1.21 | Distress Tolerance Skills

[Cat Familiar]

Distress Tolerance Skills

In DBT, Distress Tolerance skills are used when it is difficult or impossible to change a situation. Distress Tolerance skills are used to help us cope and survive during a crisis, and helps us tolerate short term or long term pain (physical or emotional). https://www.getselfhelp.co.uk/distresstolerance.htm

I've been thinking about Distress Tolerance for the Non: to be able to stand strong and not be ruffled by our loved ones being upset, anxious, overly emotional, etc. This seems to be the point where we lose our coping skills and try to step in and save them from being dysregulated.

That can be understandable in some cases, to avoid severe consequences, but what I'm thinking of is how often we might jump in to rescue, fix, help, etc. over something entirely inconsequential. This interfering certainly short-circuits their ability to handle stress and demonstrate self-soothing skills.

My epiphany is that I've done this because I was uncomfortable watching my husband starting to get upset. Now I'm working on maintaining my calm equanimity even when he's getting frantic.

[Skip]

Ever lose you cool in all of this and go off in a destructive way? We all have. We can get worn down, and there is a spark, and we blow up. What are the ways that you (or we) can best intercept our emotions before they go out of control and avoid making matters worse.Before you can make anything better, you have to stop making it worse~ Alan FruzzettiSo many times we read about how members react (over-react) in destructive ways that make matters worse. It might be saying really damaging things. It might be punching a hole in the wall. It might be worse.  Have any of you read about Joshua Federico (story here)?  A normal guys by all means (I know of him). His wife cheated on him and became pregnant. He lost it.

We have a helpful slide presentation on this DBT skill for anyone facing a crisis and who wants to dig in deep. I've posted a few of the slides below (click slide to enlarge). There are twelve more (see more information).

[Harri]

Those are excellent links and I have bookmarked it so I can see what else is there.  Thank you.

My epiphany is that I've done this because I was uncomfortable watching my husband starting to get upset. Now I'm working on maintaining my calm equanimity even when he's getting frantic.

This is good to see in yourself.  I do it too but to a lesser extent now than I used to do.  I still jump in to reassure, try to fix, etc.  It is a hard thing to break.  I can not step in on the obvious stuff but the more subtle?  Forget it, I still get caught.

A friend very recently told me that the 1st step in stopping this (getting involved in the drama triangle) is to be okay with leaving things unfinished.  I would extend that to what you say here too... .being willing to stay in our own discomfort and recognizing that that is our stuff to take care of.

Do you see this applying to other areas of your life?

[stolencrumbs]

I've repeated to myself for a long time that line from the old movie War Games--"the only winning move is not to play." But it took Joshua a lot of iterations of the game to figure that out, and I'm not a computer, so I'm still playing tic-tac-toe (or global thermonuclear war) occasionally. Maybe one day I'll really learn that lesson... .

So the thing (or one thing) I worry about is whether I'm using some distress tolerance skills as an excuse to just not do anything. I agree that people need to be able to handle their own stuff, and it's not good to constantly jump in to try to "fix" things. But I also think it's good to sometimes fix things. I do this with every other person I care about in my life, and it works out just fine. I want to do this. I want to be a person who helps others. Of course, others aren't BPD. They take the help I can give, don't yell at me for helping or not helping, and are grateful for help I can provide. So obviously that's a difference. But still, my wife is an adult, and I love and care about her, and I want to help when I can. If she is upset, I'd like to help her not be. I don't really want a relationship where I don't do that. But I also don't want to be the object of rage or endless arguments, and that is often what happens when I try to help.

So what to do? What I often do is nothing, and I say to myself that I can't help, or that I shouldn't try to help, that my trying to help won't actually help, etc. And most of the time I think I'm right. But I don't like not helping. I don't like feeling like I'm giving up on her, or just leaving her with whatever demons are in her head without trying to help. I don't know where the line is, but I think there's some line here that I'm trying to figure out. There's some amount of help I think I should offer, and some amount of "fixing" I think I should try to do, even if I'm pretty darn sure I can't actually fix anything.

