Hi everyone! I know it’s been a while since I last posted and bit longer since I shared the previous “Recovery Resources” (Emotional Awareness), so here we are with the next update in the series – Distress Tolerance.
As I previously mentioned, these posts are primarily a way for me to reflect on the DBT skills I’m learning and keep them fresh in my mind in the hopes of being able to use them as needed. However, that being said, even though I’m NOT a registered professional, I hope that by sharing the resources I’m privileged to have access to, someone reading might see something that resonates with them and be willing to give it a try. Let this serve as my attempt to remind you that that you are not alone and there are resources out there that can help.
So, distress tolerance – What is it?
Last time I spoke about my experience learning to identify my feelings and how I believe it is a crucial aspect in developing a healthier relationship with yourself. This week I’m going to discuss what you can do when the feelings you identify feel overwhelmingly strong.
You can’t always control a situation but you can manage your response to it. Distress tolerance skills allow you to manage intense emotions without doing anything destructive. The point of these techniques is not to “fix the problem” nor do what might be best, rather to safely try to stop your emotions from taking over and to prevent the situation from getting worse.
Some of these skills can be life-saving, but the idea is that we use them to tide us over until we get to a place where we feel like we can more comfortably address the situation, using them continuously can lead to their own problems in themselves (avoidance). I often think of these as similar to harm-reduction techniques that allow us to ride the wave (or urge surf) – minimizing consequences of powerful, potentially-impulsive feelings.
Importantly, all you need when considering healthier ways of coping with difficult situations is to (in some way) want to try something different or at least be a little bit curious about what else is out there. You just have to be willing to try. My advice would be not to give up too soon. So many people I have worked with lament that these skills are weak substitutes for the arousal associated with many negative coping mechanisms (and I’m not going to lie – this is to some degree true…) BUT, the point of this is that the consequences associated with what is only temporary release caused by destructive habits, far outweighs their perceived “benefits”. The literal or figurative “high” you might feel from destructive behaviours might be unparalleled, but so are the subsequent lows. You have come this far because, to a certain extent, you don’t like how you currently cope or you can recognize that there must be something healthier. However, you won’t ever know anything better unless you try something different and whether or not you believe you deserve it, or believe you can do it, I encourage you to take a shot.
It takes a lot of practice to begin to lean on these skills where you previously would have used destructive behaviours. It requires consistent trial and error to unlearn bad habits and replace them with new ones. But each time you succeed (even in delaying the symptoms or behaviours for a few minutes) the better you get at it, and the more you collect a reservoir of examples of times you were able to cope.
The best way to learn these techniques is to first be mindful of when you might benefit from them, second – to make them available for use, and third to keep practicing them and trying different things to find what works for you.
Here are some ideas you can try!
Activities – Do something to take your mind off the current stress.
* (Something that sufficiently engages you). This will necessarily be different from person to person. I like combining TV with chores or other activities.
E.g. Crafts, reading, cleaning, watch a movie or TV, go outside, play video games, make a new music playlist, engage in an enjoyable hobby, play chess or a board game with a friend/online, do a puzzle, put on makeup, do chores etc.
Here are some specific examples.
Contribute – If you struggle to do something nice for yourself, try distracting yourself by doing something for someone else. Write a letter to a friend, call someone to chat, make a craft for someone, run errands or cook/bake for another.
Compare – Have you survived equally distressing situations in the past? What are you grateful for? Try and generate some relief or gratitude that your crisis could be even worse.
Emote – Fight negative emotions with positive ones. Ideally, they will match in magnitude (but as I said before, I know this is hard).
Watch a scary or funny movie, read a funny book, watch comedy shows. Listen to upbeat music (browse youtube, apple music or Spotify for happy or relaxing playlists)
Letting go/Pushing away – This one simply suggests acknowledge the difficult situation, recognize your distress, and then go do something else.
Think – Replace overwhelming thoughts with others.
Do a word puzzle, watch TV, read a book, breathe deeply and focus on your breathe, ground yourself by identifying 5 things with each sense, play an engaging game.
Sense – Intensify other sensations SAFELY
Hold an ice-cube, squeeze a stress ball, snap a rubber band on your wrist, listen to loud music, take a hot/cold shower. [See 32 alternatives to self-harm.]
Use the DIVE reflex to slow a fast heart rate by activating the parasympathetic nervous system. Submerge your face (around your eyes and cheekbones) in icy cold water for a few seconds while holding your breathe and bending over (quite literally as if you were diving).
Self-soothing refers to using the five senses to distract the mind and calm the body. It’s fairly simple in theory – 1) be present, 2) notice the sensations, and 3) allow yourself to be fully immersed in the sensory experience.
Visualize – Use imagery to soothe your mind. “Go to your happy place”. Some people are very visual and imagining peaceful scenes can help as well as looking through nice photographs or watching videos.
Look around your environment and intent observe your surroundings. Mindfully take notice of what is around you – pick an object to really focus on and describe to yourself in your head. Maybe if you’re a creative person you can try drawing or sketching too.
If your environment happens to be distressing you – try and safely move to a different location to ease some tension.
Listen – To calming sounds, nice music or even a podcast.
Go listen to David Attenborough narrating a documentary on Netflix!
Smell – Scented candles, perfumes, fresh air, a fragrance diffuser, a face mask, scented bath or shower gels, bake or cook.
Taste – Eat a sour/sweet candy or fruit. Brew some tea. Chew some gum.
Touch – Have a shower, pet an animal, snuggle in clean sheets, huge a soft pillow or stuffed toy, change into clean/comfortable clothes, get a massage (if possible) > you could even use a foam roller or stress ball on yourself. Stretch/do yoga, brush your hair, splash cold water on your face, get a hug.
Improve the Moment
Imagery – Imagine an alternative (preferred) outcome to your current situation. Have you been successful in urge surfing before? What happened?
Create meaning – Remind yourself of your reasons/the big picture.
Relax – Progressive muscle relaxation can help release physical tension.
Take things one step at a time – Remind yourself that the only pain you have to survive is in this moment.
Take a vacation from responsibility – Set a timer to allow yourself to sit down and do something different or do nothing at all (depending on your availability).
Encourage yourself – Note your negative self-talk, how would you speak to a child in the same situation? How would you speak to a friend? Try your best not to beat yourself up and to have patience and forgiveness. Remind yourself that unpleasant feelings won’t last forever, you have survived them before and you can survive them again.