Updated February 2022
A definition and overview of DBT’s Distress Tolerance can be found here.
So, the basic foundation of DBT is to think about the idea that pain and suffering are part of life and can’t be avoided or removed. And learning to detach from the situation and not add more pain by judging yourself and others for what is.
So, learning DBT skills gives you alternative to engaging in self-destructive behaviors, such as cutting, scratching and patterns of negativity that hurt yourself.
Mindfulness, Radical Acceptance, Wise Mind, STOP, TIP are other skills I talked about before on the blog.
Let’s add Distraction to help move yourself towards healing your wounds rather than hurting yourself more, move towards positive behavioral alternatives to self-harm and self-deprecation.
The goal is not to be perfect, nor to ignore your feelings, but to live a more skillful life. Most people can benefit from methodically learned emotional skills!
Distract Yourself from Negative Behaviors, Thoughts, Feelings that Hurt
The DBT skills are all about accepting yourself, others and situations as they are.
But the thing about learning to tolerate distress is that you use the skills so that you can help yourself move forward, don’t feel stuck in terrible psychic pain and don’t do something impulsive to make things worse.
What does non-judgmental acceptance of a situation do for you in your life? It helps you live a realistic life where there is still normal pain (as pain is part of life) but not that awful feeling of overwhelm and being stuck. Linehan (2015) illustrates as such:
Pain + Non-Acceptance = LOTSA suffering and STUCKNESS
Pain + Acceptance = Normal pain (still intense) but
Moving Forward is possible
ACCEPTS is a working mnemonic to help Distract yourself from negative thoughts, actions, feelings
A Activities. Engaging in a different activity can change your physiology, your thoughts, your feelings.
Alternative and pleasurable activities to what is happening in the moment to cause you pain are good choices.
-Create a list of pleasurable activities to do for distraction:
-Take a bath, swim, hike, walk the dog, read, yoga, tai chi, exercise
-Garden, paint, draw, bake, cook, design a weekly/monthly menu
-(Many other choices for you here in developing meaningful hobbies)
And some other alternative suggestions to push away negative thoughts:
from McKay, Wood & Brantley (2007):
-Hold an ice cube in one hand and squeeze it, numbing and distracting
-Cry instead of holding it in, this release stress hormones
-Do household chores, wash dishes, sort clothes, donate them to church, organize a closet
-Write on yourself in red marker instead of cutting, then draw stitches in black for healing
-Talk to someone else, even if they are not there (a picture could work)
-Draw faces of people you’re mad at on ballots and pop the balloons
-Create an online blog and commit to writing in your blog every other day
C Contributing. Take the focus off yourself. Do something for someone else, such as do a chore for someone who could use a hand, join a local soup kitchen, join a political action group. Go to a supermarket, a shopping mall or a park and take a look around at the other people, just to focus on others, and not yourself.
C Comparison. Make comparisons with other people to get the focus off of yourself, but not to put yourself or others down. But to see how others are coping, what ttys do that works, that might work for you and how you are not alone in your situation. Others are coping with tough situations as well.
E Emotions. Generate a different emotion from the one in which you are currently mired. First, identify how you actually feel (sad, hurt, angry, ashamed, etc). Then, do something that will create a different emotional response. It would need to be an action, like watching a funny movie, looking at artwork online or in a book that is inspiring, exercising to move the emotions through.
Plan your garden, go to a garden center to browse the plants. Cut images from a magazine and create a collage of inspiring images.
P Pushing Away. Sometimes leaving is the best thing you can do. If you re in a painful situation with someone and you recognize your emotions are getting overwhelming, the perfect de-escalation skill might be to leave the situation. If you are feeling more and more frustrated, and the stress hormones are circulating, it’s ogling to be hard to calm down. So, temporarily removing yourself form the situation might be a good move. Just as escalating an argument with your partner until it is destructive is not good for the relationship, and sometimes it’s best to take a break and was way and come to things later.
T Thoughts. Distracting with other thoughts will fill up your current working memory, pushing out new negative thoughts being created by the negative emotions that might swirling about. Distraction thoughts are counting, singing a song, remembering a pleasant event in detail, recalling your forty cartoon character in detail, recite a favorite prayer or poem over and over like a mantra.
S Sensations. Different sensations can distract your mind from a repetitive negative cycle. Holding an ice cube, as mentioned before, can help distract from strong emotions. Marsha Linehan (2015) reports that she has used the technique of having her clients hold an ice pack in order to help them talk about past abuse, in order to process the memories. So that’s one technique.
Create a Comfort Kit. And you can break that cycle with other sensations with input from your five senses. Emotional and physical material is intimately connected, our minds and bodies are one and mindbody therapies are a way to relax and soothe yourself in the moment and create healthy, positive habits over time. Creating your own Comfort Kit with items pleasing to your five senses as a way to develop self soothing skills that are another positive step in creating a long-term emotional management plan. Smooth stones to touch, a small scented candle for scent, fun or soothing music to change your mood, beautiful pictures of loved ones or a place in nature. These can all be in your Comfort Kit.
Self Soothing MindBody Skills is the next post DBT skill!
Reminder! Be you! Appreciate YOU! Learning a skill takes time !
The steps to learning such skills are:
-learn them in a group or with a private therapist,
-practice the skill as homework and and
-then slowly integrate the skills into use in real-life situations
-which means being able to use them when under stress
-be kind to yourself
-remember to come to a place where you can tolerate and survive a crisis while accepting in a non-judgmental way, oneself and one’s situation
Useful DBT Skills Training articles: