Distress Tolerance

May 25, 2018 in Stress and Coping
by Valerie Siegman, M.A.

Sometimes, we get overwhelmed. Because life is difficult. Life is at times painful. Life holds a series of problems that need to be solved. These problems can sometimes be painful and create distress. When we are able to cope successfully, we feel better about ourselves and the situation. But sometimes poor coping - our tendency to avoid the problems, demand things be different, take desperate actions or sit on our hands when action needs to be taken - actually creates more distress and more problems.

Marsha Linehan, PhD, the developer of Dialectical Behavior Therapy, developed the concept of “Distress Tolerance” as both a mindset and a set of eight skills to help us survive immediate crises without making things worse. As the title implies, the mindset suggests that you can tolerate and survive challenges and setbacks. The ultimate goal is that you can eventually choose to either solve the problem or accept what cannot be changed. Either way, you are not acting on your impulses and you are not creating more distress.

The skills are meant to be used during that initial crisis period, when you might react foolishly or in the heat of the moment. Dr. Linehan refers to this state of mind as your “emotion mind,” whereas a more considered response, when you’ve had a chance to blend reason with your feelings comes from “wise mind.” Good use of distress tolerance skills allows the best immediate reaction to a problem until you can allow your “wise mind”to weigh in. Of the eight Distress Tolerance skills, the first four help us to actively cope with stressors while the other four give us permission and guidance for accepting those facts which cannot be changed or altered.

To cope with a stressor in the moment, for example, without making things worse, go ahead and use the skill: Distract. You can distract temporarily by watching a movie, listening to music, reading a book or going for a walk. By reducing your contact with the stimulus for an hour or two, you allow yourself time to ride through your “emotion mind.” Once you are in a more “wise minded”state, you can then begin to problem-solve or accept, as needed. The key to successful use of the Distract skill is doing it purposefully - and only temporarily.Those who over rely on the use of Distraction create other problems as they continue to avoid the problem and don’t come back to coping in a more effective way.

To accept those facts in our lives which must be accepted, Dialectical Behavior Therapy teaches Radical Acceptance Skills. The term radical helps us to understand that true acceptance has to be experienced fully with both our hearts and our minds. The first step in acceptance is acknowledging your choice to accept or not. If you make the choice to accept, the skill to help you stay effective is: Turning the Mind (towards acceptance). Turning the mind is opposite to capitulating. Capitulating is throwing up your hands and choosing to believe you have no other options but to stay on the current path. Turning the Mind helps you to simply acknowledge the possibility of a third option existing, even if it doesn’t seem clear to you now. Turning the Mind must be done over and over again in the moment of distress to keep you effective and to help you tolerate those stressors in life that we all must endure and which can be endured skillfully. The key to acceptance is to be certain you’re accepting just the unalterable facts; not beliefs, judgments or feelings about your worth or the future.

This is just a taste of this amazing and effective approach to tolerating distress. If you would like to learn effective skills for managing stressors through Dialectical Behavior Therapy, please contact our office. We’re planning to start a skills learning group in the Spring of 2018,so please let us know if you’re interested in getting more information.

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