Anyway, I worry about detaching too quickly, or too often. That's not who I am or who I want to be. But I know I can't play the game we've been playing. But I don't want to not play at all. That doesn't feel right, either. I guess, like Joshua in the movie, I want to play a nice game of chess instead. Can I play chess while she's playing global thermonuclear war? I don't know, but at the moment, I guess that's what I'm trying (often unsuccessfully) to do.

[Ozzie101]

I could have written that post (gender reversed), stolencrumbs.

I, too, am a helper. I like to help people -- especially when I'm feeling down. My family always taught me that when you're sad/lonely/hurt/whatever, sometimes the best thing you can do is do something for someone else. I've done that in my life and it's true. Something as simple as opening a door for someone can give me a lift.

My husband's big phrases are "Not helping" or "That's not helpful." He expects me to fix things. But I'm coming to realize that I can't. Some things? Yes. But I think I've been jumping in too much. Some of this stuff he really needs to handle on his own because my running around trying to smooth every hill and straighten every curve isn't making him any better and isn't helping my stress level either.

I think he's been leaning too much on my helpful nature. He knows how much it bothers me to see him or anybody hurt or struggling (even though he accuses me of not caring at all) and he latches onto that and plays on it -- rather consciously or subconsciously.

The key is knowing where it's OK to help and where he needs to take care of it himself. I'm already starting to get the "You only care about yourself" accusations but, like you, I know the old status quo can't go on.

[Skip]

So the thing (or one thing) I worry about is whether I'm using some distress tolerance skills as an excuse to just not do anything.

This is a skill for when we are emotionally out of control. It is about not making matters worse when we are in an emotional state. It's not intended to be a problem solving tool or a routine situation tool.  

Taking a very simplistic example.

Case1 :

A new member comes to bpdfamily because his beloved girlfriend has left him. He wants to save the relationship, but he did something really destructive at the end and he needs help. A member says something to help him, but the comment triggers him, so he goes ballistic on the member and then attacks the moderators for trying to mediate the dispute and is suspended.

Case2 :

A new member comes to bpdfamily because his beloved girlfriend has left him. He wants to save the relationship, but he did something really destructive at the end and he needs help. A member says something to help him. He asks the member helping him to explain further and he listens carefully.

So, obviously Case #2 is the preferred course of action.  Case #1 is a train wreck and that member would have been better served if he realized he was going off the rails and applied Distress Tolerance Skills.



In Case #1, distress management could have been to:

Step away from computer and make lunch, takes his lunch outside and eat under a tree and watch the squirrels (Distract, Self-soothe, Improve the moment). Later he thinks about the pros and cons of telling this member off - pro/he puts the guy in his place - con/he loses a resource he needs for the larger objective of rehabilitating his relationship. He puts that on a sticky note on his computer (to remind him), logs in, thanks the member for the thought and ask everyone for more help.
 

[Harri]

Skip gave some great graphics here and really good examples for how distress tolerance is about us, not the person with BPD.

Distress tolerance is about recognizing what is within us that is causing us to try so desperately to fix things for them.  It is about us learning how to better tolerate our own impulses to step in and rescue (aka jump on the drama triangle) to self soothe *our* feelings and to fulfill our needs.

It is about being okay with our own distressing feelings that are driving this urge and not trying to fix our pwBPD so we can feel better.  

Cat said:  

It's a new epiphany for me, Notwendy, that I've been projecting my own poor boundaries and lack of managing my own feelings upon my husband. Of course he has his own patterns in this department too, but I'd been putting the entire blame upon him and excusing my own lack by thinking that I was doing something "positive" and "helpful" by trying to fix things.

This is what it is all about Cat.  Learning to tolerate (manage) our own distress rather than pushing it away by fixing others, or soothing their emotions, or, at least in my case, controlling them so I can feel better or so I can avoid having to deal with them being upset, frustrated, etc.  Rescuing so I did not have to feel tense, scared, anxious, or whatever.  We talk about this a lot over on the Parents, Sibling and In-Law (PSI) board.  My father was co-dependent (among other things) and would avoid, accommodate, fix, try to soothe my mother to make his life easier.  I learned the same patterns by watching him interact with her.   Fixing stuff or rescuing people is a way for me to control the situation and make sure everything is going to be okay.   When I don't do that, I feel upset, anxious, scared, irresponsible, guilty, and I am sure a few other things I either can't see yet or I am forgetting right now.  

