Survival Skills

Distress Tolerance skills – known as the crisis survival skills – are  ways to help you manage strong emotions and urges without making the situation worse.  Remember: the Distress Tolerance skills are used to calm down quickly or control your behavior during very stressful situations. Not all of the skills, such as distraction (e.g., Wise Mind ACCEPTS) are useful to use all of the time, as this practice actually leads to avoidance rather than skillfulness.

Practice Exercises & Distress Tolerance Tools

URGE SURFING 

  • What is an urge? A strong desire or impulse. Examples: the impulse to…. itch your body, swallow your saliva, blink your eyes, sneeze, cough, speak, stand, leave, yell, drink, eat, use drugs, smoke, lash out, quit, laugh, sleep
  • Urges peak between 20 – 30 minutes, if we let them. If we notice the urge without doing battle with it, then it will go away. If we go to battle with our urges (e.g., “I can’t stand this! I have to get rid of this feeling right now!”), the urge will take longer to go away.  Giving into urges makes them stronger, and more difficult to stop. 
  • How to urge surf? Scan your body. Figure out where you feel the urge most strongly. Imagine the urge is an ocean wave. Waves are small when they start, grow big, and then break up. Watch the waves grow big and break up over and over again. Notice as your urge gets stronger and weaker like a wave. Focus on your breath. Use your breath as a surfboard until the urge passes. When you like the wave will swallow you, use your breath to ride it. Practice surfing the urge waves for 1 minute. Add 1 minute each time you practice. Listen to a recording: audio recording

 

“S.T.O.P.” Skill

  • STOP! Freeze! Do not move a muscle! Your emotions may try to make you act without thinking. Stay in control!
  • Take a deep breath. Take a step back. Give yourself some time to calm down and think. 
  • Observe. Notice what is going on inside you (thoughts & feelings) and outside you (how are others reacting?)
  • Proceed Mindfully. Think about your goals. Ask Wise Mind: Which actions will make it better or worse?

 

 

“T.I.P.P.” Skills

Changing Your Body Chemistry

To reduce extreme emotion mind fast.

 

Paced Breathing Video

 

Progressive Muscle Relaxation Video

   

 

 

SELF-SOOTHE Skill

Self-soothing through the 5 senses can quickly reduce the intensity of negative emotions. Be prepared & make a self-soothe kit before you need it.

1. Sight – focus your eyes on things that are soothing or pleasant 

  • Go to nature (it can be a park nearby). Look at the sky, clouds, trees, flowers, grass, snow, etc.  
  • Find pictures that are calming. Photos of people or things you know. Search the Internet of places that you find soothing to look at ( cities, nature,  art)
  • Visualize a calm place or a happy memory.
  • If you are looking for something funny, here is the Awkward Family Photos website: https://awkwardfamilyphotos.com/category/photos/

2. Hearing – listen to soothing, relaxing, or pleasant sounds

  • Talk to a person whose voice makes you happy or you enjoy hearing.
  • Listen to your favorite relaxing music – make a playlist in advance.
  • Listen to a soothing app, asmr, white noise, rain sounds, or guided meditation.

Here are some apps that may be helpful for relaxing noises and sleeping:

Here are some apps that may be helpful for meditation:

  • Insight Timer: over 30,000 pre-recorded guided meditation sessions loaded onto Insight Timer, as well as the ability to refine sessions based on how long you have to practice
  • Smiling Mind: developed by psychologists and educators to help bring balance to your life.

Here are some videos that have relaxing sounds:

 

3. Smell – focus on scents that are soothing or pleasant

  • Smell a perfume, lotion, or cologne you enjoy.
  • Cook a meal that smells delicious.
  • Other smoothing smells: lemon, peppermint, cinnamon, lavender

4. Taste – taste yummy, delicious, or strong tastes

  • Cook your favorite meal, eat it slowly and savor its taste.
  • Go to your favorite place to eat your favorite meal.
  • Drink something warm. Make yourself a cup of coffee, tea,.
  • Chew gum or eat mints/hard candy.

5. Touch – use your sense of touch to calm yourself

  • Pet an animal. Hold it in your lap.
  • Take a shower or a bath and enjoy the warm water.
  • Use a fidget toy or stress ball – put it on your keychain
  • Massage your hand – can do this anywhere
  • Put on comfortable clothes

 

 

RADICAL ACCEPTANCE Skill

Why Radically Accept the Pain?

