Distress Tolerance Skills

on

  Continuing with the notes from the book I am reading on Bipolar II Disorder, here are some more! These can be used during depressive episodes that I’ve already addressed, as well as those moments of high anxiety and even hypomania - which will be discussed in more detail in the future.


Distress Tolerance Skills:

(Dialectical Behavioral Therapy)

help you tolerate strong emotions to avoid using unhealthy coping mechanisms and make the situation worse.


Distracting Skills (reducing strong emotions so you can go back to process and deal, instead of avoiding):

  1. Distracting Activities: write down 5-10 helpful activities (ie: go for a run, listen to music, meet a friend for lunch, watch something funny, etc.

  2. Distracting Physical Sensations: pleasant/unpleasant sensations - taste, touch, sound, or smell (ie: sunbathing, hot shower, scented candles, special food / pinching, cold shower, holding ice)

  3. Distraction Through Coping Statements: encouraging / positive statements (ie: this too shall pass, I have gotten through tough situations before and can do it again, one step at a time, this is not the worst that can happen, etc.)


Mindfulness (paying attention in a  particular way: on purpose, in the present moment, and non-judgmentally) not rumination (the self-critical way of thinking, ie: “why can’t I deal with things better?”)


Awareness is key: 

  1. Current negative thoughts, feelings, behaviors, and sensations (helps ground in current moment)

  2. Focus on the present moment (replace ruminative thoughts)

  3. Deliberately turn away from negative, distorted thoughts (choice to focus on something else)


Mindfully Observing an Everyday Object:

*choose an object that is edible to engage all five senses

Note: mind may wander to unrelated thoughts/feelings - gently bring it back to object

  1. Hold the object in hand and look at it closely, pretending you’ve never seen it before. Describe out loud without judging (Surface? Color? Darkness?)

  2. Hold it between your fingers and lightly squeeze (hard? Soft? light?). Run your fingers along the front and back - it may help to close your eyes

  3. Shake the object gently and listen - is there a nose?

  4. Smell it - sweet? Salty? Fresh?

  5. Bring it to your mouth and run it along your lips so you can taste it - now put it in your mouth and hold in there for about ten seconds, without chewing or swallowing. Explore the taste and texture with your tongue. Taste? Feel? Bite down and note how the taste changes - when you swallow, note how it feels as it travels down your throat and into your stomach.


Benefits:

  • Emotion Awareness

  • Reducing Unhealthy Coping Strategies

  • Better Control of Your Thoughts

  • Improvement in Memory and Concentration

  • More Positive Emotions

  • Relaxation


Mindful Breathing

  1. Bring your attention to your body and mind - paying attention to what you're thinking and feeling, both physically and emotionally. Observe these situations without judging.

  2. Bring your attention to your breath - focusing on the physical sensation of the air coming in through your nose, traveling down through your windpipe and lungs into your diaphragm. Now notice the sensation of the air coming back out from your diaphragm and lungs and out through your nostrils.

  3. Your attention will wander away from your breathing - do not judge yourself for it, but gently bring your attention back to your breath.

  4. Continue to focus on your breath and the process of breathing for several minutes.


For me, breathing is definitely something I need to work on. I frequently find myself taking shallow breaths whenever I get worked up, which leads to panic attacks and sometimes even fainting. My husband is really good about telling me when he notices I’m not breathing properly, which helps ground me (and usually makes me giggle). 👻

Comments

Post a Comment