Notwendy said:  

In a codependency model- we step in to "calm the storm" as a means of handling our own discomfort with it. When we learn to manage our own feelings, we can then manage our urge to step in and fix it... . So the stepping in to "fix" doesn't help either of us gain better skills at managing our own feelings. We look at the pwBPD as being someone who can not manage their own feelings well, and having poor boundaries, but it is the partner ( us) who also is lacking in these skills. Maybe we respond to discomfort in a different way, but it is a lack of self soothing skills/good boundaries either way. We can't do the work for someone else, but we can work on us.

 Well said!  This is so important to understand and for us to work on.

Who has looked at the graphics Skip posted above?  
How do you see them applying in your situation?  
Can you see yourself incorporating these things into the way you respond in your relationships?  

[Cat Familiar]

Distress tolerance is about recognizing what is within us that is causing us to try so desperately to fix things for them.  It is about us learning how to better tolerate our own impulses to step in and rescue (aka jump on the drama triangle) to self soothe *our* feelings and to fulfill our needs.

It is about being okay with our own distressing feelings that are driving this urge and not trying to fix our pwBPD so we can feel better.  

I think many of us come from families where there's a history of dealing with a parent, or maybe a sibling, who reacted spontaneously with anger and irrationality. We may have learned at a very early age to tiptoe around this person, so that we "don't set them off."

At other times, this individual may have been exceedingly charming and loving to us, and as children, we desperately wanted that side of them to return, instead of the scary, unpredictable, angry part.

Through this experience, we incorporated an internal behavioral template: appease and hope that the "nice" person comes back soon.

Then when we enter the dating world, we meet an incredible partner, who is everything we could imagine in a mate. We are so taken by this person that we ignore little signs that perhaps indicate that our first impressions are not correct. (Oh, everyone has issues. This is no big deal, we tell ourselves.)

Over time, as the Honeymoon Phase draws to a close, the mask slips, and we see the Mr. Hyde side of our beloved Dr. Jeckyl. It comes truly as a shock to realize this incredibly wonderful person we fell in love with has an alternative angry persona, that can appear without warning.

Occasionally we can smooth things over through our attempts at appeasement, particularly in the early stage of the relationship, and I think this is where the concept of intermittent reinforcement can lead us into problematic behavior.

If we bend over backwards and apologize for some violation we apparently committed, for which we have no memory or understanding, and then our beloved changes back to their warm, kind self--we might think this is a useful strategy and continue to try to do this, even when later, it doesn't work.

Instead of trying something new, such as learning the "tools" taught here, we might just keep trying to appease, apologize, do more, do less, in a frantic attempt to keep our loved one from dysregulating.

Distress tolerance skills give us breathing room to step back, compose ourselves, get an overview of the situation, and bring our aware and most compassionate selves to the present moment. Having the behavioral flexibility to try new strategies, assess what works and what doesn't, give us the ability to not be drawn into the drama whirlwind, but to hold our center. 

[defogging]

Awesome topic!

I know I need to work on this, I've been pretty anxious the last few days due to my recent actions and the revenge from it.  (See my thread on videotaping her behavior  )

This recent chain of events has made me reflect on myself too.  I've had times when I've been very on edge due to her anger - stomach upset, shaky, etc.  At least I recognize that's my own issue now, and I know I need to get in control of that.  I'm going to study this topic more, thank you very much Cat Familiar for posting this!

[Cat Familiar]

I had an interesting opportunity for self awareness and use of distress tolerance skills yesterday. My husband and I went to a large social event where we knew no one, other than the person who invited us. We're both introverts and we dislike being in crowds.

On the way to the event, my husband, who had been asked to take a few photos there, started to get upset. Instead of trying to "soothe" him and "fix" things, instead I just ignored his grumblings and to my surprise, he got over it quickly. (I realized that I was getting upset due to his distress, so I just focused upon breathing and relaxing.)

Then, to make matters worse, the event was at two different locations and when we showed up where we thought he needed to be to take the pictures, only a few people were there, setting up decorations. So we hurried to the other place, where the event began, but neither of us had brought the card with the address, so we had to guess where it was, and after a few wrong turns, arrived at the venue.