  • Pain is inevitable.  Everyone experiences pain. Pain is not an optional part of being alive. Pain is most often temporary. It creates feelings of sadness, disappointment, loss and frustration.
    • Pain + Acceptance = PAIN
  • Suffering is optional.  Suffering is caused by a refusal to accept the reality as it is, resulting in a deep and prolonged state of distress, helplessness, rage, disgust, revenge, hopelessness, hatred or anger. 
    • Pain + Non-Acceptance = SUFFERING

What Radical Acceptance is NOT: 

  • It does not mean agreeing with everything that has happened
  • It is not approval
  • It is not ignoring or denying a situation

How to Use Radical Acceptance:

  • Turn your mind towards acceptance (and away from fighting reality)
  • Practice accepting (turning the mind) again and again. 
  • Use relaxation, prayer, coping statements, or mindfulness to soften the pain
  • Coping Statements:
    • “This is how it has to be.”
    • “I can’t change what has already happened.”
    • “There is no point in fighting the past.”
    • “I can survive this, even if I don’t like what is happening.”
    • “What I do in this moment, is all I have control over.”
    • “Every event in my life has brought me to now.”

Allow yourself to feel disappointment, sadness or grief, without fighting it.

 

Distract with Wise Mind A.C.C.E.P.T.S.

A – Activities. Sometimes the best way to give the mind a break from stress is to get physically busy. Focus your attention on hobbies, chores, or other activities like playing music,  going for walk, organizing a closet, or food shopping. 

C – Contributing. Focus your attention on doing something good for someone else. Volunteer for a community cause, help a friend who’s shorthanded at work, babysit your nephew – all activities that require focus. Contributing to the needs of someone else can help us to feel good about ourselves too.

C – Comparisons. Sometimes all we need to do is compare our own situation to a time in the past when we were worse off. This helps us feel grateful and, sometimes, proud. It may also be helpful to think about how fortunate you are compared to those who have less.

E – Opposite Emotions. Balance negative feelings by focusing your attention on positive emotions. Listen to music that makes you happy to counterbalance feelings of sadness. Watch a comedy to reduce feelings of anger. Find a clam place, do a mindfulness exercise, listen to soothing music to relieve anxiety. 

P – Pushing Away. Pushing away is about sending stressful thoughts away. Take control of these thoughts by writing them down on a piece of paper and then ripping it up. Build an imaginary wall between yourself and the situation. Imagine yourself pushing it away with all of your strength. Block the situation in your mind. Each time it comes up, tell it to go away, or put some other thoughts in its place, perhaps some more pleasant thoughts. Refuse to think about it. Try putting the pain on a shelf, or in a box, to contain it and get it out of the way. I use the technique of putting my distress in a locked box on a shelf in a closet. I can get it later, but right now I can let it go.

T – Thoughts. Distracting with thoughts are our “go to” thoughts that simply and quickly distract our mind. Count to 10.  Count the tiles in a floor or the panes in a window or the stars in the sky, anything to keep your focus on the counting.  Other ways of distracting with thoughts are reading, watching videos or movies, doing crossword puzzles or jigsaw puzzles. 

S – Sensations. Use an attention-grabbing physical sensation to distract you. Cold water splashed on the face may do it. You might hold ice in your hand or apply it to the back of your neck, put a rubber band on your wrist and snap it, listen to loud music, take a hot, hard shower, or a cold, hard shower. Any strong physical stimulus will distract you from painful thoughts, emotions, and physical sensations.

 

 

PROS & CONS Skill

Pros and Cons is great to use in anticipation of problem behaviors like avoiding, lashing out, shutting down, self-harm, or any kind of addictive behavior. Just make sure that you’re in your Wise Mind when you write out your Pros and Cons list, rather than Emotion Mind. Here is a great podcast you can listen to that explains how to do the Pros & Cons Skill:

  • What is it?
    • Pros and Cons is the opposite of acting impulsively or without thinking
    • Consider both long and short term goals when using Pros and Cons
    • Identify behaviors or urges that don’t help you and that you would like to change
  • How to do it?
    • Make a list of the pros and the cons of acting on the urge
    • Identify the pros and cons of resisting the crisis urge 
      • Often the downside of resisting the urge is that you feel bad, or perhaps even miserable, in the moment 
      • Usually, the major benefit of acting on the crisis urge is immediate relief
  • Keep your Pros and Cons list somewhere handy: in your wallet or on your fridge so you can see it when you need it!
Pros & Cons Worksheet

Use this skill to (1) resist impulsive or destructive urges (e.g., quitting your job, skipping appointments, drinking or using drugs, yelling at someone, other risky behavior or something harmful for your long-term goals) or (2) compare different options.

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