Distress Tolerance Handouts 1

  • 1. Goals of Distress Tolerance (P. 321):
  • a. Survive Crisis Situations:
  • without making them worse.
  • b. Accept Reality:
  • replace suffering and being “stuck” with ordinary pain and the possibility of moving forward.
  • c. Become Free:
  • of having to satisfy the demands of your own desires, urges, and intense emotions.
  • 2. Overview: Crisis Survival Skills (P. 325):
  • These are skills for tolerating painful events, urges and emotions when you cannot make things better right away:
  • a. The STOP Skill
  • b. Pros and Cons
  • c. TIP your body chemistry
  • d. Distract with Wise Mind ACCEPTS
  • e. Self-soothe with the five senses
  • f. IMPROVE the moment
  • 3. When to Use Crisis Survival Skills (P. 326):
  • a. You are in a crisis when the situation is:
  • highly stressful
  • short-term (i.e. it won’t last for a long time)
  • creates intense pressure to resolve the crisis now
  • b. Use crisis survival skills when:
  • you have intense pain that cannot be helped quickly
  • you want to act on your emotions, but it will only make things worse
  • emotion mind threatens to overwhelm you, and you need to stay skillful
  • you are overwhelmed, yet demands must be met
  • arousal is extreme, but problems can not be resolved immediately
  • c. Don’t use crisis survival skills for:
  • everyday problems
  • solving all of your life problems
  • making your life worth living
  • 4. STOP Skill (P. 327):
  • a. Stop:
  • don’t just react. Stop! Freeze! Do not move a muscle!
  • your emotions may try to make you act without thinking.
  • stay in control!
  • b. Take a step back:
  • take a step back from the situation
  • take a break
  • let go
  • take a deep breath
  • do not let your feelings make you act impulsively
  • c. Observe:
  • notice what is going on inside and outside of you?
  • what is the situation?
  • what are your thoughts and feelings?
  • what are others saying or doing?
  • d. Proceed mindfully:
  • act with awareness
  • in deciding what to do, consider your thoughts and feelings, the situation, and other people’s thoughts and feelings
  • think about your goals
  • ask Wise Mind
  • which actions will make it better or worse?
  • 5. Pros and Cons (P. 328):
  • Use pros and cons any time you have to decide between two courses of action.
  • An urge is a crisis when it is very strong and when acting on the urge will make things worse in the long term.
  • Make a list of the pros and cons of acting on your crisis urges. These might be to engage in dangerous, addictive, or harmful behaviors,
  • or they might be to give in, give up, or avoid doing what is necessary to build a life you want to live.
  • Make another list of the pros and cons of resisting crisis urges – i.e. tolerating the distress and not giving in to the urges.
  • Evaluate both sets of pros and cons
  • a. Pros of acting on crisis urges
  • b. Cons of acting on crisis urges
  • c. Pros of resisting crisis urges
  • d. Cons of resisting crisis urges
  • Before an overwhelming crisis urge hits:
  • a. Write out your pros and cons; carry them with you
  • b. Rehearse your pros and cons over and over
  • When an overwhelming crisis urge hits:
  • a. Review your pros and cons. Get out your list and read it over again
  • i. imagine the positive consequences of resisting the urge
  • ii. think of the negative consequences of giving in to crisis behaviors
  • iii. remember past consequences when you have acted on crisis urges
  • Example: Noisy neighbors
  • play/park onto our side of the driveway
  • loud car music with bass
  • loud noises/thumping sounds that carries over to our side
  • Urge: walk over and ask them to correct their behavior
  • If I walk over:
  • Pros:
  • they may stop their annoying behaviors
  • I will feel much better right away!
  • Cons:
  • they may get worse
  • they may periodically and intentionally be loud
  • they may cause more new problems
  • I’ll feel like I’m not so resilient to noises