• We need distress tolerance skills to help us cope with extremely trying or painful moments, or emergency situations. When we’re distressed, it’s easy to default to clumsy, destructive, or unconscious ways of coping—these are false coping mechanisms.

• Self-soothing is a way to acknowledge and accept pain that is inevitable—without making it any bigger than it should be. It is not distraction or avoidance, but about anchoring in the present using your five senses—a technique called grounding.

• TIPP stands for temperature, intense exercise, paced breathing, and paired muscle relaxation, all of which can help lower physiological arousal. Try cold water, vigorous movement, or breathing exercises to calm the limbic system.

• Practice radical acceptance, which doesn’t mean we like what is happening, only that we have agreed to not fight with reality. Acknowledge how you feel and the reality of the situation and remind yourself of what matters.

• The ACCEPTS acronym (Activities, Contribute, Comparisons, Emotions, Push away, Thoughts, and Sensations) can help you better tolerate momentary distress—although not for the longer term.

• With anxiety, our goal is not to force ourselves not to worry, but to worry more efficiently. Scheduling worry time puts you in proactive control and helps you gain distance.

• Notice the anxiety, write down the time you’ll postpone to—with the duration and content—then follow through as agreed.

• Mental noting and focused mundane tasks can help you turn anxious moments into opportunities for mindfulness.

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