Skip to main content

Distress Tolerance Skills Part 1: Crisis Survival Skills

All posts in this series reference working through DBT® Skills Training Handouts and Worksheets, Second Edition, and all quotes come from that book unless otherwise specified.

Goals of Distress Tolerance:

Distress tolerance skills are important because distress is always going to be a part of life, and fighting against that fact causes more suffering. Distress is also part of making any change in ourselves, and if we shy away from that pain, we will be unable to progress. The Distress Tolerance Skills section of the book will be divided into two main types of handouts: Crisis Survival and Reality Acceptance. There will also be some material for "When the Crisis is Addiction". This blog will cover crisis survival skills.

The distress tolerance section has 3 main goals:
  • "Survive crisis situations without making them worse
  • Accept reality Replace suffering and being "stuck" with ordinary pain and the possibility of moving forward
  • Become free of having to satisfy the demands of your own desires, urges, and intense emotions"

 Crisis Survival Skills

The first subsection of skills in this section is crisis survival skills. "These are skills for tolerating painful events, urges, and emotions when you cannot make things better right away."
Graphic made by Zeke, all information taken from DBT® Skills Training Handouts and Worksheets,

STOP Skill:

The first crisis survival skill is the STOP skill, which is illustrated by the graphic below:
https://miro.medium.com/max/1400/1*HCl246ca1f2AFgzmi_wrtA@2x.jpeg
Graphic found at https://miro.medium.com/max/1400/1*HCl246ca1f2AFgzmi_wrtA@2x.jpeg

Pros and Cons:

The next crisis survival skill is Pros and Cons. This works best for a recurring urge that, if acted upon, would make things worse in the long-term OR a recurring reluctance to do a specific thing that needs to be done to make your life better in the long-term.

For an urge that, if acted upon, would make things worse, before you are in crisis, make a list of pros and cons for acting on your urge AND a list of pros and cons for not acting on your urge. Rehearse this list, and carry it with you. When you are in crisis, reference this list to help you make choices that are beneficial in the long-term.

The same principle applies to something you need to do to make your life better in the long-term but are reluctant to do. Before you are in crisis, make a list of pros and cons for doing it AND a list of pros and cons for not doing it. Reference this list when the crisis hits.

TIP Skills:

TIP Skills are all about changing your body chemistry to calm extreme emotions. They're described in the flyer below:
https://dbtselfhelp.weebly.com/uploads/8/2/0/9/82096548/editor/t_485.jpg?1492524640
Found at https://dbtselfhelp.weebly.com/uploads/8/2/0/9/82096548/editor/t_485.jpg?1492524640

Other Options:

You can also do body sensation meditation or other exercises with your 5 senses for crisis management.


Labels:

Comments

Post a Comment

Popular posts from this blog

I Ordered a Walker

lly have mixe    This is the model. I really have mixed feelings about this decision. I'm choosing to get the walker due to intense pain that's been worsening for about the last year. The cause turns out to be EDS , or at least that's what the doctors are saying. EDS is a connective tissue disorder that I don't yet fully understand, but it was explained to my that my connective tissue at my joints is too stretchy, and it's leading to my pain, fatigue, and susceptibility to joint injury. I was also provisionally diagnosed with POTS , in which blood pools in some areas while I'm seated or laying down, and my heart rate goes up too much trying to get the blood back to my heart and brain when I stand. If this process is inefficient enough, I can faint. Apparently, the doctor didn't do the proper testing for this, so I'm going to take this diagnosis with a grain of salt and just call it unexplained near-fainting episodes for now. Regardless of what causes...
2 comments
Read more

Dear Unnamed Friend

Dear unnamed friend, I carefully hoarded enough spoons to do the activity you suggested at the time you suggested. I went to bed super early and planned NOTHING for tomorrow to be able to do it. I just got discharged from psych this week, and the meds still aren’t all the way in my system, so I’m foggy-minded and emotional. I also woke up every 90 minutes last night for 30-45 minutes due to nightmares about the hospital that joined my normal nightmares. I told you I’d let you know around 9am today, when my alarm was set to sound, whether I could come to the 1pm event today, and I texted you that yes, I could come, but I needed to sleep until 10 to regain spoons. You texted me 4-5 times between 9:15 and 10, effectively cancelling any change I had to sleep, since it takes me at least 2 hours to wake all the way up. You tried to change the plans to pick me up around 10:15am, and I understand why. You were already in the area for something and didn’t want to drive all the w...
1 comment
Read more

Interpersonal Effectiveness Skills Part 4

All posts in this series reference working through DBT® Skills Training Handouts and Worksheets, Second Edition , and all quotes come from that book unless otherwise specified. This blog post continues to chronicle my takeaways from the Interpersonal Effectiveness Skills section of my DBT workbook. Parts of this section either did not work for my autism or my agnosticism, but on the whole, I found it helpful. Dialectics The next section of interpersonal effectiveness skills is dialectics. Dialectics are all about balancing opposites. This has spiritual applications noted in the book (talk of the universe, etc.), but that doesn't work very well for me with trauma and psychosis surrounding spiritual things. However, dialectics can also help us see both sides of a situation, embrace change in our lives, be aware of our connection to others, and see that we are both impacted by and impacters on our environments. The book then lists some beliefs that are dialectics, and a few w...
Post a Comment
Read more