DBT Skills - Distress Tolerance

So week 3 in the DBT Skills Group dealt with distress tolerance. This couldn't come at a better time for me as I am going through some pretty distressing times. But all that will be the content of a separate post. For now, I will let you all in on what I learned - because, well, it also helps me remember it.

Distress tolerance skills teach us to:

• tolerate & survive painful situations when the situation cannot be changed at the moment
• how to survive intense emotions when we feel "triggered"
• decrease the suffering of the moment

PAIN + NON-ACCEPTANCE OF PAIN = SUFFERING

OVERVIEW OF THE DISTRESS TOLERANCE SKILLS

Crisis Survival Skills:

• distracting skills
• self-soothing skills
• improving the moment skills
• thinking of pros & cons of tolerating the moment

Radical Acceptance (accepting reality) Skills:

• learning how to "let go of fighting reality"
• teaches us to turn "intolerable suffering" into "tolerable pain"

CRISIS SURVIVAL SKILL #1: DISTRACTING SKILLS

"ACCEPT" is an acronym to help remember the distracting skills:

Activities: involving yourself in activities that change your focus. Any activity can by used as long as it does not further contribute to your distress or cause other problems. This activity should work to get your mind off the present situation rather than emphasize the current emotion.
Contributing: change your focus away from your emotions toward thinking about what you can do for others.
Comparisons/Count Your Blessings: think about how you successfully solved a problem in the past and utilize those strategies in this moment. Focus on the struggle of other & what they are doing to solve their problems. Focus on what you have or what you are grateful for.
Emotions: (generate opposite emotions) - observe the emotion and then "one-mindedly" involve yourself in an activity that will help you generate the opposite emotion. The opposite emotion produced should be at least the same intensity as the emotion causing the distress.
Pushing away: only used short term - walk away/leave the situation physically or block thoughts triggering the current distress from your mind. This skill allows you to block thoughts that create emotions of distress. You can store the problem away until you are ready to address it. this skill is not a permanent solution: the secret is not to overuse this skill and try using other skills before using trying pushing away.
Thoughts: Fill your head with other thoughts unrelated to the current situation and current distress. Distracting yourself with other thoughts can especially help if you can't get out of the situation.
other Sensations: create an intense physical sensation to focus on rather than a painful emotion or distress. Sensations can interfere with the physiological component of current negative emotion. Remember what you use is not to be harmful to the body or your person. (eg: holding an ice cube or intense exercise).

CRISIS SURVIVAL SKILL #2: SELF-SOOTHING SKILLS

Vision - light a candle & watch the flame; look at nature around you; watch your favourite movie; look at objects that remind us of beauty or that someone loves us

Hearing - listen to beautiful or soothing music; pay attention to sounds of nature; hum a soothing tune; be mindful of any sounds that come your way; letting sounds go in one ear and out the other.

Smell - light a scented candle; smell your favorite perfume or lotion; bake some cookies; carry some potpourri

Taste - have a good meal/ snack; have hot chocolate; have some ice cream; eat something you enjoy (using mindfulness)

Touch - take a bubble bath; pet your dog or cat; have a massage; put a cold compress on your forehead; hug someone; wrap up in a cozy blanket

CRISIS SURVIVAL SKILL #3: IMPROVE THE MOMENT

IMPROVE is an acronym to help remember skills for in the moment

Imagery (visualization) - you can create an experience different from the one you are currently experiencing. You can distract. soothe, bolster courage & confidence, make future rewards seem closer at hand.

Meaning - finding or cresting meaning has been researched and proven to have help people survive crises situations. Often people find it helpful to believe that their suffering has meaning even if they cannot find it in the moment.

Prayer - opening oneself up to the moment. A key point to remember is that praying is not saying "why me, why me?" or bargaining "if you take away this pain, I will do this." This is not accepting the moment. You can pray to God, Buddha, the universe, or whatever works for you. Ask for strength to bear the pain in this moment.

Relaxation - change how your physical body responds to stress and crises. It is your body responding to your mind. Example - a stressed out person often renses their body without consciously knowing they are doing it. it is as if our body is trained to respond to a situation. the goal is to accept reality with your body.

One Thing At A Time - focusing on one thing in the moment can be very helpful in the middle of a crises, it helps the overwhelming mind settle down. The secret of this skill is to remember that we only have to survive "just each moment".

Vacation - A DBT 'vacation' is to stop actively managing your life and either retreat into yourself or allow yourself to be taken care of for the moment. DBT vacations need to be brief, easy to come out of and will not harm yourself, others or make the problem worse.

Encouragement - Cheerleading statements. Speak to yourself as if you are talking to a good friend. Tell yourself what you would like someone else to say to you.

This is all we covered in week 3 of DBT skill group. The remainder of the Distress Tolerance Skills will be the subject of my next post.