DISTRESS TOLERANCE: CRISIS SURVIVAL STRATEGIES
DBT teaches us four sets of skills for tolerating (dealing with, getting
through, accepting) the distressing events and activities in our lives.
1. Distracting - Wise Mind ACCEPTS
3. Improving the Moment
4. Thinking of Pros and Cons
Look at p. 165, Distress Tolerance Handout 1. This lists all the skills.
Also look at page 96 in the manual. and p. 166, the second part of Distress
Tolerance Handout 1.
A useful way to remember these skills is by the acronym,
"Wise Mind A C C E P T S"
Distract with A ctivities:
Do hobbies, watch a video, go for a walk, play a sport,
cook, garden, go fishing, go shopping.
What other activities can you think of that you can get
involved in and distract yourself from your distress?
Make a list of your activities and put it up on your
refrigerator, so you can find it in a hurry.
Distract with C ontributing:
Contribute. Do volunteer work. Babysit so a friend can
go out. Do something nice or surprising for someone.
What have you done this week to contribute?
What can you do next week to contribute? Plan something in
advance. This takes you away from your pain and puts your
attention on your concern for someone else.
Distract with C omparisons:
Compare yourself to people coping the same as or less well
than you. If you are doing better than you were a year or
two or five years ago, make that comparison.
The manual suggests that you compare yourself to others'
suffering, watch weepy soap operas, read about disasters.
Some people find this helpful, others don't. Just do what
works for you.
Distract with opposite E motions
Read emotional books, go to emotional movies, listen to
emotional music. For this to work, you need to read or
watch or listen to things that have an emotion opposite
to one you are feeling.
If you are sad, watch a comedy. Watch a scary moviie.
Listen to silly music.
Distract with A ctivities
Distract with C ontributing
Distract with C omparisons
Distract with opposite E motions
There are four groups of crisis survival streategies: Distraction,
Self-Soothing, Improving the Moment, Pros and Cons. All of these are
strategies that help us to get though difficult feelings and situations, to
tolerate (deal with, get through, sit with, accept) the things that we can't
immediately change. This is one of the keys to DBT skill usage, to find
some of these skills and techniques that work for you, to practice them
until they are part of your everyday life and you can call them up whenever
you need them.
In DBT, there are four categories of Distress Tolerance strategues. These
3. Improving the Moment
4. Focusing on the Pros and Cons
These are strategies that short circuit or help you to cope with
overwhelming negative emotions or intolerable situations. They take a lot
of practice, but as you get the hang of using some of these techniques, you
will see your relationship to the negative emotions and intolerable feelings
Some of us may recognize these techniques as things that we already
use. But many of us have never learned how to self-soothe, how to do those
often simple things that makes us feel better. These are mostly very
physical techniques, that use different body senses. Some of us have never
had the feeling that we could do things to make ourselves feel better, calme
r, feel relaxation or pleasure. Use them when you are feeling distressed,
when emotions feel overwhelming, when situations feel like you can't stand
them any more. Instead of doing something that hurts you, try something
that gives you pleasure and comfort.
SELF-SOOTHING has to do with comforting, nurturing and being kind to
yourself. One way to think of this is to think of ways of soothing each of
your five senses:
Check p. 167 in the manual, Distress Tolerance Handout 1, for lots of
suggestions of things that you can do to soothe and pleasure your five
A few examples:
Walk in a pretty part of town. Look at the nature around you. Go to a
museum with beautiful art. Buy a flower and put it where you can see
Sit in a garden. Watch the snowflakes decorate the trees during a
Light a candle and watch the flame. Look at a book with beautiful
scenery or beautiful art. Watch a travel movie or video.
Listen to beautiful or soothing music, or to tapes of the ocean or other
sounds of nature. Listen to a baby gurgling or a small animal. Sit by
a waterfall. Listen to someone chopping wood. When you are listening, be
mindful, letting the sounds come and go.
Smell breakfast being cooked at home or in a restaurant. Notice all the
different smells around you. Walk in a garden or in the woods, maybe
just after a rain, and breathe in the smells of nature. Light a scented
candle or incense. Bake some bread or a cake, and take in all the smells.
Have a special treat, and eat it slowly, savoring each bite. Cook a
favorite meal. Drink a soothing drink like herbal tea or hot chocolate.
Let the taste run over your tongue and slowly down your throat. Go to
a potluck, and eat a little bit of each dish, mindfully tasting each
Take a bubble bath. Pet your dog or cat or cuddle a baby. Put on a
silk shirt shirt or blouse, and feel its softness and smoothness. Sink
into a really comfortable bed. Float or swim in a pool, and feel the
water caress your body.
Many of us may feel like we don't deserve these comforts, and may find it
hard to give pleasure to ourselves in this way. Some of may also expect
this soothing to come from other people, or not want to do it for
You may feel guilty about pleasuring yourself in this way. It may take some
practice to allow yourself to experience these pleasures. These are really
simple human pleasures that everyone has a right to, and that will give us
some good tools to use when we are feeling bad.
Do these skills mindfully. Breathe gently, and try to be fully in the
experience, whether it is walking in the woods or watching a flower or
taking a bubble bath or smelling some fresh-baked bread.
As you begin to overcome your feelings that perhaps you do not deserve this,
or guilt, and start to enjoy one or more of these activities, you will be
learning very useful tools to help you deal with negative feelings and