Improve Your Life with DBT: Crisis Survival Skills

Pain, both physical and emotional, is part of life. At some point, everyone experiences it. As Longfellow wrote, “Into each life some rain must fall.” Still, you don’t have to stand out in the rain and get wet. You can use an umbrella or go inside. Similarly, there are things you can do to manage painful situations.

In Dialectical Behavioral Therapy (DBT), a model of therapy created by Marsha Linehan, the tools to get through a crisis are called Distress Tolerance Skills. The goal of these skills is to get through a crisis without making the situation worse. They are intended for painful situations that you can’t readily change.

Imagine you have a big fight with your partner on your way to work one morning. You’re upset, angry, sad, but you still have to get through your workday. What’s more you have to pull yourself together enough so you don’t have an emotional outburst at work. After all, collapsing into tears or yelling at your boss is frowned upon in most workplaces. Doing so would likely make the situation worse. So what can you do? Using the following distress tolerance skills can help reduce your suffering in the moment so you can get through your day.

  1. Distracting skills: The aim of these skills is to decrease exposure to emotional triggers by distracting or refocusing attention and/or changing emotions. Examples include engaging in activities like exercise, playing video games (Candy Crush is a great distraction), call or text a friend, watch YouTube, do a cross word puzzle, take a hot or cold shower. Remove yourself either physically or mentally (push it to the back burner of your mind) from the painful situation.
  2. Self-soothing skills: These skills are aimed at reducing pain by triggering the 5 senses. Smell: Aromatherapy, fresh air, a scented candle. Taste: bubble gum (It may sound silly, but it’s hard to be sad when you’re blowing bubbles), strong mints, tea or coffee, chocolate. Touch: use a stress ball, pet a dog or cat, massage your neck and feet, get a hug. Sight: look at pictures of family and friends, watch TV, go on Face Book, light a candle and watch the flame (mesmerizing). Sound: listen to music, sing, listen to nature (either real or virtual), talk to someone.
  3. Improve the moment skills: These skills include relaxation techniques like guided imagery, meditation, taking a brief vacation (a 20 minute break or a day off), finding meaning in your pain and being your own cheerleader.

It’s important to experiment with these skills before you need them. Figure out what works for you and what doesn’t. It’s often effective to try more than one thing at a time. You might take a bubble bath with candles and soothing music for example.

These skills are not intended as a way to completely avoid pain. Doing so would only exacerbate your suffering over time. Instead, the skills act as a stopgap until you are able to process and problem solve. They are a replacement for maladaptive behaviors that ultimately create more problems then they solve. If you go for a smoke, have a drink, eat junk, yell at your kids, excessively worry, ruminate about past mistakes, take your painful emotions out on others, etc. these skills are for you. The truth is even the most well adjusted among us needs these skills at one time or another.

Remember, pain is part of the human experience, but hopefully these tips can help reduce your suffering.