So, more opportunity for anxiety. Again, I focused on my own discomfort, rather than his, and thus, didn't elicit even more agitation. It turned out that there were other photographers there, so he didn't really need to take any photos there.

I realized that to move the large number of people from one venue to the next would take some time and that if we turned around and went back to the first place, we'd be sitting around for quite some time. It also occurred to me that my husband hadn't eaten lunch and when he misses a meal, he gets more emotionally fragile.

So I suggested that we grab a snack somewhere before we returned to the party. He was really uncomfortable with that idea, thinking that we might be "late" but I prevailed. It was a good thing too, because even with the delay of having a bite to eat, we sat around a long time before everyone showed up and the festivities began. In the meantime, we were served drinks, so it was good that he had some food in his stomach. I demurred and just sipped water.

People were very friendly and nice, but they all seemed to know each other, while we sat at a far table by ourselves. My husband walked through the crowd, taking photos now and then, and returned frequently to our table.

It was a great opportunity for me to see how easy it was for me to project my own social anxiety upon him. I felt ill at ease owning it, but it gave me a lot of compassion for how it must be to be a pwBPD and so frequently have to deal with uncomfortable feelings.

[Turkish]

I confessed in another thread how I lost control with my ASD son this past week.  I yelled and i slammed a cabinet after he Lyft the room.  As I was doing it,  I thought,  "I'm doing this to show him my frustration" while at the same time thinking,  "I'm braying passive aggressive and not unlike my mother, " whose default was slapping me to control me. 

Logically, I realize that my kids,  specifically my son,  needs better than what I got.  Emotionally,  I can sometimes tend to default by projecting my own childhood.  How much of the way we were raised transfers into the way we raise our children? 

[isilme]

I rarely "blow up".  I have done so, maybe once or twice this year I think, during a very bad couple of episodes.  Mostly, I "lose it" through falling into my own depressive hole. 

Looking at the slides, I feel I live in slide #2.  Don't make it worse.  This is pretty much the essence of my life these days. 

I try when I have the energy to engage in activities - usually cleaning or chores, but it's busy enough and I feel better if I can see some progress in cleaning.  I clamp down on ruminating thoughts when I can, and when I am conscious of it, I try to focus on not feeling how I feel, but to change it.  I try to turn anger into pity for the way BPD must feel.  I try to look at how his need to not be blamed or at fault makes him say the horrible things he does. 

I guess it self soothes me a bit to clean my house, change sheets, try to get one thing on my list done a day, even if it's only one.  I try to distract myself, I am often not successful.  I find a mindless button pushing game on my phone sometimes when I am too upset to read or focus, and I am in a place where moving around the house feels like walking on eggshells. 

I don't think I understand the Pros and Cons exercise.  In reference to what?  Staying?  Leaving? 

[Skip]

I don't think I understand the Pros and Cons exercise.  In reference to what?  Staying?  Leaving? 

Blowing up vs staying cool in a specific incidence. If you hit the link for all 19 slides, there are a few that explain this in detail.

[Only Human]

I'm pretty good at looking back after I've done something destructive. I can identify which emotion is driving my actions... .usually fear and/or anger. Catching it before it gets out of control is another thing. How can I best intercept my emotions before they go out of control? I think being mindful of what triggers these emotions is the first step. I'm still identifying what triggers me.

My T gave me this very assignment months ago: identify your triggers. I had the good fortune of having some instant experience with this when I got on the freeway and not all drivers were adhering to the universal "merge" rule of, "one then one." I got ticked off and rambled in my head about how it's unfair darn it! So I determined that I valued "fairness."

I'm not sure where to take it from there, recognizing.

~ OH

[Cat Familiar]

How can I best intercept my emotions before they go out of control? I think being mindful of what triggers these emotions is the first step. I'm still identifying what triggers me.

I think what has helped me in this regard is being "Meta". By that I mean, observing myself as though I was observing a stranger. I imagine looking at myself as though I'm watching a movie with me in it. Then I can ask myself questions like, "How do you feel about feeling like this?" I might answer myself like this: "I really don't like getting anxious when my husband is beginning to dysregulate. How can I hold my center when he's getting wound up?"

Then I can have a dialog between parts of myself. It can be quite entertaining.