Distress Tolerance
These are the two main categories of distress tolerance skills.
Crisis Survival and Reality Acceptance
These are situations in which you need crisis survival skills.
1. When you're about to be overwhelmed with emotion
2. You're about to do something harmful or destructive.
You are waiting for an acceptance letter to college and it is causing you to be stressed, anxious. You decide to volunteer to give yourself something to do. Name the skill you are using and describe the other parts of this skill.
Activities- reading, dancing, work out, etc.
Contributing- volunteer, help someone
Comparisons- put your situation in perspective
Emotions- watch a comedy, listen to upbeat music
Push away-put the problem on a shelf/in a box for now
Thoughts- distract with puzzle, something challenging
Sensations- use five senses
You are practicing the skill of ______________ when you fully embrace a situation with your mind and heart.
radical acceptance
Paced breathing
A TIPP Skill
To calm your nervous system and slow down emotions and mind
This is a serious problem causing intense emotional distress, generally short term, often not immediately solvable
A crisis.
You are in an argument with your parent and feel completely out of control. You decide to splash your face with cold water. Name the skill you are using.
***Temperature-hold ice, splash face, frozen washcloth, ice packs or frozen veggies
Intense exercise-sprint back and forth, jumping jacks
Paced breathing-try square breathing, 4 s in, hold 4 s, 4 s out, hold 4 s
Paired muscle relaxation
You are completely overwhelmed with a longer term project you are completing. You decide to take a mini-vacation and go out to the movies and ice cream with a friend before restarting your work. Which skill are you using? Describe other parts of this skill and when you might use it.
IMPROVE the moment
Imagery-picture beautiful or safe place
Meaning-"What doesn't kill you makes you stronger," what will you get out of surviving this
Prayer-connect to religious or spiritual traditions
Relaxation- walk, yoga, exercise, progressive muscle relaxation
One thing in the moment- focus on surviving this moment, not past or future troubles
Vacation- step away for a bit to do something fun
Encouragement- "you got this!" "you can do it!"
True or false: Radical acceptance means you approve or agree with a situation.
False!
Coping Ahead
Help you plan ahead of a crisis or a difficult moment do you know how you will cope
True or false: If the distress tolerance skill is not making you feel better, it's not working.
False! While they may help you feel better, the true purpose is to be able to endure the situation without making it even worse
You are furious and about to yell at someone but then you take a pause. Which skill are you using? Describe it and name a specific situation in which you might use it.
S-top!
T-ake a step back
O-bserve
P-roceed mindfully
You find out about a problem while you are on a plane and are certain you cannot address it right away. You decide to "put it on a shelf" in your mind for the duration of the flight and return to it later. Name the skill you are using.
Activities- reading, dancing, work out, etc.
Contributing- volunteer, help someone
Comparisons- put your situation in perspective
Emotions- watch a comedy, listen to upbeat music
Push away***-put the problem on a shelf/in a box for now
Thoughts- distract with puzzle, something challenging
Sensations- use five senses
You feel angry at your sibling and decide to think about this while sitting with your face relaxed with corners of your mouth slightly turned up as well as palms relaxed and facing upwards. Name the skill you are using and the rationale for using it.
Willing hands
Half smile
Sends signals to deep structures in brain to change emotions, decrease fear and anger.
Progressive muscle relaxation
A TIPP Skill
Relax tension and bring mindful awareness to the body and emotions
These are different distress tolerance skills.
STOP, TIPS, ACCEPTS, Self Soothe, IMPROVE the moment, radical acceptance, turning the mind, willingness, willing hands, etc.
You are about to act on an urge to do something destructive, but instead you decide to make a list of positive and negative consequences of tolerating the distress as opposed to acting. Which skill are you using?
Pros and Cons
You are taking a test and are extremely nervous. You say to yourself in your head, "You got this!!" Name the skill you are using.
IMPROVE the moment
Imagery-picture beautiful or safe place
Meaning-"What doesn't kill you makes you stronger," what will you get out of surviving this
Prayer-connect to religious or spiritual traditions
Relaxation- walk, yoga, exercise, progressive muscle relaxation
One thing in the moment- focus on surviving this moment, not past or future troubles
Vacation- step away for a bit to do something fun
****Encouragement- "you got this!" "you can do it!"
What is the term to describe when we are refusing to tolerate a situation or give up, trying to change a situation that cannot be changed, or refusing to change something that must be changed.
What is Willfulness
Body scan
A mindfulness technique
Similar to progressive muscle relaxation without the tensing and relaxing
These are situations in which distress tolerance skills are NOT helpful.
When they lead to avoidance of all problems
When they impair your functioning at school or work
You feel anxious and decide to put on a nice smelling land lotion. Which skill are you using? Describe other types of activities you might do with this skill.
Self soothing with...
Sight- count things, look at favorite photos
Hearing- listen to music, sounds of nature
Touch- warm blanket
Taste- something delicious
Smell- lotion, flower
Movement- move through space
You are in school and found out that someone you thought was a good friend is talking about you behind your back. As you feel the panic and rage rising, you decide to breathe in a specific pattern--inhale for 4 seconds, hold for 4s, exhale for 4 s, hold for 4s, repeat. Name the skill you are using.
Temperature-hold ice, splash face, cold AC
Intense exercise-sprint back and forth, jumping jacks
**Paced breathing-"square breathing"
Progressive muscle relaxation
You make a conscious decision to accept something difficult but true over and over in your mind. Name the skill you are using.
Turning the mind
Imagery
IMPROVE the Moment skill
Create a soothing image in your mind where you are calm, relaxed and grounded, to induce relaxation and a sense of safety.