Improve Your Life with DBT: Crisis Survival Skills

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. The following Crisis Survival Skills help you get through these situations.



You’re lying in bed about to fall asleep when you suddenly remember you forgot to make your car payment. Your body tenses as you worry where you will get the money for your mortgage next week. Maybe if you take a cash advance on your credit card, but then the interest will be outrageous. How will you ever send your kids to college? Or retire?  Now you’re awake with little hope of getting back to sleep.


Today I've been thinking about the concept of Radical Acceptance mostly because I'm having a difficult time with it right now.  I have a medical condition that causes a great deal of pain, has no known cause, and treatment options that don't work well.  So my doctor can neither help me prevent the symptoms or effectively treat the pain.  Now I realize that many people are dealing with far worse situations.  This is not a life-threatening  problem or even a major life changing problem, but its really uncomfortable and unlikely to end.  

So I have two choices.  I can get really upset and wallow in the pain, tell myself that it's unfair, why did this have to happen to me, etc.  Or I can figure out a way to accept it.  This has been going on for months, and for months I've been going with plan A.  I've been whining, complaining, getting worked-up and spending hours on-line trying to find a website or a blogger or someone who can tell the opposite of what my doctors have said over and over again.  There is no known way to prevent or treat this condition.  Plan A is not working.  It's only making my feel worse when I'm trying to find a way to feel better.



Moving on to Plan B, Radical Acceptance.  Radical Acceptance  occurs when we accept what we cannot change without fighting it, without judging it and without trying to control the experience.  Keep in mind that accepting a situation is much different than approving of it.  You do not have to like something to radically accept it.  In addition, radical acceptance does not mean accepting everything without questions.  It means accepting what cannot be changed, and being open to making the changes that are possible and necessary.


Usually, when we perceive pain, whether physical or emotional, we tense up our muscles turning them into an armor against the enemy pain. Next, our minds start to spin wondering why this pain is happening and how can I stop it...now.  These instinctive actions were necessary when we where hunters and gatherers and the enemy was a wild animal bent on killing.  Our world has evolved past that threat, but our minds and bodies have not.  The problem is when we tense-up and try to think our way out of pain, the pain doesn't go away it intensifies.



When we radically accept pain, we open ourselves up to the experience.  We relax our bodies, slow our breathing and experience each moment as it unfolds.  We stop trying to figure out what we did wrong to bring on the pain.  Instead, we tell ourselves it won't last forever, and it won't destroy us.


We all have to accept pain at some point in our lives.  Whether you are waiting for an OTC medication to kick in to quell a migraine or you are fuming with anger after an argument or you have a chronic condition that you must tolerate on a daily basis practicing radical acceptance can help.  I am not suggesting that it is a miracle cure, but it will decrease your suffering.


Start today.  What do you need to radically accept?

Facts About Adolescent Suicide

“A child born today will live to be about 80 years old, on average. But the challenge is getting them through 16, 17, 18, 19 – the most hazardous time of their lives. A kid with a car, a kid with a gun, a kid with a bottle – any one of these combinations is much more of a risk than a terror attack or a flu from [overseas].”Timothy Egan, NY Times, 6/09/14 OpEd, P. A15

FACTS ABOUT ADOLESCENT SUICIDE Annually: - 19% of high school students seriously consider suicide (1 in 5). - 8.8% attempt suicide. This adds up to 1 million teens, of whom 700,000 require medical attention. - Up to 11% of teen suicide attempters will eventually die by suicide. (Diekstra, 1989; Shaffer et at., 1988) - In a typical US high school classroom, two girls and one boy will make a suicide attempt this year. - Between 31-50% of all adolescent suicide attempters re-attempts suicide (Shaffer & Piacentini, 1994) - 27% (males) and 21% (females) of adolescent suicide attempters re-attempt within 3 months of their first attempt (Lewinsohn et al., 1996). - The risk of suicide increases significantly as an adolescent accumulates more problem behaviors (violent behavior, substance use/abuse, self-injury, risky sex, etc.)

WHAT IS THE ANSWER? Dialectical Behavioral Therapy (DBT) is designed to treat patients who are struggling with multiple problem behaviors that make them at high risk for suicide.

In initial studies DBT with Adolescents is more effective than treatment as usual at the following: - Decreasing inpatient hospitalizations - Increasing treatment retention (many teens drop out in the early stages of most other treatment programs). - Reducing suicidal ideation, depression, anger, anxiety and emotional sensitivity - Reducing symptoms common in a borderline personality disorder (confusion about self, interpersonal chaos, emotional dysregulation, impulsivity). Rathus & Miller, 2002