Mental Health Series: Distress Tolerance Continued

To reiterate from the previous article in this series: “Pushing emotions down isn’t healthy, yet in some situations, we have no option except to temporarily delay them until we can properly deal with them. These skills are only meant to be used in a situation that you need to cope in order to survive a crisis. This includes impulse thoughts, or social situations like a class or hanging out with friends where you can’t deal with the emotions or thoughts you’re having in the moment. These skills are very effective for panic attacks, anxiety attacks and impulsivity.” Under Distress Tolerance, we have two other main skills we can use, one for calming yourself in the moment and one for accepting things you cannot change.

1) Self-Soothe: Self-soothing allows you to keep yourself calm by connecting to your five senses. You’ve probably used this skill without knowing (maybe you’ve watched movies to tolerate distress, listened to music or taken a bath or shower). Each option may impact different people differently, so here are some suggestions:See: a movie, a sunset/sunrise, nature, artwork, anything you use your eyes for
Hear: music, podcast, anything you use your ears for
Smell: candles, fresh air outside, essential oils, clothes, anything you use your nose for
Taste: candy, baked goods, a healthy meal, your favorite meal, anything you use your mouth for (savor each bite)
Feel: fabrics, a bath, an animal, anything you can touch

2) Radical Acceptance: A very common saying from the Serenity prayer applies to this topic: “Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” Radical acceptance is the process of accepting the things you cannot change. The pain may still be there, but you can reduce the suffering.

What’s the difference between suffering and pain? Suffering is pain plus non-acceptance of the pain. Your pain can be a lot worse if you’re not accepting it. Pain is a part of living, but suffering doesn’t have to be.

Some common myths about acceptance are that if we refuse to accept something, it will disappear. I hope it’s obvious why this one is not true. Nothing just disappears, especially when we’re dealing with emotions. Another common one is that if you accept your painful situation, you are accepting a life of pain. Accepting your pain isn’t sitting in it and letting it suffocate you. Let’s run through how this one is used. Ask yourself these three questions.

1) What realities are you refusing to accept?
2) What behaviors do you engage in when you are refusing to accept a reality (manipulation, arguing, giving up, letting emotions get the best of you)?
3) How do you experience suffering when you refuse to accept a reality?

Then, dive into the 8 actions.
1) Observe yourself:
– Observe your thoughts, feelings, body cues, and words – Ask yourself, “Am I questioning or fighting reality?”
2) Remind yourself that reality is what it is and usually cannot be changed.
3) Consider the causes of this reality:
– Think, “What has led up to this moment?”
4) Practice full acceptance of the reality:
– Body: Scan your body, practice releasing any areas of tension. Use TIPP skills (hint: I wrote about this in my article from April 27th).
– Mind: Change my thinking to acceptance. Think, “It is what it is.”
– Spirit: Practice meditation or prayer.
5) Engage in opposite action:
– Act as though you’ve fully accepted the situation: calm voice, relaxed face, open hands (it’s scientifically proven that keeping your palms open helps you stay more relaxed).
6) Cope ahead:
– Name any future occurrences that may seem unacceptable. Imagine the situation and fully accept it.
7) Allow your emotions:
– As you allow acceptance, you may notice feelings of sadness, disappointment and grief; that’s okay!
– Remember: even though feelings seem like facts, often they’re not. Observe your emotions and let them come and go.
8) Recognize the truth:
– Life can be worth living even when it’s painful
– Remind yourself: everyone has some level of pain (you won’t always see it on social media)
– Say to yourself, “I can get through this hard time”
9) Do Pros and Cons:
Most of you have probably used pros and cons to make decisions. However, you can also use them to remain calm in a crisis. Here we look at the pros and cons of tolerating versus not tolerating distress. You’re looking at the consequences of potential actions. This is good for impulsivity especially, if you know you’re drawn to do something negative to cope instead of positive. The chart looks like this: