Joye Anestis commented on 'It's just too much for me: The role of distress tolerance in problematic behaviors'

2009-03-24T18:27:28Z

I have 2 other really good book recommendations to add to Mike's comment above. Thich Nhat Hanhn's book "The Miracle of Mindfulness" is a classic text on the practice of mindfulness. Also, "The Dialectical Behavior Therapy Skills Workbook" by McKay, Wood, & Brantley condenses DBT skills into a nice self-help manual. But it's important to note that we do not have evidence as of yet to indicate that self-help versions of this therapy are effective...we only know that DBT administered by a psychotherapist is greatly effective.

Mike Anestis commented on 'It's just too much for me: The role of distress tolerance in problematic behaviors'

2009-03-24T17:01:05Z

Thanks, Alicia!

If somebody believes she has low distress tolerance, but can not address this with a therapist, I would suggest a few things. First, I'd recommend buying the book "Radical Acceptance," by Tara Brach or the skills training manual for DBT, both of which are described and available in our online store (link on the main page). I would also suggest reading about and practicing mindfulness. Urban Mindfulness (www.urbanmindfulness.com) is a great blog about mindfulness for folks who want to read more about it and consider working that into their lives.

In terms of just straight forward distress tolerance skills, I would borrow from the DBT skills manual and suggest a few things:

- Try to distract yourself with something happy or neutral for 10-30 minutes (e.g., an episode of a TV comedy). Do NOT listen to upsetting music during this time! Emotions, even at their worst, are temporary states and, if we don't prolong them ourselves through rumination, etc..., they will fade. Distracting yourself will help you get to a state of mind in which you're better able to problem solve
- Try to let go of visions of how things SHOULD be and accept how they actually are. This doesn't mean you have to like the situation. It simply means that you have to deal with the hand you're dealt and try to find an outcome that works for you. After all, life is rarely perfect and yet, quite often, we manage to be very content - there must be room for compromise, right?
- If none of this is working, I suggest trying to distract yourself using healthy physical sensations. Some people suggest holding a few pieces of ice in your hand and concentrating only on the physical sensation. I suggest a milder approach - take a hot (but not scalding) shower. Focus on how the water feels, what the temperature is like, how the water drips onto the ground, etc...Try to mindfully focus only on these sensations and neutral stimuli for as long as you can until your emotion has calmed down enough to enable you to think through the problem.
- Try to view things in small, clearly defined ways. Rather than thinking about how bad everything is, identify what specifically happened, what is problematic about it, and what needs to be done to take one step towards improvement. The idea is, you don't have to solve it all at once. In this moment, you just have to survive this moment. In the next moment, you will survive the next one. Not everything can or should be done all at once - when we try, it all starts to feel vague and daunting. Wait until you are calmer to take on a larger share of the problem.

Alicia commented on 'It's just too much for me: The role of distress tolerance in problematic behaviors'

2009-03-24T16:29:41Z

Hey, great post Mike! I'm looking forward to the future posts about dialectical behavior therapy.

Right now I'm interested in what - if any - ways are out there for folks with cope with low distress tolerance outside a doctor's office? What would you say to someone who says to you, "I'm pretty sure I have a low distress tolerance. What can I do right now?"

Comments on It's just too much for me: The role of distress tolerance in problematic behaviors

Joye Anestis commented on 'It's just too much for me: The role of distress tolerance in problematic behaviors'

Mike Anestis commented on 'It's just too much for me: The role of distress tolerance in problematic behaviors'

Alicia commented on 'It's just too much for me: The role of distress tolerance in problematic behaviors'