Overview
What are the two types of distress tolerance skills?
A) Crisis Denial & Reality Acceptance
B) Crisis Survival & Reality Acceptance
C) Solution Focused & Motivation
D) Crisis Survival & Reality Distortion.
B) Crisis Survival & Reality Acceptance
What is a crisis?
A crisis is:
- A short-term situation
- Makes you really upset or stressed out
- You want the situation resolved ASAP
- You can't resolve the situation immediately
Name one Reality Acceptance Skill (5)
1) Radical acceptance
2) Turning the mind
3) Willingness
4) Half-smiling
5) Willing hands
BONUS: Explain how to use one of these skills.
How do you use the TIPP skill?
- TIP the temperature (ice, face in cool water/dive reflex)
- Progressive muscle relaxation (squeezing muscles, hold the tension for a few seconds, relax and focus on that sensation)
- Intense exercise (burpees, sprinting, pushing the wall)
- Paced Breathing (box breathing, Jay's tracing finger breathing)
True or False. Distress tolerance is about solving problems
False!
How do we use Mindfulness in Distress Tolerance?
What kind of problem do crisis survival skills help with?
Any problem that causes emotional pain and can't be solved right away.
Which statement about Radical Acceptance is false?
A) Change is possible
B) Accepting what others say or do doesn't mean we have to love or have compassion from them
C) We have to agree with the situation or the other person
C
Name the 7 types of distractions from Distract with Wise Mind ACCEPTS
1) Activities (Do something)
2) Contributing (Do something nice for someone)
3) Comparisons
4) Emotions (Create different emotions)
5) Pushing Away (Push the painful situation out of your mind temporarily)
6) Thoughts (Replace your thoughts)
7) Sensations (Intensify other senses)
List 3 ways to use relaxation skill from IMPROVE skill
- Progressive muscle relaxation
- Body scan
- Deep breathing
- Meditation
- Guided imagery
Why is pushing away emotions not a good long term goal?
We either need to accept or problem solve
Name 1 crisis survival skill
Distract with Wise Mind ACCEPTS
Self-Soothe with the 6 Senses
Improve the Moment
Pros and cons
TIPP
BONUS: Explain how to use one of these skills.
When does pain become suffering?
Pain + Non-Acceptance = Suffering
Suffering happens when:
1) You can't accept or refuse to accept pain
2) You focus on getting what you want rather than what you already have
3) You reject reality as it is in the moment
Name 3 ways you can self-soothe using a sense and explain how it helps you.
- Smell
- Taste
- Touch
- Sound
- Vision
- Movement
How does physical activity help us tolerate distress?
Physical activity expels our body's energy and helps us feel better and more regulated.
Why should we bother tolerating painful feeling and urges? (3)
- Life is not pain free -> everyone has to deal with pain in life
- Always trying to avoid pain might lead to more problem than it solves
- Avoiding pain may lead you to act impulsively (and you may end up hurting yourself, others, or not getting what you want)
How do Crisis Survival skills help us?
Helps us cope with big emotions or intolerable situations (the crisis) without making it worse (acting on an urge or impulse).
Why should we bother accepting reality? (5)
1) Rejecting or denying reality doesn't change it
2) Changing reality require first accepting reality
3) Pain cannot be avoided
4) Rejecting reality turns pain into suffering
5) Accepting reality can bring freedom
Dive reflex
What is the difference between Willingness and Wilfulness?
Willfulness is:
- Refusing to tolerate a situation or giving up.
- Trying to change a situation that cannot be changed, or refusing to change something that must be changed
- Not doing what works
Willingness is:
- allowing the world to be what it is and participating in it fully
- Doing just what is needed—no more, no less (being effective)
- Listening carefully to your Wise Mind and deciding what to do
- When willfulness doesn’t budge, ask: “What is the threat?”
BONUS: Give an example of willingness and wilfulness.
What are the 5 ways we can respond to a problem?
1) Solve the problem
2) Change how you feel about the problem
3) Accept it
4) Stay miserable
5) Make it worse
How long does it take for an urge to peak in intensity and start to subside? Hint: Impulsivity management
15 minutes
What gets in the way of Radical Acceptance?
- Believing that accepting reality minimizes it or approves it.
- Strong emotions (feeling that accepting reality will lead to experiencing unbearable, overwhelming emotions)
- Lack of skills for Acceptance
- Willfulness
What does it mean to "turn your mind" in DBT
What number on the emotional thermometer represents the "skills breakdown point"
SUDS= 7
This is when we need to use distress tolerance skills to bring emotion down to a more manageable level because the risk of being impulsive is HIGH