Episode 31 – Distress Tolerance (Pt. 1)

This week in my DBT skills group, we started the distress tolerance module. We discussed two skills in handling a crisis situation. These methods are not designed for everyday use or for all problems, but are instead more for handling an emergency event – such as a sudden turn of bad events, an emotional reaction brought on by bad news, etc.. These typically involve using a sort of mindfulness skill to bring yourself back to a calmer state.

One is called the STOP skill. This acronym stands for Stop, Take a step back, Observe, and Proceed mindfully.

1. Essentially, the first step is to simply stop, freeze, and refrain from reacting or taking action. Stay in control!
2. Take a step back is also somewhat self-explanatory, as you just take a step back from the situation, take a break to breathe, and keep from letting your emotions make you act impulsively.
3. To observe, you make an active effort to notice what’s going on inside and outside you. Note the situation, your thoughts and feelings, what others are saying or doing.
4. Then, you proceed mindfully by acting with awareness. You consider all of the things you observed and your goals. Your goal is to ask wise mind what actions will make it better or worse.

The STOP skill can be useful in shutting down arguments before they start, in preventing yourself from acting impulsively on the urge to do something less than positive (reaching out to someone who’s not good for you, for example), and in other things.

The second one we discussed this week was the pros and cons list. This is useful for crisis urges, where you can weigh in pros and cons of both acting on the urge or resisting the urge. You can write out your pros and cons to carry with you, and then in the case the crisis urge hits you, you can pull out the list and remember it. Your goal is to imagine positive consequences of resisting the urge, think of negative consequences of giving in to the urge, and remember past consequences when you have previously given in to the urge. You can divide it into four different sections:

1. The first is pros of acting on crisis urges. Basic pros of this section would be that it’s easy, simple, comfortable, and familiar.
2. Next is cons of acting on crisis urges. Some typical ones of this are that it can lead to bad situations, can ruin relationships, solves nothing, and gets you nowhere.
3. Now you weigh pros of resisting crisis urges. First, this one is a big flex – to avoid doing what’s familiar and easy to you because it’s best to avoid it is an impressive demonstration of willpower and strength. It tends to be better in the long run and maintains your health and safety, and will gradually increase things like self-esteem and self-image.
4. Then there are the cons of resisting crisis urges. It takes effort and skill to resist this urge, and it can be uncomfortable or even painful.

Over the next few weeks we’ll be going over other methods of distress tolerance before we move on to the next module. I’m glad to be sharing this experience with anyone else who reads this, and I hope it helps even one person to read about these methods and my experiences. No one is truly alone.