Hi, folks, I'm here today to go over with you an intro to the distress tolerance skills module.
There's a few different goals of distress tolerance.
The first and arguably the most important one is to survive crisis situations without making them worse. So this is when we can immediately change a situation or we can't sort out our feelings enough to know what our goals are in the situation. But we know that doing certain things is likely might feel good in the moment, but going to cause bigger problems in the long run.
Another big goal here is to accept reality. That means reality just means life as it actually is. So the idea here is that the only way out of suffering is with acceptance.
And so I'm going to just sort of walk you through. So we conceptualize this as all humans experience pain, this might be pain of intense negative emotions, this might be things that are difficult to overcome, or where we experience struggle.
But when we have that pain, and we don't accept life, as it actually is, this is when we're most likely to experience suffering. And suffering is just a whole heck of a lot worse. Now, the idea is when you experience sort of the ordinary pain that we all experience as humans, and you accept reality as it is, there's still the pain that doesn't disappear.
However, along with that pain, is the ability to move forward to problem solve, and sort of connect with your values.
Finally, the last big goal of this module is freedom. This is the idea that you can feel at peace and content with yourself and with your life. No matter what the circumstances are.
These skills are here specifically to help you cope with these really intense desires, urges or emotions that we can have, and quiet those down so that it makes room for you to have choices and how you respond to a situation.
You may also have other goals that you could consider writing down on your own sheet. So another thing that I want to sort of run over is essentially, a roadmap for what the upcoming skills will look like.
The distress tolerance module is split into two sections, crisis, survival skills, and reality acceptance skills. So we're going to be focusing right now on crisis survival skills. The first one would be is the stop skill is specifically designed to help you stop impulsive behaviors. pros and cons are, help you to connect with longer term values and goals that you might have over sort of immediate desires to respond in a certain way.
The TIPP skills are helpful to actually change your body chemistry and decrease arousal levels so that you're better able to problem solve and apply other skills. And then distractions, self soothe and improve the moment all help sort of change the environment. And or change where you're directing your attention, to let arousal come down to a level where you can be more effective in a situation.
Now, we're going to go into when and how to use some of these skills. So first of all, it's really, really important to note that there's a dialectic here with regards to these skills. So they can be both helpful and unhelpful. The problem is when people apply them to situations that aren't crisis relator related situations that are every day, or situations that make someone feel uncomfortable, but that discomfort is actually important in some way. Then people are venturing into the land of avoidance, which generally does not help with anything, except in these very short term situations to help you decrease your your, the intensity of emotions, urges or desires enough to be effective.
So let's walk through what is a crisis.
First of all, so crisis is any situation which is highly stressful that has the high potential for negative outcomes. So if you are using certain substances, and you have the goal to stop using those Things like alcohol, or other types of drugs. And you are really, really panic, just one thing after another has gone wrong this day, and you have the urge to go to the liquor store, or to call up your dealer. This is a situation in which chances are the consequences to those behaviors might be pretty big.
The other important thing is that the situation is short term. So if this is a situation, perhaps an argument that comes up every single day with your partner or your kids, something that's happening over and over again at work, chances are, this is not the appropriate skill set, you might need to use it very briefly to help bring your arousal down enough to respond and use other skills.
But if you're using just these skills, things are not going to get better. 'And in fact, they might just be building an intensity over time.
The last sort of way that you know, that you're in a crisis, is if there's really intense pressure to resolve the crisis right now. So for example, this tends to go in two different ways, either, because arousal is so high that you're likely to use some type of destructive behavior, drugs, suicide, self injury, lashing out at loved ones, quitting a job, whatever. And that has the potential to really derail your life. Or if there are serious consequences for you not meeting a demand.
So things like if you're feeling really overwhelmed at work, or at school, or even with stuff around your own household, and you just shut down and don't do any of the things that you were supposed to do. Chances are that there might be serious consequences for not doing those things. So when do we use crisis survival skills, I'm going to give examples of some of these some of these I feel like might be more self explanatory.
So first of all, if you have intense pain that can't be helped quickly. So if for example, to use physical pain, instead of emotional pain for once, you just had a C section, and you are maybe having urges to overuse some of your pain medication, or having urges to just shut down and sleep the day away, not in a way that's healthy and balanced. But where you're disconnecting from your baby, your loved ones, you're not taking care of yourself, then these skills might be able to help you bring down the level of physical pain that you're having enough to tolerate the situation that you're in.
Next situation is if you find that you are having really strong urge to act on your emotions, but you know that it's only going to make the situation worse. And Haven't we all, every single one of us acted in a way which has made our lives worse in crisis situations in the past, so you are not alone.
The next one emotion mind threatens to overwhelm you, and you need to stay skilful. So let's say for example, that you are at home with a partner or a family member, and your kiddo. so in this situation, perhaps everyone's sleep deprived, your kiddo is melting down, maybe they're a newborn that is screaming and colicky during that sort of witching hour in the evening. Maybe they're a toddler going through a developmental change. And nobody is in a good mood, right?
You need to say skillful to be able to respond to your kid. But you might have the urge, you might be feeling really intense anger, frustration, your urge to lash out at your partner to lash out at your kids in a way that you know is only going to derail the situation.
Number four, you're overwhelmed and yet demands must be met. So, in this situation, I want you to think about a time perhaps when things at home have just piled up right? There's not a clean dish in the house, you haven't gone grocery shopping, bottles are piled up on the counter. And you look around your house and are just feeling completely overwhelmed. But you also know that your baby is about to wake up and you are going to have to meet their needs in terms of feeding holding clothing them. And this situation. If you were to just give up and go sit on the couch because you're overwhelmed. Chances are the situation is only going to get worse.
Finally, thinking about situations where your arousal you're sort of internal emotional level fight or flight, etc, is really elevated, and yet you can't solve problems immediately. So many of us have had the experience of leaving a social situation and afterwards realizing that someone could have, that's something that we said could have been easily misconstrued and feeling a lot of anxiety about that, or leaving work and realizing that you just made a huge mistake.
And so, in some of these situations, we maybe can't get ahold of the other person right away, or we can't easily just go into work and fix it, it's gonna have to wait until the next day. And so and leave situations at these types of skills will help us put those problems on the shelf until we actually can attend to them. S
Last, but not least, do not use crisis survival skills for everyday problems, solving life problems, making your life worth living, or any other long term problem that is showing up, okay, it will not work.
Now, how do you know that these skills are working?
The biggest point is, you haven't done anything to make the situation worse. If you have achieved that you have done it, congratulations, you are being skillful.
Additionally, maybe you feel better able to tolerate the distress and do something differently. You could for example, rate how able you feel to tolerate that a stress from zero not at all can't handle it to 100. Like, who this is painful, but yeah, I thought it.
Finally, this one's just a maybe if you find that you're just feeling better, you're feeling less intense emotions, and so forth.
These skills are not emotion regulation skills. They are not designed to help you feel better, but that is often an after effect of them.