DBT Distress Tolerance Skills

Photo Credit: Sarah Cardwell

I am a bit overwhelmed with my own emotions right now.  I have been caught up and in my own internal drama as I work hard to not let it consume me.  Yes, I am working VERY HARD to use my DBT (Dialectical Behavior Therapy) skills to help me through this rough patch.  I am working hard to learn from my past mistakes and overreactions…my tendency to go into black-or-white catastrophic thinking and to fall into a role of feeling/being victimized.

I have been having a lot of anxiety (which affects my appetite and sleep, which causes more anxiety), so I have given in to taking a couple of additional tablets of Ativan.  It is prescribed to me as 0.5 mg at bedtime, but the label says “May take an additional 1-2 tablets on occasion for extreme anxiety.” I almost never utilize it, but I would categorize my current state as being in extreme anxiety, and I want to feel better, so I have gone ahead and taken it.

Before doing so, and in the meantime, I have been practicing my skills today. It hasn’t been easy. At all.  But now I fully understand why our doctors and therapists recommend practicing the skills when we are doing well and feeling stable. It really does seem to help them to be more effective when used in “crisis mode.”

Today I really felt like I needed to focus on skills that would help me take control of my mind, so to speak.

I  used some Distress Tolerance skills, particularly Distracting (during which you do the best you can to allow your Wise Mind to ACCEPT the current situation while you distract yourself.)  According to Dr. Marsha Linehan, the word’s respected leader on Borderline Personality Disorder research and treatment, Distress Tolerance skills such as Distracting can be used “for tolerating painful events and emotions when you cannot make things better right away” (Linehan, 1993, Skills Training Manual, 165).

ACCEPTS breaks down to:

Activities (I cleaned the house. Every single room. I also did the laundry.)
Contributing (I consider getting online and posting this as contributing to others out there.)
Comparisons (I compared my current situation to what could be worse and realized I am blessed.)
Emotions (I haven’t done this yet. It is when you do things like watch movies or listen to music that evokes the type of emotion you WANT to feel in the moment. I will watch something funny tonight in hopes of feeling the emotion of happiness or joy.)
Pushing Away (As my head started filling with TONS of negative thoughts, I literally stopped in my tracks and repeated the word “NO!” as I envisioned putting the emotions away in a box while I cleaned the house. Funny, but it helped.)
Thoughts (This is where you focus your thoughts on anything. Counting to 10, counting colors in a painting, watching a tv program.  I decided to listen to some talk radio to hear what other people who aren’t in crisis are thinking about.)
Sensations (Recently, in DBT class, we practiced holding ice in one hand. The other day, while at the ocean (the Pacific Ocean is VERY COLD), I went in up to my ankles/shins to experience the same thing – a distraction caused by a sudden, intense, non-harmful change of sensation. I haven’t practiced this skill today, but I may do the ice cube later.)

I am going to focus on some of the Taking Hold of Your Mind skills that we learned in DBT this past week. These include Observing, Describing, and Participating, as well as being Non-Judgmental, One-Mindful, and Effective.  I hope to share more with you about this soon.

I have an appointment in the morning with my therapist and may be going back into the intensive outpatient (IOP) program again for a little longer.

Thanks for reading. I really hope this helps you on your journey.

More soon.

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