Nora Josephson, LPC AMFT: Distress Tolerance Skills

Nora Josephson returns! This time she's diving deep into the distress tolerance skills. If you'd like to read about what the Distress Tolerance Skills are--they're added below!
Distress tolerance skills in Dialectical Behavior Therapy (DBT) are strategies to help individuals manage and cope with intense emotions and difficult situations without resorting to harmful behaviors. These skills are designed to help people tolerate and survive crises and to accept life as it is in the moment. Here are some key distress tolerance skills used in DBT:
1. TIPP Skills: These skills are used to quickly change your body chemistry when emotions are running high.
- Temperature: Use cold water or ice packs to quickly reduce emotional arousal.
- Intense exercise: Engage in vigorous physical activity to expend energy and reduce stress.
- Paced breathing: Slow down your breathing to calm your mind.
- Paired muscle relaxation: Tense and then relax different muscle groups to relieve physical tension.
2. Distracting with ACCEPTS: These skills help take your mind off distressing thoughts and feelings.
- Activities: Engage in hobbies, exercise, or other activities you enjoy.
- Contributing: Do something nice for someone else, volunteer, or help out.
- Comparisons: Compare yourself to people coping the same or worse to gain perspective.
- Emotions: Create different emotions by watching a funny movie, listening to music, etc.
- Pushing away: Mentally leave the situation for a while.
- Thoughts: Focus on different thoughts, like counting or puzzles.
- Sensations: Use sensory experiences, such as holding an ice cube, to shift focus.
3. Self-Soothe with the Senses: Use your five senses to calm and comfort yourself.
- Vision: Look at beautiful scenery, art, or photos.
- Hearing: Listen to soothing or uplifting music, nature sounds.
- Smell: Use pleasant scents like essential oils or fresh flowers.
- Taste: Enjoy a favorite treat or drink.
- Touch: Wrap yourself in a soft blanket, take a warm bath, or pet an animal.
4. IMPROVE the Moment: Use mental strategies to make a difficult situation more bearable.
- Imagery: Visualize a peaceful place or situation.
- Meaning: Find or create meaning in the situation.
- Prayer: Use prayer, meditation, or other spiritual practices.
- Relaxation: Practice relaxation techniques like deep breathing or yoga.
- One thing in the moment: Focus entirely on one task or activity.
- Vacation: Take a brief break from the situation, if possible.
- Encouragement: Give yourself positive affirmations and encouragement.
5. Radical Acceptance: Accepting reality as it is, without judgment, to reduce suffering.
- Understand that fighting against reality can lead to more pain.
- Acknowledge and accept the present moment, even if it’s difficult.
These skills are part of DBT's approach to help individuals handle distressing situations without resorting to harmful or self-destructive behaviors.