Understanding Distress Tolerance in Therapy

Distress tolerance is a term used in Dialectal Behavioral Therapy.  Dialectal Behavioral Therapy is an effective treatment technique for a variety of issues such as depression, anxiety, trauma symptoms, and eating disorders. Distress tolerance skills are used to help people cope during intense stress and/or crisis. When a person is in a situation or circumstance which is difficult or impossible to change, these skills help to manage negative emotions rather than trying to escape from them.  They help individuals tolerate short term and long-term pain (both physical and emotional) as well.  

The Challenge of the Holidays

The holidays often cause extremely stressful situations.  Whether it’s loneliness or enduring difficult family dynamics or financial pressures, the holidays are not a time of joy for many people. Tolerating distress looks a little bit different for each individual, but I’d like to give you a brief way of enacting some distress tolerance skills.  

Mindfulness Techniques for Distress

Many people utilize mindfulness, which includes mindfulness of breath and mindful awareness of situations and yourself. The way mindfulness of breath works is you simply focus on the way the air feels coming in through your nose and exhaling out through your mouth. How does the temperature feel, is it quick or slow, etc.  Mindful awareness of situations and ourselves is really having a direct knowing of what is going on inside of us and around us at all times. For many of us, this takes a bit of training to master. 

The Power of Radical Acceptance

Another aspect of distress tolerance is radical acceptance.  In this context, acceptance means to be willing to experience a situation as it is, rather than how we desire or want it to be.  Many times, we as human beings get caught up in judging or evaluating our feelings, emotions, and responses. In the judgment and evaluation of those feelings, and emotions, and responses we do ourselves a disservice. If we can just radically accept our feelings, emotions, and responses and allow them to exist it makes it easier for them to dissipate.  

Navigating Life Changes with Distress Tolerance

Life changes such as a divorce can be particularly challenging, especially during the holiday season. This is often a time when you're faced with the reality of shared parenting responsibilities and the need to establish new traditions. Employing distress tolerance skills in such scenarios enables you to accept and acknowledge your feelings and reactions without labeling them as good or bad, right or wrong. Recognizing these emotions as natural responses allows for a healthier coping mechanism.

Self-Soothing Through the Five Senses

The final skill I would like to describe is using some self-soothing with your five senses.  The way it works is that by focusing on your five senses it shifts the focus off the stressful events and onto something completely different. In trauma work, we refer to this type of exercise as a grounding exercise. 

Vision

• Focus on what you can see with your eyes. Maybe take a walk in a pretty part of town. Look at a detailed picture and focus on the colors and the images and the details of the picture. 

Hearing

• Go outside and listen to the leaves, listen to cars, listen to some soothing music, or listen to the sounds of the ocean or other nature sounds. 

Smell

• I’m a big fan of intentionally smelling your favorite safe smells. Something that reminds you of a favorite memory or a positive place or experience. Maybe it’s campfires, lemons, sugar cookies, or chocolate. It’s going to be personal for you. 

Touch

• Pet your dog or cat. Feel some silky fabric. Take a nice warm bath. Cuddle up with your favorite blanket. 

Conclusion and Professional Support

The purpose in each and every one of these skills is to distract yourself from the emotional pain, physical pain, or temporary crises that you are experiencing. These skills also give you something positive to focus on. If you find yourself experiencing an increase in stress this holiday season, reach out to a trained professional.  

For help with any mental health issue, contact The Mental Wellness Center at 309-807-5077 or e-mail info@TheMentalWellnessCenter.com. We are invested in empowering you to return to — or achieve, possibly for the first time ever — a state of complete mental wellness.