Distress is defined in the dictionary as great pain, anxiety, or sorrow, acute physical or mental suffering, affliction, or trouble. Everyone has to cope with distress and pain at some point in life. Suffering can be either mental or physical and can often be unavoidable. Most of the time, distress is unpredictable. For those people who feel emotions more intensely and more frequently, distress can come on more quickly and feel quite overwhelming.
Overwhelming emotions are often times dealt with in unhealthy and unsuccessful ways because no alternatives are known. Many times, when a person is in such emotional pain, it is difficult to be rational or think of positive solutions. Some examples of common coping strategies are:
- spending great deal of time thinking about past pains, mistakes, and problems
- getting anxious worrying about possible future pains, mistakes, and problems
- using drugs or alcohol to numb out feelings
- engaging in dangerous behaviors such as cutting, hitting, or burning self
- engaging in unsafe sexual activities
- avoiding dealing with the causes of issues or problems
- taking negative feelings out on others in excessive or controlling ways
- surrendering to pain and resign self to living a miserable and unfulfilling life
Negative coping strategies may offer relief, but the effects are only temporary and typically cause more suffering in the future. Costs of these self-destructive coping strategies lead to the pain being prolonged into long-term suffering. Although there may not always be a way to control the pain in life, the amount of suffering in response to the pain can be managed.
Distress Tolerance Skills
The focus of DBT is to teach ways to help endure and cope with pain in new, healthier ways so those who have overwhelming emotions do not suffer. Distress tolerance skills educate ways to “distract, relax, and cope”.
- Distract: Distracting skills help temporarily divert thoughts from pain and help gain time to find appropriate coping responses. Distracting does not mean entire avoidance.
- Relax: Relaxation can help bring peace and relief from pain to regain strength. Many with overwhelming emotions panic when faced with conflict, rejection, failure, or other painful events. Self-soothing skills helps to aid in relaxation and can also teach methods to treat oneself with compassion, kindness, and love.
- Cope: Radical acceptance is a method to acknowledge the present situation, taking it as it is in the moment, without judging the events or criticizing oneself. Being overcritical about a situation prevents necessary steps for change. Coping with radical acceptance is not condoning or agreeing with bad behaviors in others, but rather an effort to stop attempting to change the past by blaming or getting angry. Radical acceptance is the most difficult skill in DBT to master.
One of the most important purposes of DBT is to help stop engaging in self-destructive behaviors, such as cutting, burning, scratching, and mutilating. These behaviors are highly dangerous and possibly lethal. Stopping self-destructive behaviors is the first step to help recover from the pain. Remember, distress is common to everyone. Dealing with overwhelming emotions can be completed in safe, effective, and healthy methods.
Note: Please review the first article in the Dialectical Behavioral (DBT) Skills Series for a brief overview of DBT and the four primary skill modules.