Adulting, Chapter 3: Basic Distress Tolerance Skills

Everyone experiences overwhelming emotions sometimes. It’s not an experience unique to people who are neurodiverse or in recovery. We will all feel overwhelmed from the loss of a loved one at some point. And who goes through life without ever having a Terrible, Horrible, No Good, Very Bad Day? It would blow my mind to meet the sort of person who is so enlightened they have no ‘hot buttons’ to push. But it is worth acknowledging that some people find themselves overwhelmed by emotional or physical pain more often than others.

Sometimes I have a Big Feelings Day. The intensity and magnitude of my feelings disorients me, and I can focus on little else. This happens less often than it used to, but the main change has been how I cope. Some of my coping strategies have been maladaptive, meaning they helped to alleviate my distress to some extent but didn’t adequately help me adjust to the situation. Over time, I have come to rely on many of them less as I’ve developed basic distress tolerance skills.

Basic distress tolerance skills have helped me to be less judgmental of myself or any situation, which has helped me not run through mental loops when I feel stuck in Big Feelings, fixated on How Things Should Be, unable to tolerate how things are.

So how do you develop basic distress tolerance skills?

Step 1: Inventory your current coping strategies.

It helps to begin by inventorying your current coping strategies and asking your friends how they deal. In my case, taking a few minutes away from other people to focus on my breathing or letting myself get sucked into a book often help me. But they don’t always feel like options, so I’ve often turned to maladaptive coping strategies. For example, sometimes I deal with stress by playing out uncomfortable conversations I will probably never have in my head while I’m showering. Or I isolate myself from other people and avoid dealing with my problems. I might avoid anything I enjoy because I feel like I deserve to be miserable. Most likely, I pick my skin, subconsciously scanning my face with my fingertips until I find some (possibly imagined) defect. The main appeal of these coping strategies is their familiarity. I roughly know what to expect. But some come at the cost of possible future suffering.

Step 2: Weigh the possible costs of your coping strategies.

It is necessary to weigh the possible costs of your coping strategies if you want to develop a set of distress tolerance skills. Keep in mind, they might not all cause you problems in the future. A lot of people get stuck here and want to skip this step. It can be tough to do this without feeling critical towards yourself or guilty. But it’s important to be honest with yourself about the future costs you’re willing to pay for relief in the moment.

For example, my skin-picking comes with a cost. I’ve been picking my skin for over 20 years now. Of course I feel self-conscious about how I’m covered with scars. I do it less than I used to, but sometimes I am willing to pay the price of scarring or the risk of infection for guaranteed relief. Admitting this to myself gives me the space to not analyze why I engage in self-harm.

I find it more difficult to examine the possible consequences of maladaptive coping strategies that feel abstract. My excessive worrying about the future has caused me to be indecisive and miss out on opportunities. My isolation has alienated friends, causing people to reach out less over time so I’m not often included in things. It’s hard to acknowledge those consequences: My instinct is to judge myself for repeatedly making those mistakes. But to develop basic distress tolerance skills, we need to find a way to suspend judgement.

Step 3: Try suspending judgment through radical acceptance coping statements.

When the present moment is painful, our first instinct might be to get upset or blame someone. Our internal monologue might sound like “Why is this happening to me? What did I do to deserve this? I can’t deal with this. I can never catch a break. I wish things were different. People shouldn’t act the way they do. This isn’t fair.” But does that change that whatever caused us pain already happened? No. Does judging ourselves for how we’re handling the pain make us handle it better? Probably not. It probably just blinds us to what’s happening around us and keeps us from doing anything to improve the present moment. So why not reframe it?

Radical acceptance is a way of reframing the present moment: We acknowledge the present situation without judging what’s happening or how we’re responding. We acknowledge our present situation exists in the context of a chain of events that began in an immutable past. We make space to develop a new perspective and notice details we might be missing.

