You may think Dialectical Behavioral Therapy is only for those that live with borderline personality disorder. However, I am an example of a person with bipolar disorder that has benefitted from this approach.

What is Dialectical Behavioral Therapy?

Dialectical Behavioral Therapy (DBT) is an approach that combines cognitive and behavioral therapies together. It also incorporates other methodologies including Eastern mindfulness techniques.

DBT allows the learner to build skills in areas like mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

Distress Tolerance

One of the things I’ve been working on in therapy the past couple weeks is distress tolerance. According to DBT, distress is something that is a normal part of life, and people should learn to handle the pain and discomfort skillfully.

In fact, the inability to accept pain and suffering is the reason why the pain and suffering is so massive (I have heard this all somewhere—anyone Buddhist?). But DBT says there are higher stakes involved.

Distress tolerance is extremely instrumental in changing oneself in a positive way; not having control of one’s emotions doesn’t allow for much growth.

Some crisis survival strategies for those that cannot tolerate stress includes distraction, self-soothing, improving the moment, and thinking of pros and cons.

I learned last session how to improve the moment, and I want to share it with you.

Improving the Moment

My distress manifests most often in anxiety and anger. If I am in a moment of distress, I can use a few strategies:

• Imagine a very relaxing scene, one that means something to you. It could be a beach scene from one of your favorite vacations or a mountain setting from your imagination. Use all of your senses. Imagine everything going well. Imagine a world that is calm and wonderful.
• If the location allows, you may choose to go into a room or area that makes you feel better. Perhaps it is your bedroom or a nook under the stairs. In this space, imagine things being better than they were. Let your hurtful emotions drain out of you.
• Pray, meditate, open your heart to the supreme being. Whatever you choose to focus on, ask to be relieved. Turn things over to God or a higher purpose.
• Relax by tensing and relaxing each large muscle group one after another, or take a hot bath. Breathe deeply. Give yourself a massage. Drink a nice hot drink. Exercise and wear yourself out a bit.
• Find or create meaning in your pain. There has to be some value in it, right? Focus on the positive aspects of the situation. Repeat them again to yourself.
• Have some “me time”. Rent a room at the beach for the weekend. Eat some chocolate ice cream and watch a movie. Whatever makes you feel like you. And here’s a challenge—unplug your phone for a day and see how it makes you feel.

These are just a few of the distress tolerance strategies you can use to make a moment a little less painful. I am going to start practicing the applicable ones in the next week and I hope you join me. Let me know how you fare in the process.

I believe in DBT and I think it can really transform my life and the lives of others. Anyone can use DBT—it is versatile and personable.

I want to hear what you think of DBT. Let me know if you’ve tried it and if you haven’t, what kind of therapy works for you. 

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Photo Credit: Michelle Brea via Compfight

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    Last reviewed: 6 Mar 2013