DISTRESS TOLERANCE SKILLS

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WHAT ARE Distress Tolerance Skills?

At some point in our lives, we all have to cope with distress and pain. Either it can be physical, like a broken arm, or it can be emotional, like sadness or anger. In both cases, the pain is often unavoidable and unpredictable. You can’t anticipate when the arm will break or when something will make you sad. Often, the best you can do is to use the coping skills that you have and hope that they work.

But for some people, emotional and physical pain feels more intense and occurs more frequently than it does for other people. Their distress comes on more quickly and feels like an overwhelming tidal wave. Often, these situations feel like they’ll never end, and the people experiencing them don’t know how to cope with the severity of their pain. People struggling with overwhelming emotions often deal with their pain in very unhealthy, very unsuccessful ways because they don’t know what else to do.

 This is understandable.

When a person is in emotional pain, it’s hard to be rational and to think of a good solution. Nevertheless, many of the coping strategies used by people with overwhelming emotions only serve to make their problems worse.

Here’s a list of some common coping strategies used by people dealing with this problem. Check (…) the ones that you use to cope with your stressful situations!

(…) You spend a great deal of time thinking about past pains, mistakes, and problems.

(…) You get anxious worrying about possible future pains, mistakes, and problems.

(…) You isolate yourself from other people to avoid distressing situations.

(…) You make yourself feel numb with alcohol or drugs.

(…) You take your feelings out on other people by getting excessively angry at them or trying to control them.

(…) You engage in dangerous behaviors, such as cutting, hitting, picking at, or burning yourself or pulling out your own hair.

(…) You engage in unsafe sexual activities, such as having sex with strangers or having frequent unprotected sex.

(…) You avoid dealing with the causes of your problems, such as an abusive or dysfunctional relationship.

(…) You use food to punish or control yourself by eating too much, not eating at all, or by throwing up what you do eat.

(…) You attempt suicide or engage in high-risk activities, like reckless driving or taking dangerous amounts of alcohol and drugs.

(…) You avoid pleasant activities, such as social events and exercise, maybe because you don’t think that you deserve to feel better.

(…) You surrender to your pain and resign yourself to living a miserable and unfulfilling life.

All of these strategies are paths to even deeper emotional pain, because even the strategies that offer temporary relief will only cause you more suffering in the future.

Use the Cost of Self-Destructive Coping Strategies overview below to see how. Note the strategies that you use as well as their costs, and then include any additional costs that you can think of.

At the end of the worksheet, feel free to add any of your own strategies that aren’t included as well as their costs.

THE COST OF SELF-DESTRUCTIVE COPING STRATEGIES

Behavior and possible costs

 1. What you do: You spend a great deal of time thinking about past pain, mistakes, and problems.

What it does to you: Miss good things that might be happening now and then regret missing those things, too; depression about the past

Other: ____________________________________________________

2. What you do: You get anxious worrying about possible future pain, mistakes, and problems.

What it does to you: Miss good things that might be happening now; anxiety about the future

Other: ____________________________________________________

3. What you do: You isolate yourself to avoid possible pain.

What it does to you: Spend more time alone and, as a result, feel even more depressed

Other: ____________________________________________________

 4. What you do: You use alcohol and drugs to numb yourself.

What it does to you: Addiction; loss of money; work problems; legal problems; relationship problems; health consequences

Other: ____________________________________________________

 5. What you do: You take your painful feelings out on others.

What it does to you: Loss of friendships, romantic relationships, and family members; other people avoid you; loneliness; feel bad about hurting other people; legal consequences of your actions

Other: ____________________________________________________

 6. What you do: You engage in dangerous behaviors, like cutting, pulling out hair, burning with cigarettes, biting fingernails and self-mutilation, self-harm.

What it does to you: death; infection; scarring; disfigurement; shame; physical pain

Other: ____________________________________________________

 7. What you do: You engage in unsafe sexual activity, like unprotected sex or frequent sex with strangers.

What it does to you: Sexually transmitted diseases, some life threatening; pregnancy; shame; embarrassment

Other: ____________________________________________________

8. What you do: You avoid dealing with the causes of your problems.

What it does to you: Put up with destructive relationships; get burned-out doing things for other people; don’t get any of your own needs met; depression

Other: ____________________________________________________

9. What you do: You eat too much, restrict what you eat, or throw up what you eat.

What it does to you: Weight gain; anorexia; bulimia; health consequences; medical treatment; embarrassment; shame; depression

Other: ____________________________________________________

10. What you do: You have attempted suicide or engaged in other nearly fatal activities.

What it does to you: Possible death; hospitalization; embarrassment; shame; depression; long-term medical complications

Other: ____________________________________________________

11. What you do: You avoid pleasant activities, like social events and exercise.

What it does to you: Lack of enjoyment; lack of exercise; depression; shame; isolation

Other: ___________________________________________________

12. What you do: You surrender to your pain and live an unfulfilling life.

What it does to you: Lots of pain and distress; regrets about your life; depression

Other:___________________________________________________

 

13. What you do: ____________________________________________

 What it does to you: _________________________________________

 Other:________________________________________

 14. What you do: ____________________________________________

 What it does to you: _________________________________________

 Other: ________________________________________

 

The costs of these self-destructive coping strategies are clear. All of them lead to your pain being prolonged into long-term suffering. Remember, sometimes pain can’t be avoided, but many times suffering can.

 The first distress tolerance skills you’ll learn will help you distract yourself from the situations that are causing you emotional pain.

Distraction skills are important because

(1) they can temporarily stop you from thinking about your pain and, as a result,

(2) they give you time to find an appropriate coping response.

Learn more:

Distress Tolerance Skills:

  1. DISTRESS TOLERANCE SKILLS
  2. RADICAL ACCEPTANCE
  3. DISTRACT YOURSELF FROM SELF-DESTRUCTIVE BEHAVIORS
  4. DISTRACT YOURSELF WITH PLEASURABLE ACTIVITIES
  5. DISTRACT YOURSELF BY PAYING ATTENTION TO SOMEONE ELSE
  6. DISTRACT YOUR THOUGHTS
  7. DISTRACT YOURSELF BY LEAVING
  8. DISTRACT YOURSELF WITH TASKS AND CHORES
  9. DISTRACT YOURSELF BY COUNTING
  10. CREATE YOUR DISTRACTION PLAN
  11. RELAX AND SOOTHE YOURSELF
  12. Self-Soothing Using Your Sense of Smell
  13. Self-Soothing Using Your Sense of Touch
  14. Self-Soothing Using Your Sense of Taste
  15. Self-Soothing Using Your Sense of Hearing
  16. Self-Soothing Using Your Sense of Vision
  17. Self-Soothing – CREATE A RELAXATION PLAN

Advanced Distress Tolerance Skills:

  1. Advanced Distress Tolerance Skills: Improve the Moment
  2. SAFE-PLACE VISUALIZATION
  3. CUE-CONTROLLED RELAXATION
  4. REDISCOVER YOUR VALUES
  5. SELF-ENCOURAGING COPING THOUGHTS
  6. TAKE A TIME-OUT
  7. LIVE IN THE PRESENT MOMENT
  8. IDENTIFY YOUR HIGHER POWER
  9. ADVANCED RADICAL ACCEPTANCE