Distress Tolerance 1: Introduction

Here comes the tough love people, because when facing the goliath that is distress tolerance you’re going to find it sounds an awful lot like a more complicated way of saying “just get over it” when you’re in pain. But that’s not what this is about. Telling someone to ‘buck up’ and ‘get over’ their pain is like trying to tell someone with a broken leg to walk it off. What do we tell the broken leg person? We hope they get better soon, we put their leg in a cast, we give them physiotherapy, we give them time to heal and adjust to life without the use of the leg for as long as they need.

Distress Tolerance is a way to learn how to manage the mental and emotional pain that comes along with Borderline Personality Disorder skillfully, so you can live a life worth living; even with the pain.

Many of us with BPD have used some of the following unhealthy coping strategies:

  • Isolation and avoidance of distressing situations
  • Taking your feelings out on others
  • Engaging in dangerous behaviours
  • Avoiding dealing with the cause of the distress
  • Surrender to the pain and live a miserable life

Sound familiar? Take your pick, we’ve all done these and have they helped? Well, in the short term, yes. They do work. That’s why we do them. Are they healthy? No. These kinds of behaviours will only make things worse in the long run. So we must learn to cope with them in healthy ways. We learn to control our impulses so we don’t hurt ourselves or anyone else. We learn how to manage a crisis without making anything worse.

We are our own worst enemy sometimes

Let’s break down some facts about crises. What is a crisis? It’s a stressful event or traumatic moment. It can be triggered by something external or internal. Its intense and painful.

4 things you can do in a crisis:

  • 1. Solve the problem !
  • 2. Change how you feel ;
  • 3. Accept it .
  • 4. Stay miserable 😦

A crisis is usually short-term, needing to be resolved NOW, or it could be made worse if impulses or attempts to escape are likely to occur.

A crisis involves a problem that maybe can’t be resolved RIGHT NOW, or it can be solved, but you’re unable to use the skills to deal with the crisis safely.

The good news is it is possible to learn how to bear pain skillfully. The key is to not make things worse by acting impulsively. You must accept the situation, not avoid it. Because guess what sweetie, pain and distress are a part of life. There is no escape, you have to face it. But, as we’ll learn later in this module, life with pain can still be a life worth living.

Tough stuff. But here’s the choice you face right now: learn the skills and practice them to live a better life, or continue to face your distress in pain and suffering.

Here’s what distress tolerance is NOT:

I’m not going to tell you that your pain builds character, or that everything happens for a reason. I used to believe those things, and if you still do that’s fine, it’s a comforting philosophy, but it’s not used in DBT, because it doesn’t work for everyone. The DBT philosophy goes more like this:

Everything has a cause. Everything is as it should be. Everything is as it is.

It means if you took every moment and every probability and every factor leading up to an outcome, the outcome would be the same. You can’t change the past, but you can adjust the present and build a better future.

In the meantime here are some words of encouragement to help get you started. Copy these out for yourself and post them around your home, or jot them into a notebook for your own reference as we go along.

  • I’m strong and I can deal with this
  • This situation won’t last forever
  • I’ve got this!
  • My feelings make me uncomfortable right now, but I can accept them
  • It is not what happens to me, but how I handle it that determines my emotional being
  • I’ve survived other situations like this before, and I’ll survive this too