15: Distress Tolerance
More strategies to share!
I work with a handful of teenagers that have poor distress tolerance skills — maybe you do, too!
Distress tolerance is the ability to withstand negative emotions or physical discomfort. Similar to the resiliency skill, distress tolerance skills allow a person to survive an immediate emotional crisis, without making it worse.
For an adult, this can look like:
when a partner unexpectedly raises their voice, you’re able to calmly redirect the conversation so the discussion can continue in a respectful tone.
With escalated voices, our amygdala (your “emotional brain”) is activated, resulting in fight, flight, freeze or fawn mode.
you mistakenly miss a credit card payment, but you’re able to creative problem-solve. You have the ability to reason the “natural consequence” of not paying it on-time OR, you have the capacity to call the credit card company to “shoot your shot” and hope they wave the fee. You proceed to make the payment.
For a teenager, it might look like:
a teacher kicks you out of class because you were talking back or being disruptive. Rather than arguing back or making the situation worse, you calmly leave the room so you can gather your thoughts to have a productive conversation with admin or the teacher.
this does not mean “buying time” to make excuses — it’s calming yourself down to be able to own up to your behavior and to take time to reflect on the situation.
Distress tolerance skills not only help the person get through the emotional crisis, but it also helps them accept the reality of the situation. With this skill, a person is able to identify what is in control, so they can creative problem-solve or use effective communication skills.
But, most importantly, distress tolerance allows a person to accept the reality of the situation when they can’t change the situation — which, in terms of life, is A LOT of the time.
we can’t fully control the traffic
we can’t control our peers’ thoughts or judgements
we have no control over the weather, especially on the special events planned
we will get sick at the most inconvenient time, even when we’re doing our very best at taking care of our health
Adversities are inevitable; some will experience more stress than others, but we ALL can develop (or enhance) distress tolerance skills.
Another benefit of distress tolerance is that it helps people have the ability to cope with the overwhelming feelings, even when they don’t know exactly what they want or need in that moment.
Distress tolerance skills are also known as crisis survival skills. When facing a crisis, there is no question our emotional brain is activated and we are on high-alert. Without the ability to manage emotional pain, people will often default to destructive behavior (substance use, breaking/throwing things, hitting/punching, etc) OR to avoid the emotional pain (very common!!), which, unfortunately, can lead to more harm or risky behaviors that can have long-term consequences.
Distress tolerance helps a person lower the intensity of the emotional pain. This allows the person to utilize emotion regulation or interpersonal skills.
In this week’s newsletter, I am going to briefly share 5 different distress tolerance skills. These skills are primarily taught in the Dialectical Behavioral Therapy (DBT) models, a modality often used in therapy for individuals experiencing anxiety, depression and many other mental health challenges.
It is my hope that after browsing over each skill, you’ll be able to implement 1, 2 or 3 of them this week, as some of them you probably already do, but intentional awareness will enhance your confidence in utilizing that skill.
When we confidently approach an adversity with more than 1 tool, we can feel more at ease knowing we have the ability to withstand the discomfort.
Enjoy!
Self-soothing techniques
helps reset bodily systems after a stress response
rather than reaching for substances or ice cream, try one or some of these instead:
change the environment — step outside, go for a walk or run an errand
stretch
take a warm shower or bath
light a candle, look at feel-good pictures or go on pinterest to read inspirational quotes
play soothing music
focused breathing, such as 3-4-5 breathing (breathe in for 3 counts, hold your breath for 4 counts, exhale for 5 counts)
self-soothing touch (right hand on your heart / left hand on your belly - focus on the rise of the belly as you inhale, gentle fall as you exhale)
if nothing else, you can always ground yourself by engaging the 5 senses.
ground yourself by taking your time to notice what you see, hear, touch taste and smell. PRO TIP: this is a great one for kids!
Pros and Cons
rather than making emotional decisions, STOP and weigh out your choices. To avoid impulse decision-making, set a timer (at least 5-10 minutes) to think of the in-between details, not just the obvious ones. In each column, not only identify how each choice could affect you, but also affect others (if applicable).
Writing down a list of pros and cons can help you see the logic, especially when feeling emotional.
