Distress
Tolerance
Distress Tolerance
Breathe
IMPROVE
Improving the moment is replacing immediate negative events with more positive ones.
Some strategies for improving the moment are cognitive techniques having to do with changing appraisels of oneself (encouragement) or the situation (positive thinking, meaning, imaginging). Some involve changing body responses to events (relaxing). Prayer and focusing on one thing in the moment have to do with acceptance and letting go. A way to remember these skills is the word: IMPROVE.
Imagery can be used to distract, soother, bolster courage and confidence, and make future rewards more sailent. Using imagery, you can create a situation different from the actual one; in this sense, it is like leaving the situation. With imagery, however, you can be sure that the place you go to is a safe and secure one. Going to an imaginary safe place or room within can be very helpful during flashbacks.
For it to be useful, however, you have to practice it when you are not in a crisis enough times to get it firmly down as a skill.
Distress Tolerance
The skills in this module are ones that help people get through life and situations and when they can’t make changes for the better in their situation. Basically, the skills are ways of surviving and doing well in terrible situations without resorting to behaviors that will make the situations worse.
Distress tolerance is the ability to perceive one’s enviournment without putting demands on it to be different, to experience your current emotional state without attempting to change it, and to observe your own thoughts and action patterns without attempting to stop or control them. Acceptance of reality is not equivalent to approval of reality.
Imagery Practice
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Posttramatic Stress Disorder
can be seen primarily as a result of trying to avoid all contact with cues that cause discomfort. Pathological grieving – that is, grieving that never ends – is a result of the same avoidance. Avoiding all cues that are associated with pain insures that the pain will continue. The more you attempt to avoid and shut emotional (as well as physical) pain off, the more it will come back to haunt you. Trying to suppress emotional pain or aviod contact with pain-related cues leads to ruminating about the painful eventsl paradoxically, trying to get rid of painful thoughts creates painful thoughts.
Meaning Practice
Finding or creating Meaning helps many people in crisis. Victor Franl (1984) wrote an important book about surviving Nazi concentration camps, Man’s Search for Meaning, based on the premise that people need to find or create meaning in their lives to survive terrible suffering. Finding or creating meaning is similar to the dialectical strategy of making lemonade out of lemons.
It is important to note that like is at times unfair for reasons that no one can understand. People do not have to assume that there is a purpose to their suffering, although those who are religious or spiritual may see it this way. Those who do not believe in a higher purpose can still create meaning or purpose, however. Get feedback about participants’ views on the meaning or purpose of suffering.
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Prayer Practice
The essence of Prayer is the complete opening of oneself to the moment. This practice is very similar to the notion of radical acceptance. Note that the suggested prayer is not one of begging to have the suffering or crisis taken away. Nor is it a "why me?" prayer.
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Relaxation Practice
Step 1: Use a relaxtion tape/CD or other for assisting you through this practice. You can even use a “sounds” machine. Practice tensing your muscles and then relaxing them. Start from the toes and work your way up.
Step 2: Journal about your use of this technique. What was easy and what was difficult?
Relaxing is changing how the body responds to stress and crisis. Often people tense their bodies as if by keeping them tense, they can actually make the situation change. They try to control the situation by controlling their bodies. The goal here is to accept reality with the body. The idea is that the body communicates with the mind, accepting with the body can help in accepting with the mind.
"One thing" Practice
One thing in the moment is the second mindfulness “how” skill. Although it can be very difficult to do, focusing on one thing in th emoment can be very helpful in the middle of a crisis; it can provide time to settle down. The secret of this skill is to remember that the only pain one has to survive is “just this moment.” We all often suffer much more than is required by calling to mind past suffering and ruminatinv about future suffering we may have to endure. But, in reality, there is only “just this moment.”
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Vacation Practice
Taking a “vacation from adulthood” is ceasing to cope actively and either retreating into oneself or allowing oneself to be taken care of for the moment.
Everyone needs a vacation from adulthood once in a while. The trick is to take it in a way that does not harm you, and also to make sure the vacation is brief. When you have responsibilities, taking a vacation depends on getting someone else to take over your duties for a while.
Borderling individuals are usually experts at taking vacations. The problem is that they are not in control of their vacations; that is, they take them at inappropriate times and stay on them too long, Making vacation a skill to be practiced, gives them the potential for getting in control.
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Encourgement Practice
Encouragement is cheerleading oneself. The idea is to talk to yourself as you coulw talk to someone you care about who is in a crisis. Or talk to yourself as you would like someone else to talk to you.
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Breathing & Half Smiling
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