Learning Distress Tolerance through Dialectical Behavior Therapy
Originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD), Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment method now recognized as a leading treatment of those struggling with suicidal thoughts. It has also been effective in treating other disorders such as substance abuse, depression, anxiety, and post-traumatic stress disorder (PTSD).
- Mindfulness – Mindfulness is the practice of being fully aware and present in this one moment.
- Distress Tolerance –Distress tolerance teaches our clients how to tolerate pain in difficult situations, not change it.
- Interpersonal Effectiveness – Interpersonal effectiveness is the ability to ask for what you want and say no while maintaining self-respect and relationships with others.
- Emotion Regulation – The ability to change emotions that you want to change.
Daphne Crawford, Psychotherapist at Smoky Mountain Lodge takes a deeper look at distress tolerance more specifically. DBT distress tolerance skills tackle the tendency of some to experience negative emotions as overwhelming and unbearable. Those with a low distress tolerance can become overwhelmed at a mild level of stress and react with negative behaviors. Many traditional treatment approaches focus on avoiding painful situations, however; within the behavior skills of DBT, we teach that pain is unavoidable and there is a way to accept it, not change it.
Radical acceptance is an important part of distress tolerance and refers to the process of experiencing and accepting the reality of a situation that cannot be changed. Through radical acceptance, an individual is less vulnerable to intense and prolonged negative feelings. Using the acronym “TIPP”, we use four skills categories within the distress tolerance module that we often encourage and practice:
- T– changing body Temperature
- I– engaging in Intensive exercise
- P– Paced breathing
- P– Progressive muscle relaxation
We have learned through research that TIPP skills activate the parasympathetic nervous system to reduce emotional arousal and aid residents in coping with distress without engaging in self-destructive behaviors. In addition to ice packs and cold water to reduce their temperature, we often use workout facilities or climb the steep mountain roads to exercise intensely for 20-30 minutes. The program at Smoky Mountain Lodge also offers several classes and frequent coaching to use breathing techniques to improve distress tolerance.
Distress tolerance skills are valuable in helping our clients to maintain balance in stressful situations, and teaching them to accept distress and cope with it in a healthier way. By practicing skills through TIPP, clients can weather stressful circumstances and decrease painful feelings and destructive impulses.
Pasadena Villa uses DBT in addition to other therapeutic methods for the treatment of mental health and co-occurring substance use disorders. Using our Social Integration Methodology, our professional staff observes and interacts with residents in real life situations to help ensure customized treatment plans are as accurate and effective as possible. Using recreational, social and life-skills activities within the community, in conjunction with individual, group and family therapy, we have been successful in assimilating individuals back into everyday life and reaching the highest level of individual functioning possible. Pasadena Villa is committed to offering the highest quality clinical services; within a physical environment that promotes health/well-being, recovery, and personal motivation.
If you or a loved one would like more information on mental health or co-occurring substance use disorders, please call us at 877-845-5235 or complete our contact form. We currently offer treatment at two residential locations in both Orlando, Florida and Knoxville, Tennessee, and outpatient services in Raleigh, North Carolina.