Over recent years, Dialectical Behavior Therapy, or DBT, has continued to grow in its popularity as a psychological treatment approach. Dialectical means “the existence of opposites,” referring to two seemingly opposite strategies used in DBT; acceptance (i.e. that experiences are valid, of things one cannot change), and change (i.e., making positive changes to manage emotions and move forward).
In DBT, clients are introduced to a variety of skills related to the four modules of psychological and emotional function that DBT focuses on; mindfulness, interpersonal effectiveness, distress tolerance and emotion regulation. The development and advancement of these skills can help individuals overcome challenges and reach their full potential. While DBT was originally developed to treat individuals with Borderline Personality Disorder, research has shown that it is effective in treating a wide range of other disorders including substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders.
What is distress tolerance?
Distress tolerance refers to our ability to tolerate stress or pain during difficult situations, and not attempt to change it. DBT provides skills to assist in accepting reality when reality is difficult to accept or when strong urges to engage in maladaptive behavior are present (i.e., urges to self-harm).
While not everyone experiences mental illness, we all experience a wide variety of stress throughout our lives. These stressors can range from “annoying” to “life-altering,” such as a break up, job loss, or a traumatic event. No matter your stress-level, your ability to tolerate distress plays a major role in your ability to respond to stressful situations effectively. Learning and practicing distress tolerance skills can make a very positive difference – for anyone!
One popular distress tolerance skill taught in DBT is the STOP skill. When confronted with a stressful situation, we may feel pressure to make decisions and reach a solution as quickly as possible. However, we can make healthier, more informed decisions and find better solutions when we give ourselves the chance to stop and slow our racing minds down. Let’s walk through this skill together.
When you are in distress, STOP.
S – STOP
When you begin to feel like your emotions are getting out of control, just stop where you are. Be still and quiet. Take a moment to remind yourself that you are in control of what you say and do. Name the emotions that you are feeling and try not to judge them as good or bad, positive or negative.
T – TAKE a step back
When dealing with a difficult situation or feeling overwhelming emotions, it may be hard to think clearly about the next best steps. Give yourself some time to slow down and think. Try taking a few deep breaths so that your mind can begin to calm and your thinking brain can turn on. Continue breathing deeply as long as you need, until you are in control. It is okay to take our time to decide how to respond.
O – OBSERVE
Simply observe what is happening around you. Where are you? Who else is there? Try to do so objectively. Next, observe your internal experience. Notice any automatic negative thoughts (ANTs) that come up and remember they are based on an outdated belief system. In order to make effective decisions, it is important to NOT jump to conclusions and, instead, gather the relevant facts so you can understand what is going on and what options you have.
P – PROCEED mindfully
After stopping, taking a step back and observing, you can consider how to proceed. Check-in with yourself and ask, “What do I want from this situation?” or “What are my goals?” You can feel more calm and self-assured knowing that you are in control of your emotions and be better prepared to address the situation appropriately.
Practice Slowing Down & Stopping
Like most things, using this skill regularly and effectively is easier said than done. As with any skill, practicing the STOP skill will improve your ability to use it when stress and emotions run high. Try practicing this skill in moments of calm, when nothing is wrong. By practicing this skill when you are regulated, you will be able to use it well the next time you are dysregulated.
Taking an opportunity to stop, take a step back, and observe what is happening in and around you in the present moment can improve your self awareness, relational awareness, and help you be more attuned to your own emotions. Next time you find yourself stuck in a difficult situation or feeling overpowered by big emotions, STOP.
These skills work their best when used in combination with treatment. Want to learn more and begin to live life fully? Learn more about our transformative treatment options on our website!