A DBT skill for Distress Tolerance. Use this skill to help you get through and reframe difficult situations.
The point of this skill is not to distract yourself from difficult situations, but to help lower the intensity and make it more manageable, improve the moment and keep going.
Imagery: Imagine your “happy place”, whatever and wherever that is for you. Picture in your mind a calming scene, a real or fictional place, where you feel safe, protected and coping well.
Meaning: Take a moment to think about what you’re learning from the difficult situation. Reframing the struggle as a challenge to grow through will help you push through the pain or discomfort.
Prayer: Look to higher powers for patience, wisdom or grace. This doesn’t have to be a religious exercise, looking to the cosmos and nature can be just as soothing as gods or deities. Connect with something bigger than yourself.
Relaxation: With the goal of reducing mental or physical pain, take some time for a guided meditation, box breathing, stretching, a shower or bath to calm the mind and body.
One Thing at a Time: To reduce stress, dedicate a set amount of time to focus on one thing only. You can wash dishes, go for a walk, stretch, meditate, or commit to one task on your to-do list.
Vacation: Take a short mental and physical break, but make sure it’s time-limited. Watch a movie or show, read a book, take a nap. The goal is to calm your mind and come back with a clearer perspective.
Encouragement: Be your own cheerleader. Boost your resolve and validate your feelings by repeating affirmations, mantras, or simple statements like “this won’t last forever” or “I’ve got this”.
I’ve had this workbook for a while but my therapist mentioned it today so I’ve been giving it some more thought.
The first section is about everyday wellness.
It starts with selfcare. Sometimes he’s hard for me to fully conceptualize what that is because the name seems redundant to me. But generally we all know we have to do things that make us feel good and healthy. It’s like taking preventative measures. It’s meeting our needs.
Physical needs (meds, sleep, nourishment, water, moving our bodies, and taking breaks), emotional needs (therapy, boundaries, getting affection, special interests), social (friends, date nights, alone time, social media curation, boundaries), and sensory (breaks, comfy clothes, limiting time in busy spaces, being a good temperature, and stimming).
In terms of my needs…
Physical- coffee, hot showers with all my hair stuff and lotions afterwards, washing my face and brushing my teeth make me feel so good
Emotional- no pressure and fewer time constraints (which I guess falls under boundaries), writing, and talking about my feelings
Social- reaching out to stay connected and asking for help with stuff when I need it (I moved away from most of my friends and family, so this one’s tricky)
I need help when: there are more than one or two major things going on or when I can’t focus long enough or well enough to do what comes next
I will ask for help by: explaining that I’m my limit, stating it all as fact, and doing it before I go beyond the point of return
It goes through making a safe space and making a sort of kit for when things go haywire.
Then some affirmations. “I do not have to hold myself to neurotypical standards rules and expectations.” “My brain works the way it was designed to. and I deserve to support my brain.”
This is a DBT skill that is useful for resisting urges.
Reframe the situation
When we feel overwhelming emotions, it's easy to start thinking things like "this is terrible and nothing will ever get better" especially with a lot of us dealing with a lack of emotional permanence. Reframing the situation means changing your perspective. While things may feel overwhelming and it's easy to get stuck in that, changing our thought to "Things are really hard right now. But I've experienced things being really hard before and I've survived. I will survive this too."
Engage in a distracting activity
The next part in the RESISTT technique is engage in a distracting activity. Pick an activity that you enjoy or find distracting. I find it helpful to create a list of distracting things I can do when I'm calm that I can pull out in times of need. This might include things like watching a show, playing a game, reading a book, etc.
Someone else
Focus on someone else. Maybe you can be there for a friend, or plan a surprise for someone. Focusing our attention on someone else can work as a distraction. You could even focus on your pet if you have one. Taking your dog for a walk, or a game of fetch might make them really happy and distract you.
Intense sensations
Intense sensations can work really well as a distraction. This might include holding an ice cube, having a cool shower, or have a hot drink or hot shower. Please be sure to do these things safely.
Shut it out
We're often told that "shutting it out" is a bad thing to do, and that can be really true. But sometimes we don't have much of a choice. If we're experiencing our crisis while we're out shopping. The goal of this is to get to a quiet place to sit down and think about the situation. Is it a problem you can solve right now? If the answer is "no", then try and visualize yourself physically putting your problem into a box and sealing it. Putting it aside for the time being until you
Neutral Thoughts
This involves thinking about things that don't add to your stress. Counting in your head, reciting song lyrics in your head or things like that can be helpful. Maybe there's an activity you can even do in your head.
Take a break
How taking a break looks will be unique to you. Maybe this means putting aside some of your "to do" list for the next day. Maybe it means taking a mental health day if that's available to you. There is no shame in needing to rest and take a break.
The FAST skill is useful for working to communicate in a way that preserves relationships while also maintaining one’s own self-respect.
be Fair - Validate your own emotions as well as the person you are communicating with.
Listen to others’ needs but also do not avoid voicing your own needs. Another person’s wants and needs are important. So are yours. Try to keep both people in mind, and try to be open to compromise, but do not allow your desires to be ignored. Compromise may allow both of you to get what you need.
don’t Apologize unnecessarily - Many people over-apologize, or apologize when they haven’t actually done anything wrong. They may apologize for having an opinion or for disagreeing, or to calm conflict or soothe anger.