TIPP
acronym for Temperature, Intense Exercise, Paced Breathing, Paired Muscle Relaxation
temperature with cold water — another reason why cold plunges are all the hype! Cold water provides a shock to the system, to allow relief from an elevated emotional state.
examples: cold plunge, splash cold water on the face (also great skin benefits!), take a cold shower, hold ice cubes in your hands, rub an ice cube along your chest (one of my personal favorites!)
intense exercise — the heart rate is up and adrenaline is pumping, which provides a euphoric feeling.
useful because it is difficult for a person to feel both distressed AND elated simultaneously!
paced breathing - counted and regulated breathing can help one regain a sense of control by controlling the most basic biological function…THE BREATH!
3, 4, 5 breathing (explained above) is a great option!
5-finger breathing, square/box breathing and figure 8 breaths are all great options, as well. Also kid-friendly!
when breathing slowly and calmly, your blood pressure will lower, allowing you to feel more relaxed and less stressed
great for anxiety, insomnia and fatigue
paired muscle relaxation - a great exercise that has the ability to relax the entire body! When the body is physically relaxed, it is difficult to be emotionally agitated.
the mind-body connection is very strong — this exercise teaches the mindfulness of the body and self-awareness. It is one of my favorite mindfulness activities to guide!!
You pair a group of muscles at a time, working through the entire body. When you inhale, you tense the muscles as hard as you can, then on the exhale, you relax.
TIPS:
work on the muscles in a particular order; top of the head to the feet or vice versa.
toes + feet; calves + quads; glutes + core; fists + biceps; all muscles in the face (think: you just bit into a lemon)
I always like to end with a full body tension, which precedes a full body relaxation. Sit in that full body relaxation for 2-3 minutes.
Radical acceptance
radical acceptance is accepting the state of things as they are, without working to change them.
It is what it is
ability to observe a situation without emotion — to accept the situation/outcome is out of one’s control
Distractions
temporarily engage in something else to distract yourself from the distressing situation — return when you can deal with the situation calmly
some examples:
EXERCISE! always a go-to.
leaving the location
call a friend
watch TV
clean
read a book
play with a pet
As mentioned, you are likely already using least one of these strategies. We are all resilient in our own ways, but I would argue we all can benefit from intentionally incorporating 1, 2 or all 5 of these to our regular routine.
All of these strategies are healthy and beneficial, which means we don’t have to wait until we’re in crisis mode to use them!
PROACTIVE, BABY!!
I have used many of these strategies with elementary-aged kids, and my current teens are also benefiting from implementing them. If you’ve never been to a yoga class, maybe consider it!
If you’re a busy adult that wears many hats, I encourage you to find a reputable yoga studio near you so you can be guided through some mindfulness. I am yoga-certified and I guide many of my teenagers through these interventions, yet, I still find myself signing up for classes because I merely want someone to do the thinking for me; I just want to follow their lead so I can focus on experiencing my own calm.
Life is short, yet so incredibly exciting and beautiful, even in our moments of distress. A recurring message I kept hearing this week is the importance of gratitude. While we can be sensitive and compassionate to our own overwhelming feelings, we can ALSO recognize it could always be worse.
Some people would do almost anything to have the schedule you have. To have the family your have. To have that soft blanket you use. To have a loving pet like you do. To hear the “I love you"s. To have a vehicle to drive. To have a job with benefits. To be able to sip coffee in the morning.
The list can go one. In short, we do have our own blessings and we are all guilty of overlooking them all too often.
My supervisor uses the Catastrophe Scale and it makes me chuckle every time — mostly because it’s so dramatic, yet, impactful.
The Catastrophe Scale he uses with his clients is a scale 1-10 (10 being nuclear war). After he shares the scale, he asks the client to rate their stressor.
If your traffic jam is rated at an 8, then the next lesson needs to be about size of the problem.
If you can reason that an argument with a loved one is no where near a nuclear war, making it only a 5 or so, then that can bring some immediate relief.
We can work through life’s challenges, especially when only rated as a 5 out of 10. 💕
Thank you for being here. Thank you for sharing. Feel free to comment below!
I hope you all have the opportunity to proactively implement a couple of these strategies this week. I will be practicing a few right along with you! ✨
Cheers,
Jordan ☕️