How DBT Skills Can Help You Accept Your Reality

By: Zana Van Der Smissen Illinois

Hello and welcome back to another blog on how to use DBT skills in everyday life. Today the focus is on distress tolerance skills, one of the modules within Dialectical Behavioral Therapy. So, before we break down what distress tolerance skills are, let’s give a refresher on what DBT is.

Dialectical Behavioral Therapy or DBT has a set of modules that allows an individual to work on reacting to their environment, regulating their emotions, and being more mindful and present in their life. It also includes interpersonal effectiveness, covered in how DBT skills can help you get what you want, which focuses on improving how we communicate and connect with others. The second part of that series builds further on those same skills.

Distress tolerance skills are the skills we use when heightened emotions show up or we are in crisis; they allow us to come back to a state where we feel more comfortable and in control. Within distress tolerance there are several acronyms and ways that we can use these tools, so let’s break them down!

What Is TIPP?

First, there is TIP or TIPP which stands for Temperature, Intense exercise, Paced breathing and Paired muscle relaxation. When going through these steps, we can find physical and emotional ways to soothe ourselves. With temperature, it has been found that most people get warm when they get upset or are in a heightened state of emotions.

By splashing your face with cold water or grabbing an ice cube out of the freezer, we are shifting our body’s physical state to help bring us back to the present moment.

Intense exercise is another way to calm our bodies because we are releasing that energy in a healthy way. Paced breathing can look different for everyone but boils down to how can I control my breath at this moment? And what works best for me? There are so many various techniques that trying out a few might help you find what works best.

The paired muscle relaxation is a more recent addition to the acronym where you use a body scan to tighten and then relax your muscles throughout your body. By doing so, you are allowing your body to become even more relaxed than before doing the exercise. With this acronym in mind, we really are trying to focus on the mind-body connection.

IMPROVE

The second acronym we will be covering today is IMPROVE and is one of my favorite’s because client’s have found it helpful to have multiple options presented to them. IMPROVE includes steps or techniques that allow the individual to replace the negative situation they are in with a more positive “image” that can make the present moment more bearable.

I stands for Imagery, where the client is asked to imagine a scenario that feels safe, happy or positive in some kind of way. M and P can go hand in hand here where M is for meaning and P is for prayer. By finding meaning in the behaviors we are doing, we can feel more connected and have a higher chance of enjoying the moment. Prayer is also a way of reflecting and connecting more with the present. Relaxation is the next technique in the acronym, where if we can find a way to decompress through breathing, meditation or another activity, we can make the moment more manageable. The O in IMPROVE, stands for one thing that you can change or do to make the situation better for yourself, whatever that means for you. V in IMPROVE is for vacation and how an individual needs to escape from the day to day every once in a while as a preventative measure or as a way to recharge. The final letter is E; Encouragement where we can improve our self-talk or say our positive affirmations to make us feel more confident or comfortable in the situation.

With these two acronyms in mind, we can have multiple options of behaviors that we can choose to do while in distress and have the flexibility to make it our own.

You can read more about how these skills fit into the wider approach on our DBT page.

If you would like to speak with a counselor about the information above, Symmetry Counseling is here for you. We offer a variety of online counseling services, ensuring that you’re able to get practical advice for putting the information above into practice in your life. Explore our website to learn more about how we can help, or contact us now to schedule a virtual therapy appointment.