Distress Tolerance & Self-Soothing: Guidelines for Clients
- Stop what you’re doing and say to yourself:
- I can afford to slow down and try to relax.
- I’ve got some time to figure out how to handle this situation.
- I’m not going to just let it go without saying something.
- If I can get calmer, I’ll be more powerful.
- Now identify the behind-the-scenes facts that are making you feel upset. Write your answers to these questions:
- What seems to be the sad or disturbing truth about why this person is acting this way?
- What bad thing is happening here that seems similar to a bad situation that’s happened before? Is the same bad thing happening now?
- What will happen if I can’t get this sort of thing to stop happening?
- Propose to yourself that the answers to these questions may not be as clearcut as they seem. One by one, go back through each question and say to yourself: “Maybe things are as they seem, and maybe they aren’t.”
- Set your thinking about these questions and about the upsetting situation aside for now. Assume a first-things-first attitude: “First I’m going to get myself into a state of mind where I feel less upset; then I’ll think things through and figure out what to do.”
- Pay attention exclusively to the physical sensations that go along with your feelings. Welcome these sensations. Avoid trying to change them. Just accompany them while “giving them air” through slow breathing. Think of slow breathing as like putting an oxygen mask on the part of you that feels upset. Take big inhales and then long, slow exhales.
- If thoughts pop up, acknowledge them. Then without judging yourself, gently bring your attention back to the physical sensations. Do this as many times as needed.
- Alternate between paying attention to physical sensations that go along with the feeling and giving mindful attention to your breath, other body sensations, and your immediate surroundings. Use any mental images that help you feel more at ease.
- If you can’t seem to stop ruminating about the upsetting circumstances, engage in an activity that requires your full attention. Later, when you’re feeling better, go back and give some thought to how you can best respond to the upsetting circumstances. If you begin feeling upset again, start at #1 and follow these guidelines one more time.
Brent Atkinson, PhD, is director of postgraduate training at the Couples Research Institute in Geneva, Illinois, and Professor Emeritus at Northern Illinois University. He’s the author of Emotional Intelligence in Couples Therapy: Advances from Neurobiology and the Science of Intimate Relationships and Developing Habits for Relationship Success. Contact: firstname.lastname@example.org.
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