Distress Tolerance 5: Problem Behaviour Pros and Cons

A enormous part of distress tolerance is learning how to identify problem behaviours or unhealthy choices, and correct them so that crises and distress can be avoided. An effective way of doing this is by creating pros and cons lists to break down the behaviour and consequences of each choice we could make. Its a more scientific way to look at your behaviour and choices allowing you to make more informed decisions in your life.

Let’s break it down.

First choose a behaviour you know you fall into when you’re struggling. Its best to do this exercise when you’re not in the middle of a distressful episode, so you can be more detached and scientific.

Next, seperate a page into four sections in a squares with “pros” and “cons” along the side and “problem behaviour” and “tolerating distress” along the top:

Problem BehaviourTolerating Distress
Pros
Cons

Then you get to work.

Problem Behaviour Pros

Ask yourself why you engage in the problem behaviour. Why do you choose to manage your distress in an unhealthy way? You know it’s not healthy, your rational brain could be screaming internally but you go ahead and do it anyway. Why? Because it does work. You wouldn’t do it otherwise. In the short term, there is relief, comfort, thrill, completion… Describe these things in the section where “pros” and “Problem behaviour” intersects..

Problem Behaviour Cons

Now we turn to the consequences of the problem behaviour. There is usually at least one; it could be as simple as the fact that the relief you get from the problem behaviour is short term. It’s usually something that is unsustainable. Maybe its expensive, or maybe it’s difficult to keep secret. All the judgemental rants you’ve heard from people who want you to stop the problem behaviour (including yourself) go in the space where “problem behaviour” and “cons” intersect.

Distress Tolerance Pros

What if you choose not to engage in problem behaviour? What if, instead of indulging in something you know is only a short-term solution, you stayed with the distress, or better yet, find another way to cope? Something more sustainable. Think about the benefits of avoiding the problem behaviour. This goes in the space where “tolerating distress” and “pros” intersect.

Distress Tolerance Cons

But if we’re not relieving our pain with the behaviours that have worked in the past, what does that leave us with? It’s painful, it’s challenging, it’s hard. The distress and pain you feel that usually leads you to engage in problem behaviour goes in the final space, where “tolerating distress” and “cons” intersect.

Doing a pros and cons chart is hard work. It’s a good idea to do this with your therapist so you can bounce ideas around and keep yourself focused on the task without getting stuck in the details. The purpose of this exercise is to be able to look at your problem behaviours in a quantifiable way, so you can study them and get a real sense of what the process looks like when you find yourself suffering and looking for immediate relief. You can refer back to these charts later when you’re finding the temptation overwhelming and need a realistic reminder of why you’re choosing a healthier life, and how to take care of your emotional and mental well-being in the long term.

Here are some examples of my own pros and cons charts. Don’t judge!

Isolation/Avoidance

Problem BehaviourTolerating Distress
Pros*Familiar
*Get to be alone
*Little/no effort (for now)
*Don’t have to answer to anyone (yet)
*Little/no responsibility
*Wallow in self-pity
*Feel better about my *Choice/intention/self
*Not making anything worse
*Accomplish something
*Time spent with loved ones
*Reduce future urges
*Promote positive emotions
Cons*Reinforces behaviour I’m trying to change
*Self-doubt
*Impact on loved ones
*Not living life – missing out
*Problem not solved
*Makes things worse
*Takes effort/energy/hard work/tiring – opposite action is challenging
*Self-doubt – it might not work, it’s a risk
*Having to deal with the pain
*Set up expectation that needs to be maintained

Skipping Meals/Ignoring Appetite

Problem BehaviourTolerating Distress
Pros*No meal prep
*No mess
*Not spending/costing money
*Won’t gain weight/might lose weight
*No time to eat
*I’d rather sleep/distract
*No/low appetite anyway
*My kids steal my food anyway
*Food is going bad
*I just don’t want to eat
*Get nutrition and energy
*Opportunity for a break
*Mindfullness exercise
*I might enjoy the food
*Set a good example for kids
*Food doesn’t go bad
*Better health overall
Cons*Stay hungry
*Food goes bad
*I’ll get h-angry
*Husband disappointed
*Setting a bad example for kids
*Low energy
*Low mood, productivity, nutrition, immune system
*Takes time
*Costs money
*Fighting non-appetite/forcing myself to eat
*Effort to prepare food
*Can’t decide what to eat
*Don’t want to eat what they have
*I might gain unwanted weight
*A mess to clean up

Shoplifting

Problem BehaviourTolerating Distress
Pros*Exciting/thrilling
*Free stuff
*My little secret
*Satisfying challenge
*I don’t necessarily need the stuff
*I won’t get caught
*No guilt
Cons*It’s illegal
*I might get caught
*It’s difficult
*Feeling guilty
*Boring
*If I really want it I’d have to pay