470 - Distress Tolerance

Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs

Podcast Host: Counselor Toolbox & Happiness isn’t Brain Surgery with Doc Snipes

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Objectives

~ Define goals of distress tolerance

~ Discuss why some clients do not choose distress tolerance

~ Explore a variety of Distress Tolerance and Reality Acceptance Skills including

~ STOP

~ Pros and Cons

~ TIP

~ ACCEPTS

~ Self Soothing

~ IMPROVE the Moment

~ Radical Acceptance

~ Turning the Mind

Objectives

Goals of Distress Tolerance

~ The goal of distress tolerance is to accept, find meaning for and tolerate distress

~ Pain and distress are part of life. Refusing to accept this leads to suffering

~ Any attempts at change will produce distress, therefore distress tolerance skills are necessary

Change causes crisis and crisis causes change

Distress Tolerance

~ Distress tolerance is a natural progression from mindfulness

~ Accepting, nonjudgmentally, oneself and the situation

~ Not trying to change the situation, your feelings, thoughts or urges

~ Distress tolerance means surviving crises, accepting life as it is in the moment.

Tolerance and acceptance of reality do not equate with approval

Proving How Bad It Is

~ Sometimes people so want others to understand how bad it is they focus on that instead of surviving the situation

~ Short Term Gains (Look what you made me do)

~ Controlling another’s behavior

~ Going to the hospital and getting attention/break

~ Long Term Benefits

~ ??

~ Have clients remember a time they acted out to try to get someone to see how bad it was. What were the results?

Distress Intolerance Thoughts

~ I can’t stand this

~ It’s unbearable

~ I hate this feeling

~ I must stop this feeling

~ I must get rid of it

~ Take it away

~ I can’t cope with this feeling

~ I will lose control

~ I’ll go crazy

~ This feeling will keep going on forever

~ It is wrong to feel this way

~ It’s stupid and unacceptable

~ It’s weak

~ It’s bad

~ It’s dangerous

Avoidance Behaviors

Urge Surfing

~ Urges are generally intense for 20-30 minutes

~ Every time you have an urge think, I have a choice!

~ Surf the urge by opening yourself up to the urge. This doesn't mean that you consume yourself in it (which feels horrible) or fight it and push it away. What you do is experience the feeling of the urge with acceptance, non-judgement, and be sensitively aware that it is there.

STOP Skills

~ Stop

~ Take a step back

~ Observe

~ Proceed Mindfully

Pros and Cons

~ What are the benefits to acting on impulsive urges?

~ What are the drawbacks to acting on impulsive urges?

~ What are the benefits to __[insert the skill] __

~ What are the drawbacks to __[insert the skill] __

TIP Skills

~ Temperature

~ Intense Exercise

~ Paced Breathing

~ Paired Muscle Relaxation

~ The act of muscle relaxation is paired with a verbal cue

~ What reactions do you have that are paired with verbal cues?

Distract with Wise Mind ACCEPTS

~ Activities (pleasant)

~ Contributing

~ Comparisons

~ Emotions (opposite)

~ Pushing Away

~ Think about something totally different

~ 4 3 2 1

~ What did you used to do on long car trips?

Self-Soothing

~ Body Scan Meditation

~ Self-Soothing Using the 5 Senses

~ Sight

~ Smell

~ Hearing

~ Touch

~ Taste

IMPROVE the Moment

~ Imagery

~ Safe place

~ Successfully dealing with this

~ A force field

~ A coach/fairy godmother/angel

~ Feelings and thoughts are clouds in the sky

~ An unstoppable train

~ Meaning

~ Changing how you think about yourself and your situation

~ Make lemonade. Find the silver lining.

~ Prayer

~ Relaxation

IMPROVE the Moment

~ One thing in the Moment

~ Focus on one thing you are doing right now