“The greatest weapon against stress is our ability to choose one thought over another.” – William James
Dialectical Behavior Therapy (DBT) teaches distress tolerance skills as a way to mindfully tolerate and move through uncomfortable thoughts, emotions, and sensations. Internal distress can feel overwhelming and unbearable at times, but reacting to distress by fighting or denying it only increases unnecessary suffering. It is important to remember that emotional pain is temporary and can be met with an attitude of calm mindfulness. The urge to react, rather than respond, to distress only creates additional discomfort.
Consider the way that the thoughts you experience during moments of distress can either increase or decrease suffering. While the emotional pain is not under your direct control, you have complete control over which thoughts and behaviors you will choose to respond to the emotional discomfort. Does your intuition and experience tell you that thoughts such as “this can’t happen” or “I can’t handle this” are generally unproductive and increase your subjective sense of emotional pain?
When you allow your mind to feed you negative thoughts such as these, your emotional distress will only persist that much longer. On the other hand, when you make the choice to confront your emotional pain with an attitude of acceptance, openness, and curiosity, you are taking proactive steps toward minimizing suffering. The conscious choice to change your habitual patterns of thought during times of intense distress can dramatically intensify or minimize suffering. Are you willing to try a new way of thinking in the face of emotional pain?
Dialectical Behavior Therapy: Distress Tolerance
Three types of self-soothing thoughts:
Validating thoughts are ones that are openly acknowledging and accepting your experience precisely as it is in this moment. When you are truly validating toward yourself, you are directing understanding, empathy, and compassion toward whatever it is that you are experiencing. There is no judgment, labeling, or criticism of what you may be experiencing… simply pure understanding and acceptance.
Example: “It’s okay that I am hurting right now and just want to feel better.” or “It’s understandable that I feel just as I do.”
When you adopt reassuring thoughts, you are actively reminding yourself that you are capable of tolerating the pain of this moment and that things are going to get better with time. You are remembering that no emotional pain lasts forever and that there have been times in the past when you have felt happy and at peace. Reassurance means acknowledging your pain while also reminding yourself that you can make it through to the other side.
Example: “I can handle this pain, even though I don’t like it.” or “I know that pain is temporary… this will pass.”
(3) Perspective Taking
Perspective taking means using your skills of mindfulness to step outside of complete fusion to your current experience and develop greater mindful awareness and observation. When you truly take perspective, you are looking at the big picture, rather than narrowing your attention in on the details or facts that you perceive as negative or threatening. Mindfully shift out of the thoughts that are fueling the emotional distress by reminding yourself that you have gotten through emotional pain and discomfort in the past. Put things in perspective by remembering that this is one moment in time out of many.
Example: “I’ve felt this way before; I can handle this.” or “The bad feeling didn’t last forever in the past; it will pass this time too.”
Use the power of self-soothing thoughts to tolerate distress more effectively in the future. Try to avoid falling into the trap of buying into the story that you “can’t cope” or that “things will always be this way.” Recognize that we all experience pain in life at various moments. You have a choice about how you wish to relate to that pain and whether or not you will allow it to cause you unnecessary extended suffering.
Begin to accept that you are experiencing emotional distress in this moment. Acknowledge your experience, but then take a step out of it and see it for what it is: a temporary experience. Know that you can tolerate distress with greater mindfulness in the future by actively replacing thoughts that increase suffering with those that soothe and alleviate suffering.
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Marra, T. (2004). Depressed & anxious: The dialectical behavior therapy workbook for overcoming depression and anxiety. Oakland, CA: New Harbinger Publications, Inc.
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