The Distress Tolerance module of Dialectical Behavior Therapy (DBT) incorporates a number of types of Distress Tolerance skills designed to help distract us and get us through challenging emotions in situations where we feel a loss of control.
Decreasing emotional distress as a symptom of situational challenges is one of the primary goals of DBT. There are a number of skills trainings that go into the Distress Tolerance module which can help with this, including:
- PROBLEM SOLVING
- RADICAL ACCEPTANCE, and
In particular, the self-soothing skill is very easy for patients to take and apply in almost any situation. It’s a positive and easy way to distract yourself from emotional pain, to promote positive and pleasant, comforting experiences instead, and to offer a sense of relief. Self-soothing helps us to pass the time amidst a challenging circumstance without making things worse, and can help us avoid an escalation of symptoms like emotional distress, panic attacks, withdrawal, or even slipping into impulsive and unhealthy coping behaviors like self-harm or substance abuse.
Self-soothing means using your 6 senses to ground yourself in the present. Doing this helps you to avoid spinning out of control, getting caught up in an emotional torrent and increasing your distress.
The simplified version of Self-Soothing involves:
- Hearing: listen to soothing music or focus on sounds you like around you, such as wind, birds, etc.
- Vision: focus on soothing visuals such as the trees, skyline, nature
- Smell: choose scents that relax you such as peppermint, lavender, fresh baked bread, etc.
- Taste: find a tea or food that has a calming effect on your body, like herbal tea, or fresh fruit.
- Touch: use a texture like a soft blanket or your pet’s fur to help you relax.
- Movement: use dance, running in place, or any form of exercise to move your body.
The theory behind self-soothing exercises is that our five senses can be a healthy and effective way to relax and find peace amidst distress. When we engage in sense-focused activities, we distract ourselves from distressful situations and re-ground ourselves in the present. Each person is different, so some senses may offer more relief than others. You might feel better listening to sounds, where someone else may find greater peace in soothing visuals.
Here are some additional ways you can engage your senses that you might find beneficial and enjoyable and centering. Achieving a sense of relaxation can positively impact your physical health and improve your situational awareness.
- Find somewhere in nature or anywhere outside that offers a respite from your day-to-day life. Take time to observe trees, grass, sky, different colors and animals or people around you.
- Find soothing images to look at such as places you’ve been that offer nostalgia, beautiful sunsets, cities, nature or other images.
- Watch a movie well-known for cinematography, or find something with a story that won’t be difficult to watch.
- Collect images that you find pleasant in advance of any stressful situations, so you can look at them as needed.
- Listen to your favorite music or any sounds that make you feel relaxed, like ocean waves.
- Call someone whose voice makes you happy or you find soothing to talk to.
- Listen to live sounds at a nearby park or such as people talking, birds, wind, leaves rustling.
- Play a musical instrument or sing if you normally participate in these activities.
- Find an audio book or podcast that helps you relax and disconnect.
- Cook a delicious meal or make a snack that you can enjoy that smells delicious.
- Put on a perfume with a smell you enjoy.
- Take a bath with aromatic salts or lavender to relax.
- Buy yourself flowers with a strong, beautiful smell.
- Go somewhere with a scent you enjoy like a leather shop, restaurant, bakery or somewhere outdoors.
- Cook a favorite meal and eat slowly to enjoy every bite.
- Get some healthy snacks or comfort food like chocolate, a smoothie or popcorn.
- Make yourself a cup of tea, cocoa, or anything else you enjoy sipping on (avoid alcoholic beverages).
- Wrap yourself in your favorite blanket or sweater and think about how it feels on your skin.
- Pet your dog or cat slowly and enjoy the sensation.
- Take a hot shower or bubble bath and feel the water flowing over you.
- Put on your most comfortable clothes and relax somewhere peaceful.
Every attempt to re-ground yourself through self-soothing exercises makes the next time a little easier. Don’t get discouraged! Learning to turn to this DBT practice can significantly improve your quality of life and diminish your symptoms over time.