Core Distress Tolerance Skills
In the previous lesson we touched upon skills that we already use in our everyday lives when we are in difficult situations, in this lesson we look more into healthy coping skills.
There are three groups of skills taught in distress tolerance:
- Crisis survival skills
- Reality acceptance skills
- Skills for addiction
CRISIS SURVIVAL SKILLS
There are six sets of crisis survival strategies, which should be used in conjunction with the other problem-solving skills we learn in therapy.
- STOP – a mnemonic for Stop, Take a step back, Observe and Proceed mindfully
- TIP – a mnemonic for Temperature, Intense exercise, Paced breather and Paired muscle relaxation
- Pros and Cons – thining through the consequences, both negative and positive, of taking impulsive action in the moment
- Self-Soothing – using the five senses (vision, hearing, smell, taste and touch) to comfort, nurture and soothe
- ACCEPTS – a mnemonic for Activities, Contributing,
Comparisons, Emotions opposite to the current
negative emotion, Pushing away from the situation,
Thoughts, and Sensations.
- Improving the Moment – IMPROVE is a mnemonic for Imagery, Meaning, Prayer, Relaxing actions, One thing in the moment,
Vacation, and Encouragement.
REALITY ACCEPTANCE SKILLS
- Radical acceptance – accepting the facts of the reality without judging or approving
- Turning the mind – choosing to accept reality without approval, and turning the mind towards choosing
- Willingness not wilfulness – wilfulness is responding to individual needs (being right) whereas willingness involves being effective and responding to the situation in terms of what the situation needs
- Half-smiling and willing hands – these are skills that we can use alongside others by using the body to help us accept reality, such as relaxing facial muscles, or clenched and unclenched fists
- Mindfulness of current thoughts – this skill helps you to differentiation between thoughts and facts
SKILLS FOR ADDICTION
- Dialectical abstinence – helping you learn how to cope when their is a lapse in addictive behaviour
- Clear mind – a middlle ground between being abstinent and having addictive behaviour, a clear mind allows you to remain abstinent while acknowledging relapse is possible
- Community reinforcement – focusing on using the community to reward abstinence
- Burning bridges and building new ones – burning bridges refers to actively removing triggers for your addiction, while building new coping skills to compete with addictive urges
- Alternate rebellion and adaptive denials – where your addiction is a rebellion, alternate rebellion finds ways to rebel that are safer but still expressive. Adaptive denial is when you work to shut out the urges for addiction, rather than denying this behaviour is possible