's about letting you decide the next move instead of the urge. This exercise adds one look-back question at the end, comparing this pause with reacting straight away.

No study has tested STOP on its own; it is one part of DBT skills training, and the full skills training, led by trained instructors, is supported by research. This exercise isn't therapy and doesn't replace professional support. If urges often get the better of you, practising with a counsellor or psychologist will take you further.

The STOP skill is adapted from Marsha Linehan's dialectical behaviour therapy (DBT) skills training, one of its skills for getting through an emotional peak. The steps and examples here are rewritten in our own words.

How it works

1. 1Stop: tap the stop sign and hold still for a count of three; then pick what the urge wants you to do and rate how strong it is.
2. 2Step back: breathe slowly three times with the circle. With each out-breath the picture steps back, and you watch the moment from the corner of the room.
3. 3Observe: pick where you feel it most in your body, write the sentence in your head, then the facts a camera would record (each can be skipped).
4. 4Proceed: rate the urge again, imagine yourself three days on, and choose one small next step for your STOP card.

When it isn't the right tool

If the urge is to hurt yourself or end your life, please don't treat this as a routine exercise; reach out now. These lines are answered around the clock; in an emergency, call 999:

The Samaritans Hong Kong (24-hour) 2896 0000Samaritan Befrienders Hong Kong 2389 2222Suicide Prevention Services 2382 0000Caritas Family Crisis Support Centre 18288Hospital Authority Mental Health Direct (24-hour) 2466 7350Emergency services 999

Choosing "Hurt myself" in the exercise takes you straight to the support lines.

If someone near you is frightening you, leave first and get somewhere safe; don't stop to do an exercise.

References

1. Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.
2. Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., McDavid, J., Comtois, K. A., & Murray-Gregory, A. M. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: A randomized clinical trial and component analysis. JAMA Psychiatry, 72(5), 475–482.