When is the last time you were in such an awful situation, you felt like you were crawling out of your skin, it was so unbearable?
Psychotherapy Academy describes “when there is intense physical and/or emotional pain and that pain cannot be alleviated quickly or it cannot be alleviated without causing additional problems.” You may not be in this level of distress regularly, so know that Distress Tolerance skills are also useful anytime you are in something you can’t change. Too-long meetings (have definitely made me feel like I’m crawling out of my skin), stop-and-go traffic, and doing chores you hate can e managed using Distress Tolerance skills, as well as things that trigger a trauma response in you.
IMPROVE the Moment Distress Tolerance skills will help you hang in there when it feels like you might explode. These skills allow you to manage urges to do something you will regret, like hurting yourself or someone else. Tthey are also quite useful when you are stuck doing something you’d rather not be, so you can probably practice using these skills today- you don’t have to wait for something super challenging to occur.
First and foremost, make sure you are practicing mindfulness, because you need to be present enough in any given situation to recognize you can use a skill to manage your thoughts, feelings and choices.
When you are so aware of what is happening inside of you that you can notice urges to do something you will regret, you can bust out a skill or two and save yourself. What was once a vicious cycle of disappointment and guilt can be turned around by using skills.
Continuing our outline of Distress Tolerance skills, here are some ways you can IMPROVE any moment that you’d like to improve.
This is a list you can run through, so you have options when you are in the middle of something that sucks.
Imagery is the option to take your focus to a safe place, or to imagine the best possible outcome of what is happening.
Meaning is the option to find usefulness in what is happening- what might you learn? How can you grow? What is meaningful about what is happening?
Prayer is the option to allow something bigger than you to be in charge and have it all figured out. You aren’t the most almighty in the universe. It is quite possible that the way you think things should be isn’t actually the best way.
Relaxation is the option to unclench your jaw, drop your shoulders, and if you have time- take a hot bath, do some stretches or schedule a massage.
One thing at a time is the option to only focus on the next thing in front of you. Not the whole huge challenge. ONLY: what do I need to do next?
Vacation is the option to take a break: shake it off (literally- shake your hands and jump up and down). Splash some water on your face. Walk around the block.
Encouragement is the option to speak kindly to yourself. Be a cheerleader for you. Remind yourself that you have the skills to do this!
To really make a dent in the distress you have to tolerate day-to-day, reading through an outline of a few DBT skills once a week probably isn’t enough. Beyond learning the skills outlined here and reviewing them, it can be really helpful to join a Skills Group, practice with a *DBT workbook, or discuss the skills you are learning with someone else so that they are front-of-mind enough to remember them when you need them.
*There are many great DBT workbooks: some general, focusing on the skills, others more specific to using DBT for shame, bipolar disorder, PTSD, bulimia, etc. Because there are many workbooks to choose from, I did not link to any in particular. A search for DBT Workbooks will bring up several. No matter which book you choose, the skills are the same, so you will be able to translate using DBT skills to any situation.
**Special thanks to Susan Mengden, PhD, Founder and Executive Director of Esperanza for Eating Disorders in San Antonio for the DBT Flow above and for her dedication to healing and recovery in Texas using DBT.
This is the first week we are switching to bi-weekly posts. You won’t hear from me next week, so I recommend Anita Bhagwandas’ post Do you get the summer body scaries? Bookmark it for next Thursday, or keep reading now, along with previous posts from BAP !