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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.

Imagery Practice

Step 1

Identify and describe a "safe place" image for yourself. This can be an actual physical place or it can be with another person. Describe your safe place in detail and include your emotions and sensations when you imagine it.

Step 2

Now imagine you are experianing a distressing moment. Really focus on that moment. Then switch your thoughts to your safe place and focus on you with your safe place.

Step 3

Write about your experience. Include how it felt to use imagery this way. Was it effective, why or why not and any other thoughts that come to your mind while you are doing the exercise.

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. 

Step 1

Imagine you are experiencing a distressing moment. Focus on how you felt during and after. Indentify the nagative meaning you attached to this experience.

Step 2

Write down some things about what possible meaning or lessons may have been happening for you in that moment. Some philosophical statements to keep in mind are "this is happening for a reason," "I'm supposed to learn something throught this," "everything has a higher purpose, I just don't know what it is yet." Try to attach a different meaning to the distressing experience, one that makes it more bearable.

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.

Step 1

Imagine or "get in touch with" a current pain or suffering, and then silently try each type of prayer (an acceptance prayer, a "deliver me" prayer, a "why me?" prayer).

Step 2

Journal about your use of this technique. Include which type of prayer appears to be most effective for you and how you will use it in a crisis situation.

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.”

Step 1

Write about how you will use this skill the next time you are experiencing a crisis situation. 

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. 

Step 1

Identify and describe your last “unplanned” vacation that resulted in you having a loss of control, i.e., hospitalization, jail, etc. Write about how you could have planned your vacation that could have resulted in an increase in control. 

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. 

Step 1

Identify a distressing experience and imagine you are in it now. Use “cheerleading” statements to encourage yourself to get through it. These can include “I can do this, I don’t have to harm myself,” or “I’ve been through worse before, this isn’t going to break me,” or “I have skills to handle this, I can handle this.”

Breathing & Half Smiling

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  • Pritzker Architecture
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  • AIA Gold Medal
  • RedDot Design
  • Ribba architecture
  • Pritzker Architecture
  • Architecture MasterPrize
  • AIA Gold Medal
  • RedDot Design
  • Ribba architecture

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— meet the team
Alex Martinez

Alex Martinez

Villa Architect
Alex Martinez

Alex Martinez

Villa Architect
Alex Martinez

Alex Martinez

Villa Architect
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