Dr. Elisheva Jakobov-Assouline
Have you ever struggled with managing a pretty intense situation, and engaged in maladaptive coping, further exacerbating the stressor, and sometimes even creating an additional crisis for yourself?
The Distress Tolerance module in Dialectical Behavioral Therapy (DBT) teaches individuals to tolerate painful emotions, distract without avoiding, act instead of react, and learn to manage crises without making them worse. If you feel that you cannot solve the problem, or now may not be the right time to solve the issue, or you are not in Wise Mind (the integration of rational and emotional minds), Distress Tolerance skills may be beneficial for you. Distress tolerance skills are considered crisis survival skills and should be used when an individual is experiencing a lot of pain that does not go away and when a situation is overwhelming however demands must be met. It is important not to use these skills for everyday problems. This is because when a real crisis will occur, you may not gain the benefits from these skills.
The Self-Soothe skill in DBT focuses on using the five senses to reach a state of relaxation and calmness. Because no two individuals are alike, one individual may preference activities that utilize one sense while another individual may prefer to use an activity that incorporates a different sense when feeling overwhelmed. Learning how to relax and self-soothe is crucial. When one is relaxed, they function more adaptively.
Self-soothe is a form of distraction from emotional pain. Distraction has a time and place, and can be beneficial. Distraction is not the same as avoiding. Distraction entails doing something else, with the intention of eventually facing the problem once you are more calm. Self-soothe activities also allow you to treat yourself with love, kindness, and compassion. As you explore the different senses, decide what works best for you. If something does not bring you calmness, do not engage in it. Do and use what works for you.
Smell can have a powerful impact on an individual as it can trigger different kinds of memories. It is important to identify smells that are meaningful and helpful to you verses smells that bring along bad memories.
Below are examples of self-soothing using your sense of smell:
- Wear perfume, cologne, or something that makes you feel good
- Wash your clothing with softener that makes you feel happy
Smell a food item you enjoy: coffee, pizza,etc.
- Surround your space with scents that you enjoy
- Bake or cook a meal you enjoy
- Sit in the sand by the beach or on the grass and enjoy its smell
- Smell flowers or buy plants you can smell
- Hug someone you love whose smell makes you feel calm
Vision is crucial to humans. Whatever an individual looks at, impacts them, positively or negatively. Make sure you are using your vision for things that are positive, and bring you joy.
Below are examples of self-soothing using your sense of vision:
- Look at a picture of someone you love, or a memory that was positive
- Decorate your home with things that make you feel happy. Be it plants, paintings, candles…
- Visit a place that brings you comfort (library, museum, clothing store)
- Color something that makes you feel happy and calm
- Be in nature and look around you
- Make a collage of different places that feel pretty to you
- Watch a funny clip
- Go window shopping
- Watch the sunrise or sunset
Certain noises can bring about calmness and joy.
Below are examples of self-soothing using your sense of hearing:
- Listen to your favorite music that brings you joy
- Listen to a podcast or audiobook that you find relaxing
- Listen to the radio or TV
- Sit by the beach and listen to the waves
- Listen to a recording of a relaxation exercise
- Let the water run for a minute and listen to it running
- Speak to someone who you appreciate and pay attention to their voice
- Play an instrument
- Listen to the birds chirp
Taste is powerful. If you struggle with an eating disorder, I recommend you utilize activities from the other senses.
Below are examples of self-soothing using your sense of taste:
- Enjoy your favorite meal. Try to eat slowly and be mindful, with little distractions around you
- Go to your favorite restaurant and enjoy your favorite food there
- Eat a soothing food or snack that makes you feel good
- Drink something soothing (hot cocoa, coffee, tea)
- If you are warm, suck on ice and let it slowly melt in your mouth
The power of the human touch is crucial. It makes one feel connected and loved.
Below are examples of self-soothing using your sense of touch:
- Hold onto a fuzzy blanket
- Touch fresh clothing that came out of the dryer
- Hug or kiss your loved ones
- Go for a massage
- Take a hot bath or cold shower
- Play with your pets
- Wear comfortable clothing and enjoy how it feels on your skin
- Touch something calming
It may be helpful to write down 3-5 activities that calm you down on a sticky note, or on your phone for easy access. This serves as a reminder of skills you can use in moments of distress.
In addition to the self-soothe skill, Improve the moment skill can be helpful when faced with a crisis. It refers to a set of strategies that can be helpful when self-soothing skills don’t do the job.
- Imagine a safe room that has all the essentials you need to feel safe. Picture yourself there. What thoughts and feelings does this safe room create for you? Where in your body do you feel it? Visualizing a peaceful or comforting place can serve as a stress reduction technique and provides you with relief from the intense emotions you are experiencing.
- Imagine yourself coping successfully with the difficult situation. Imagine what it would feel like when things go really well for you.
- Finding meaning in a difficult situation can help you cope with it more effectively. It can be finding religious or spiritual meaning. We are not denying the fact that we are struggling and things are tough. Rather, by finding meaning, we are hoping it will make us feel better in the moment.
- Prayer refers to God, a higher power, or supreme being. Or, acceptance prayer. The goal is to be present with your distress. If you do not believe in something, turn to your wise mind.
- Life can be very stressful at times. As such, it is imperative to learn how to relax. When you learn how to relax your body, your mind relaxes too. Deep breathing exercises or progressive muscle relaxation can be beneficial.
O-One thing in the Moment
- Essentially, this refers to mindfulness. Focus on one thing, in the present moment. This can reduce our suffering, as it allows you to calm down.
- This does not refer to a luxury vacation and breaking the bank. Taking a much needed vacation refers to taking a momentary break from your situation, with the intentions of eventually addressing the problem at hand. Do not take a vacation that will cause more harm than good, and do not take a long vacation since it can lead to avoidance.
- Instead of engaging on a mini getaway, you can also try other ways of vacationing. For example, take your lunch to the park, sit in your car for some time, shut your office door…. By engaging in these activities, you can distance yourself from your suffering and do what you need to do.
When we are distressed and overwhelmed, we engage in a lot of negative self-talk. In order to combat the negative thoughts we feed our minds, it is important to practice some encouraging statements.
When we talk to ourselves more positively, we can in turn impact our mood for the better. Examples include, “I am strong,” “I got this,” or “This too shall pass.”
In conclusion, by engaging in the self-soothe or improve the moment skills, we can cope more adaptively, rather than resorting to unhealthy coping. If you struggle with overwhelming emotions, these skills can be worth implementing. They are brief and simple, and will hopefully make you feel better.