DBT Skills for Eating Disorders: Distress Tolerance
If you struggle with eating disorders, then you can likely relate to the concept of “distress.” But have you heard of “distress tolerance” – and wondered what this actually means? Is it simply a way to tolerate stressful situations or events? Maybe it describes tools for coping with tough relationships? The answer includes all of the above.
At some point in life, everyone goes through painful circumstances – including physical pain such as illness or injury, or emotional pain such as anxiety or depression. Dialectical Behavior Therapy (DBT) focuses heavily on teaching people to be able to cope with painful stressors in life in appropriate and healthy ways. There are several unhealthy ways to cope with stress which include various addictions such as eating disorders, drugs and/or alcohol, gambling, shopping, sex/love, or self -harm. DBT teaches that there are many other ways to deal with pain in a way that will promote healing and growth.
There is a very basic formula for handling stress and pain: DISTRACT, RELAX, COPE. When you feel stress coming on or find yourself in a tough situation, you can follow this simple formula and move through the hardship quicker than if you ignore it or try to cope in an unhealthy manner, as listed above.
DISTRACT: The first step is to find ways in which to distract yourself so that you are not engulfed in difficult feelings. There are many things you can do! Find a pleasurable activity, such as: watching a movie, taking a walk, reading, calling a friend, going for a drive, exercising, writing in a journal, gardening, listening to music, dancing, singing or anything else that will feel good and help you take your mind off of the problem at hand.
RELAX: Next, after you have successfully distracted your mind and your distressing situation is not as overwhelming as it once was, find ways in which to relax. Sometimes these can be the same as the pleasurable or distracting activities. Some suggestions include taking a bath or a long hot shower, getting a massage, doing yoga, taking an easy walk, sitting outside in nature, playing relaxing music, meditating, deep breathing, lighting candles, saying mantras, drawing or other art projects, sleeping or resting, wearing your most comfortable clothes, reading a peaceful book or poem, or spending time with animals. Think about ways to engage your 5 senses. What can you do to soothe your sense of sight? Touch? Hearing? Smell? Taste?
COPE: Once you have arrived a more relaxed state of mind, you can begin to cope with the stressful situation or difficult feelings. A way to begin this is to find a coping statement that resonates with you. Some examples are as follows: “This situation won’t last forever,” “This too shall pass,” “I can take all the time I need right now to let go and relax,” “This is an opportunity to grow,” “I’ve survived other hardships before and I will get through this.” Try to think of some on your own, too and repeat to yourself as often as needed. Sometimes, just saying one or two words to yourself can be helpful. Included may be: “breathe,” “relax,” ‘release and clear,” “peace,” or “strength.” Find phrases and words that are meaningful to your life and your situation. Remember, there are no right or wrong ways to use coping statements. Find something to help you process and work through your difficult times and you will be able to heal and move forward quickly.