This can lead to undermining one’s own self-respect, and may also make you seem insincere when you have good reason to apologize, and you are really sorry. If you apologize for everything, it may be hard to tell when you actually mean it.
Stick to your values - Don’t do things that go against what you are sure is right for you. Don’t go along with things just to impress a new friend or please a new partner, if they are against your values.
If they push you to give up your values, maybe that relationship isn’t right for you.
be Truthful - Don’t tell lies. Don’t stretch the truth, or exaggerate, or make up excuses.
Making a habit of being untruthful often has a way of coming back to bite you, and of harming relationships. It’s better to avoid it completely.
Disclaimer: This advice is meant to be used for relationships that you want or need to preserve. It is also not meant to be used in a situation that you feel may be unsafe.
This breathing exercise is great for de-stressing and grounding yourself for meditation.
To start, get into a comfortable seated position, straighten your spine, keep your hands relaxed by your sides or on your lap, and legs relaxed with your feet on the ground.
Inhale deeply, counting 4 beats.
Continue by holding that breath and counting another 4 beats.
Exhale slowly for another 4 beats.
Hold for another 4 beats.
Repeat 3 or 4 times.
*For help pacing, you can use a 60 bpm metronome, which can be found on any music streaming platform or Youtube.
This post will talk about the Pros/Cons skill. This is a distress tolerance skill. This skill is useful to help you to resist the urge to be
Here is a blog post I've written about the DBT Skill Pros & Cons.
This is a really useful skill to help realize why it's important to resist certain urges, and can also be useful in choosing between two actions in response to a situation.
I've also included a printable PDF worksheet in the blog post!
Here's a tip: If you are aware of an urge you frequently get, it might be helpful to make a pros & cons list when you don't have the urge that you can look at when the urge does arise!
(This article links to my website which has no pop ups and you don’t need to sign up for to read posts. It’s as simple and safe as possible! Please consider hearting the article on the webpage?)
All of this is written out in a blog post that you can find here.
I'm also going to paste the blog post beneath the read more for those who can't read the images and don't want to click the link. (The link does have a worksheet I made to go with it!)
This post will talk about the Pros/Cons skill. This is a distress tolerance skill.
This skill is useful to help you to resist the urge to behave in a way you are trying to avoid. When you are in a situation where you feel such an urge, describe the behaviour you are trying to avoid.
Consider the positive consequences (pros) or negative consequences (cons) of giving into the urge for that behaviour. Think about the results of that behaviour from past times acting on those urges and any consequences of them, and consider whether those would be pros or cons of doing it again.
Example:
I am feeling the urge to self isolate.
Pros:
No one else will be exposed to my mood.
No one will be able to distract me.
People may worry about me which will affirm that I am cared about.
Cons:
In the past, it has made me feel worse and made my negative mood last longer.
It may put strain or tension on my relationships.
It may make people worry about me and it makes me feel guilty when people worry about me.
It may make it harder for me to meet my needs, such as hydration, food, etc.
(Please note that it is valid to need space as a form of coping in a lot of situations, but there is a difference between needing to be alone and actually self isolating and the latter is why I’ve used it as an example of a behaviour to avoid.)
This skill can also be used to decide between two or more actions. It might seem obvious which is the right choice outside of the moment, but in moments of intense emotions, our thoughts can be clouded and it can be difficult to use reason to choose the best course of action.
Example:
I am feeling frustrated because my partner said something that upset me. It wasn’t his intention to upset me, but I am angry.
I could either: Yell at him and make him understand how wrong he was.
Pros:
I get to vent how I feel.
It will feel satisfying in the moment.
In the end, I end up crying and having a breakdown which ultimately helps release a bunch of emotions leading me to feeling lighter.
Cons.
It will be hurtful and potentially scary to my partner.
I will punish myself afterwards with guilt.
There may be tension between us and/or it may damage our relationship.
I may not explain the problem in a way that my partner can understand, which may lead them to upset me in the same way in the future, or to change their behaviour in a way I don’t want them to do.
Or I could: Use my Coping Skills.
Pros:
I get to feel proud of myself for using my coping skills.
It will likely lead to me communicating with him in a healthy manner afterwards about what upset me, and potentially strengthen our relationship.
Will help calm my body and mind which is better for my physical well-being.
Will help build and reinforce positive thinking patterns.
Cons:
It is draining sometimes to use coping skills.
Sometimes it feels good to get a reaction out of my partner in the moment.
Weighing pros and cons can be helpful for making any decision between two or more options, but it can be particularly useful to help avoid negative behaviours which we have found hard to resist in the past. It may help to consider a potential future situation or an urge we know we experience sometimes, before it happens. We might even write a list of pros and cons for that possible future decision or urge. If we can remember the list we made, or even read a written list at the time when we have the urge for a behaviour we want to avoid, it may help us resist that urge.
The goal of this skill is to help us to realize that the positive consequences of not giving into our urges will outweigh the discomfort we may feel when we work at resisting those urges.
