DBT Self Help

Week 50: No More Distress

This week we are going to put into practice all that we have learned about distress tolerance because when you have BPD a small situation can quickly spiral into a big one because you often can’t think clearly and react in a proportionate way. While it is easy for anyone to get stuck in a thought pattern for those of you with BPD it is especially problematic as you have heightened emotions backing up your clouded thinking. But there are still things you can do to help break this cycle of impulsive or self-harming behaviour…

Week 50: No More Distress

If there is one thing I hate it is suggestions for distress tolerance that don’t relate to the real world situation we all so often find ourselves in. Things like “have a bath with plenty of bubbles” or “do some exercises for 30 minutes to clear your mind”. Sure, those do work, but when a difficult situation arises finding time to have a bath or go for a run is not always possible. So that is why I have always taught you more practical skills like wearing a rubber band on your wrist or keeping bubble paper in your pocket.

The truth is distress tolerance is not as black or white as you might think. It is not necessarily something that will help you avoid a crisis or highly stressful situation, but it will help you to work out if it is indeed a crisis or just your brain overthinking. So no, it won’t help you if you see an asteroid heading for Earth, but when you are having an argument with a loved one utilising your distress tolerance skills will help you to think clearer and not over-react in a way that you might regret later.

With BPD the emotional mind is often the one that does the most thinking, so in these stressful times, you should be implementing the TIP skill. But let’s do this in a practical way that you can do anywhere and at any time.

T – Stands for Tipping and it is the act of touching your face or wrists with very cold water. Unless you have a tap nearby this is not something you can do obviously, but what you can do is carry something that feels cold, but isn’t. A small ice-pack is best and you can carry a small fridge stick with you at all times, but even better than that (and smaller) is HypaCool instant ice packs. These small packets have two chemicals inside that when mixed together create an instant ice pack. You can break this in your pocket and even hide it in your sleeve to bab your face with it.

I – Stands for intense exercise which you simply can’t do in the spur of the moment. But what you can do is to do a quick, hard snap of a rubber band on your wrist or pinching your wrist. This will get your adrenaline pumping and do much the same thing as exercise does, only without the calorie-burning. But it works and it works quick. Just snap it quickly and deliberately hard so you can get that much-needed boost of clear thinking. Just don’t overuse this technique and don’t snap the rubber band to the point that it causes you physical damage. You just want that buzz on your skin to help ground yourself.

P – Stands for paced and it is the act of doing deep breathing exercises. You can indeed do some deep breathing and not look as if you are doing it, just go in through the nose and out through the mouth, but try and hold each breath inside of you for a little while. You don’t have to overreact to the point that it looks like you are meditating standing up, you just need to slow down your breathing a little and you can practice this at any time.

While there are many other distress tolerance skills with DBT the TIP skill set is the best one for on the spot situations and when you have BPD those are the situations you need to tackle the most. Remember, don’t just think about using this skill one time, use it daily, use it often so when you need it the most it is already ingrained in your mind. Once again there is no more homework, not more teachings, it’s time to put these skills into practice and get control of your life again. So do give them a go and let me know how you get on with them in the comments below.

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