BY VAALPARK MHU | June 16, 2021

Blog By

Dr Melané van Zyl
Psychiatrist

In the previous article we looked at Mindfulness, the first component of Dialectical Behavioural Therapy (DBT). Distress tolerance is the second module, and it means DBT gives us skills us to cope better in painful or distressing moments in effective ways, without making things worse. It is important to learn how to cope in times we feel upset or distressed. It is not always possible to avoid pain and distress, it is in fact part of life. We also cannot change ourselves if we do not first accept or acknowledge that we are in pain.

Distress tolerance is different from Emotional regulation, the third DBT module. Distress tolerance means we cope better in a difficult situation, where Emotional regulation means we can control or influence our emotions.

Distress tolerance flows naturally from mindfulness and is also an acceptance skill. The aim is to accept ourselves and the situation as it is, without wanting to change it. This does not mean that we approve of reality e.g.it is not ok to be in an abusive relationship.

5 Dialectical Behaviour Tharapy (DBT) distress tolerance skills to try:

  • The STOP skill

The STOP skill can stop us from doing something impulsive. The STOP skill means:

Stop

Take a step back

Observe

Proceed mindfully

  • Self-soothing

This strategy focusses on the five senses. Find smells, sounds, tastes, something to look at or to touch that feel comforting and nurturing. A cool idea is to make yourself a self-soothing box. Put in things that you like and will stimulate your senses.

  • Living in the present moment

Back to mindfulness. Remember whatever is happening- this is just a passing moment.

  • Focussing on pros and cons

Look at the pros and cons of behaving like you feel you want to behave now, what will the short- and long-term consequences be? Is it worth it?

  • Radical acceptance

Radical acceptance is an extremely powerful concept. I have tried it several times with patients in individual sessions, and it can be life changing.

To radically accept something means to accept all the way, with your mind, heart, and body. This does not mean we allow bad things to happen to us e.g., being abused. But radical acceptance is the first step to change ourselves in such a way that we can move forward, however bad the situation is.

Dr Melane Van Zyl

Read our next article on Emotional Regulation

Interesting Read;

Stop Walking on Egg Shells

Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder: Mason MS, Paul T. T., Kreger, Randi: 9781684036899: Amazon.com: Books

Do you feel manipulated, controlled, or lied to? Are you the focus of intense, violent, and irrational rages? Do you feel you are ‘walking on eggshells’ to avoid the next confrontation?

If the answer is ‘yes,’ someone you care about may have borderline personality disorder (BPD). Stop Walking on Eggshells has already helped nearly half a million people with friends and family members suffering from BPD understand this destructive disorder, set boundaries, and help their loved ones stop relying on dangerous BPD behaviors. This fully revised edition has been updated with the very latest BPD research and includes coping and communication skills you can use to stabilize your relationship with the BPD sufferer in your life.

This compassionate guide will enable you to:

Make sense out of the chaos
Stand up for yourself and assert your needs
Defuse arguments and conflicts
Protect yourself and others from violent behavior