DBT Skills - Distress Tolerance Pros and Cons

Crisis Survival Skill #4

Pros and Cons

This is where we learn to identify the beneficial and harmful effects of choosing to tolerate the distress.

How To Use The PROS AND CONS Skill

When using the pros and cons skill, individuals are making 2 separate lists. One list is about the pros and cons of tolerating distress; the other list is about the pros and cons of NOT tolerating distress.
By not tolerating the distress means choosing avoiding, using alcohol or drugs, binge eating or engaging in some other impulsive self-defeating or self-destructive behaviour.

People use pros an cons all the time to help make decisions. For example, each day, you do a pros and cons list to get out of bed. We do not necessarily thing "the pros of getting up today are..." and the cons of getting up today are..." but we do this on a subconscious level.
The key is to strengthen this skill and practice it before a crisis happens so that we can consciously use pros and cons when we are feeling distressed.
The goal of practicing pros and cons is to help make decisions from a wise mind perspective.
This skill help us to look at a situation from every perspective and identify all possible outcomes. The eventual goal is to see that accepting reality and tolerating distress leads to a better future than fighting reality and refusing to tolerate distress.

WHEN COMPLETING PROS AND CONS LISTS...

• focus on both the short-term and long-term pros and cons
• thing of the positive consequences of tolerating the distress. Imagine how good you will feel when you can tolerate distress without 'making the situation worse' i.e. acting impulsively (which is an example of a pro)
• think of the negative consequences of not tolerating the distress. Remember past times when you may have acted impulsively to escape the moment and the situation is now the same or worse and you have no better coping methods.
• Fill our the chart completely and make it easily accessible
• in the midst of a crisis, focus on the pros of not giving into the urges. This will help get through the moment and make you feel stronger in the long run.

Note: if doing it once is not enough then re-do or reuse the list if the need arises even if it is 2 minutes later.

Note: Remember to practice self-soothing when not in distress to make it easier to use when in distress. If you start feeling and thinking you do not deserve to self-soothe, then observe those thoughts, put them aside and practice the skill again.