In Dialectical Behavior Therapy (DBT), managing distress is a key skill for handling difficult emotions without making the situation worse. DBT uses a set of tools and techniques called Distress Tolerance Skills that help you navigate high-stress moments, especially when you’re feeling overwhelmed and immediate relief is needed. Below are some core DBT techniques for managing distress, with practical tips for when life gets tough.
1. TIP Skills: Change your physical state quickly
The TIP skills are quick techniques designed to bring immediate relief by directly changing your body’s stress response.
- T – Temperature: Splash cold water on your face or hold an ice pack against your cheeks. The sudden change in temperature can activate the “dive response,” which helps lower heart rate and creates a calming effect.
- I – Intense Exercise: When stress is high, a burst of physical activity (even 20–30 jumping jacks or a brisk walk) can help reduce the intensity of the emotion by releasing physical tension.
- P – Paced Breathing and Paired Muscle Relaxation: Slow, deep breathing (e.g., inhale for 4 counts, exhale for 6) combined with progressively relaxing your muscles can shift your body from a state of high stress to relaxation.
2. Self-soothing with the five senses
Using your senses to ground yourself in the present moment can help you stay anchored and calm when you’re feeling overwhelmed.
- Sight: Look at something calming or visually pleasing, like a picture of nature or a favorite painting.
- Sound: Listen to soothing music or nature sounds. Even a short playlist of your favorite songs can help shift your mood.
- Smell: Try aromatherapy with a scent that relaxes you, like lavender or chamomile, or simply take deep breaths of a comforting scent.
- Taste: Savor something pleasant, like a piece of chocolate or a warm drink. Focus on each sip or bite to bring yourself back to the present.
- Touch: Hold a soft object, like a blanket or stress ball, or focus on the feel of warm water on your hands.
3. Distract with ACCEPTS: shift your focus
The ACCEPTS skill is a go-to list of distraction techniques that allow you to step away from distressing thoughts or situations momentarily.
- A – Activities: Engage in a hobby, start a task, or try something new. Doing something active, even simple chores, can help refocus your mind.
- C – Contributing: Helping someone else, even in a small way, like texting a friend or lending a hand, can provide a mental break from your own stress.
- C – Comparisons: Shift perspective by recalling past challenges you’ve overcome, or thinking of others who’ve faced similar challenges.
- E – Emotions: Create a contrasting emotion by watching a funny video, reading a light-hearted story, or listening to upbeat music.
- P – Pushing Away: Mentally “set aside” the distressing thought temporarily, with the intention of returning to it later. This pause can make the issue feel less immediate.
- T – Thoughts: Distract yourself with mental activities like solving a puzzle, reading, or counting backward by threes.
- S – Sensations: Use intense physical sensations, like holding an ice cube or taking a hot shower, to bring your focus back to the present moment.
4. Radical acceptance: embrace reality as it is
Radical acceptance means fully accepting reality without fighting or denying it. This doesn’t mean you agree with or approve of the situation, but it helps stop the emotional pain from escalating into suffering.
How to Practice: When faced with something you can’t change, say to yourself, “It is what it is” or “This is happening right now.” Breathe deeply and practice relaxing your body as you repeat phrases that help you accept the situation. By letting go of resistance, you save energy and focus for what you can control.
5. IMPROVE the moment: shift your perspective
IMPROVE skills are tools to help reframe your mindset in times of stress, allowing you to shift from distress to hopefulness.
- I – Imagery: Visualize a calming place or a positive outcome. Imagine yourself in a relaxing environment, or think of a comforting memory.
- M – Meaning: Find purpose in the struggle. Reflect on how this challenge might help you grow or what lesson it could teach.
- P – Prayer or Meditation: If it resonates, take a moment to meditate, pray, or find inner peace through stillness.
- R – Relaxation: Engage in deep breathing, progressive muscle relaxation, or another relaxation technique to calm your body.
- O – One thing in the moment: Focus fully on what you’re doing right now, whether it’s washing dishes or taking a walk, without allowing your mind to drift.
- V – Vacation: Take a mental break for a few minutes by visualizing a different setting or imagining yourself on a “mini-vacation.”
- E – Encouragement: Give yourself positive affirmations or words of encouragement, like “I can handle this,” or “I’ve been through challenges before.”
Final Thoughts
Handling distress is about finding practical ways to cope without escalating or avoiding emotions. The techniques from DBT can help you build resilience, making it easier to face life’s difficult moments without feeling overwhelmed. Incorporating these skills regularly can help you better manage and understand your emotions, creating a more balanced and positive approach to life’s challenges. Remember, each small step builds greater emotional strength for the future.