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Distress Tolerance

The distress tolerance skills are a set of tools that will help you manage intense emotional states without doing anything destructive.

Be aware that these skills will not necessarily wash away the emotional pain you are feeling or even make you feel less distressed. Instead, the goal of these skills is to prevent you from doing something that will make the situation worse.

These skills are best used when you are faced with a situation that you can’t fix—there are many events in our life that we can’t change, but that cause tremendous pain. In those situations, distress tolerance skills can be critically important.

Many people with BPD have problems with substance abuse, alcohol abuse, spending, reckless driving, physical violence, and impulsive sex.

In many cases, all of these impulsive behaviours are preceded by strong emotions. Here’s how this works:

  1. You have a strong emotion that is triggered by some event (e.g., rejection by a loved one.)

  2. You feel and believe that the emotion is intolerable (e.g., “I cannot stand this feeling.”)

  3. You engage in an impulsive behaviour in order to reduce the seemingly intolerable emotion (e.g., drink alcohol).

  4. The behaviour is reinforced because it works in the short term (e.g., you feel better temporarily).

Wise Mind ACCEPTS

A Activities (see distraction ideas below)

C Contributing – helping others

C Comparisons – comparing self with (better) self

E Emotions – generate different emotions by watching movie/tv, listening to music etc

P Pushing away – thinking about or putting our attention onto something else

T Thoughts - new thoughts. E.g. counting, playing 10 (10 colours in room, 10 musical instruments, 10 fruits, 10 Bond films etc)

S Sensations – use seeing, hearing, smelling, tasting and touching senses

DISTRACTION IDEAS

Distraction helps us feel better by diverting our attention away from the distressing thoughts. It works even better if you choose something that will really grab your attention and keep you absorbed in that activity. Different things work for different people.

Home and garden

  • Mow the lawn

  • Clean the car

  • Do some gardening

  • De-clutter a room or part of a room

  • Purge your wardrobe (give to charity)

  • Clear out the spare room (give to charity)

Leisure

  • Do a crossword or Sudoku

  • Try out aromatherapy or reflexology

  • Visit the hairdresser – try a new style or colour

  • Watch television or a DVD

  • Play on the computer

  • Surf the internet

Going out

  • Join a leisure centre or health suite

  • Go for a walk or jog

  • Get the old cycle out!

  • Visit a new church

  • Go to the library

  • Visit a museum

  • Check out what movies are on

  • Go to a concert

  • Browse an antiques or charity shop

  • Find out what free classes are on offer

  • Potter around window shopping

  • Go out for lunch

  • Go to the beach – whatever the weather!

  • Learn to drive, or take a trial lesson

Being creative

  • Take up a new hobby

  • Learn another language

  • Start an evening class

  • Write a letter or article for a magazine

  • Learn to meditate, do yoga or tai chi

  • Start a diary or journal

  • Write a short story or poem

  • Take up a musical instrument

  • Decorate a room, or a piece of furniture

  • Paint, draw, sculpt

  • Join a dance class

Express yourself physically

  • Bang a drum!

  • Scream, shout or sing loudly!

  • Rip up a phone book or newspaper

  • Dance energetically to loud music

  • Write – prose, poem, story, music, journal, diary, weblog, whatever comes into your head

  • Write a letter to someone, but don’t send it – shred or burn it outside

  • Run, walk, cycle, swim, go to the gym

  • Paint

  • Vacuum enthusiastically

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