#shrinkthinks DBT DIY :: Making A Distress Tolerance Kit For Healthier Coping

Whether you're trying to manage eating disorder symptoms or alcohol/substance abuse problems, creating a "coping skills" toolbox--a place to keep things that can help you feel calmer and more grounded is a practical and helpful tactic in supporting your recovery goals. Instead of using symptoms and negative behaviors, turning to your toolbox can give you other options that immediately engage your five senses and include healthier distractions, self-soothing strategies and making different choices in the moment!

TOOLBOX TIPS

What you will need for your self-regulation and coping toolbox:

  • Tactile (something to feel) - textures, warm or cold objects, stuffed animal, stress ball, the ground beneath your feet
  • Visual (something to see or look at) - flowers, photos, art, vivid colors
  • Auditory (something to hear) - music, focusing on sounds in the environment, meditation guides, books on tape
  • Olfactory (something to smell) - essential oils, perfume, candles
  • Gustatory (something to taste) - gum, mints, sweet or sour candies

DISTRACTION TIPS

How to Distract yourself when you have the urge to reward yourself in negative ways or when you have self-destructive urges:

  • Take a walk or brief run
  • Stretch or do yoga
  • Use a guided meditation tape
  • Dance to music
  • Cook
  • Start a puzzle
  • Paint or draw
  • knit, sew or crochet
  • Write in your journal
  • Watch a movie or television show
  • Play a video game
  • Read an engaging book
  • Call a trusted friend

CRISIS PLAN

Many Therapist suggest having a crisis plan when you feel overwhelmed with strong feelings or emotions. What might this look like?

  • Call a family member or friend
  • Reach out to your psychotherapist or psychiatrist, or make notes for your therapist to discuss at your next session which can help you feel more connected during distress
  • Call a hotline, 911 or go to your local ER if you're in distress

PRACTICE EMOTIONAL AWARENESS

Practicing emotional awareness helps you identify important triggers, feelings and emotions in an effort to disrupt a potential downward spiral. Identifying what may be going on for you sooner rather than later builds personal competency and supports healing and emotional growth. Some examples to help you include: using a journal to express yourself, drawing your emotions and feelings, using movement that describes how you're feeling. If you're not sure what you are feeling (this happens!), look at a chart that describes or lists a range of feelings.

BECOME MORE MINDFUL

While some find that being in the body increases anxiety to unbearable levels (guided meditation is a solution for this), many are able to learn to tolerate feeling grounded and being in the present moment. You may not know what works for you which is okay, so experiment with the following: meditation, restorative yoga, breathing exercises, relaxation recordings and focusing on an object that can ground you such as crystal. 

OPPOSITE ACTION

Whatever your impulse or act of self-sabotage may be (binge eating, cutting, drugs, alcohol or any form of "acting out" which evokes shame and later causes self-loathing and guilt, try something different that's more in line with a positive emotion. It's always easier and more familiar to do the usual behavior that you rely on to cope and it takes great effort to make a different choice in the moment. What follows are some options for opposite action:

  • Walking away from a situation when you are angry
  • Distracting yourself with something pleasant instead of punishing yourself
  • Instead of staying in bed, get up and do something that will lead to more positive feelings
  • Tackle something you're avoiding (organizing a closet, cleaning, calling a friend, taking first steps to start a project)
  • Do something that has caused you shame in the past (which is a message you likely learned, but does not need to be in your life now) such as: practice self-care, get medical care, get a massage, eat something good or nourishing, buy a new dress and so on. You will find that the more you practice this, you will become desensitized to feelings of shame.

It's important to know that the goal here is not about trying to suppress your emotions, rather, it's using that anger, sadness or anxiety to take a different action. With time, you can create more resilience, increased self-esteem, better coping mechanisms and an increase in positive emotions.