Case in point: This morning I made a smoothie. I knocked the entire glass onto the kitchen floor. Green goo spilled out across the linoleum, studded with shards of broken glass. I was about to spring into action. I was pissed off at myself: Today had to be the day I poured my smoothie into a glass instead of drinking from the plastic blender cup. I used a radical acceptance coping statement: “I can’t change what’s already happened.” (Did you think I was going to say, “No use crying over spilt milk,”? Well, it was dairy-free.) I noticed where the broken glass was, so I didn’t hurt myself. I cleaned up the mess. My day was fine. The minor inconvenience wasn’t a bad omen or a reflection of my character.

Radical acceptance coping statements aren’t appropriate for everything—they should not be used to accept abuse or exploitation, to let burnout go unchecked, or so you don’t have to make a choice you are afraid of making. The point of these statements is they allow us to conserve emotional energy and attune ourselves to areas where we can actually affect change. Consider the first stanza of the serenity prayer so many people in recovery use:

God grant me the serenity
To accept the things I cannot change;
Courage to change the things I can;
And wisdom to know the difference.

Serenity Prayer

Find yourself a radical acceptance coping statement. Something like “I can get through difficult emotions even if it is hard,” or “Even though I might not like what happened, the present moment is exactly what it is,” or “What I am going through right now is hard but it is temporary.” Pick a minorly annoying event, like having to wait in a long line or heavy traffic. Instead of judging the situation, use a radical acceptance coping statement. Work up to more stressful situations. This becomes easier with practice.

Step 5: Develop ways to distract yourself from overwhelming emotions and maladaptive coping strategies.

A distraction technique is any activity you can engage in to redirect your focus from something upsetting, like a panic attack or a flare up of chronic pain, to something less upsetting. Try starting a conversation with your friends about how they distract themselves from something unpleasant. Maybe they use something they learned from a person who works in mental health, like progressive muscle relaxation or a breathing exercise. Maybe they call someone up and ask them how they’re doing instead of ruminating on their negative emotions. Some people go for a walk to clear their heads. Maybe they play some video games or draw.

Make a list of ways to distract yourself. Without being critical, consider the possible costs of these distraction techniques. When you distract yourself with video games, are you likely to spend 8 hours on them while you neglect to drink enough water or stretch? I am. In those cases, ask yourself if there’s some way you can minimize the cost or if it isn’t a viable distraction technique for you. In my case, it’s fine for me to play video games as long as I set a timer and I don’t have any assignments due.

Step 6: Organize these strategies into a distraction plan.

Consider these your distraction techniques in terms of “if-then” statements:

  • “If I am at home and I feel overwhelmed, then I can _____.”
  • “If I am away from home and I feel overwhelmed, then I can _____.”

Try to come up with ten for both categories. Consider relevant scenarios at home and away:

  • “If I am away from home and I feel overwhelmed, but I have no money, then I can _____.”
  • “If I am at home and I feel overwhelmed but it’s 2am and none of my friends are available, then I can _____.”

Write down both lists in places that will be accessible to you even if you don’t have your phone, like a notecard in your wallet and a post-it on your fridge or bathroom mirror.

Step 7: Develop ways to relax and soothe yourself.

The ways you currently cope tell you a lot about what you’re seeking on a deeper level. Ask someone whose opinion you value how they relax and soothe themself. We discussed how we relax at JRB and started this list you can use to explore some options:

  • Pick up a hobby you can do in 5-minute intervals, like playing an instrument, crocheting, or practicing a foreign language
  • Engage your sense of smell using a scented candle or essential oil diffuser
  • Get outside and rollerskate, play basketball, or snap some photos
  • Listen to music or a podcast (this can even make chores more relaxing)
  • Learn some deep breathing exercises
  • Practice progressive muscle relaxation
  • Spend time with an animal companion
  • Try gratitude meditation
  • Stretch and move

Step 8: Organize these strategies into a relaxation plan.

Same deal as step 6. Figure out what works within time, space, energy, social, and budget constraints.

For example, Skyler carves out time to relax in his schedule. By designating time for self-care, he accomplishes a few things: He makes himself actively practice his relaxation skills so it’s easier to use them when he needs them and it’s less likely he’ll run at a deficit. He holds himself accountable for his well-being, but he also models this behavior to his friends, encouraging all of us to step-back from the hustle culture grindset. For him, immersing in reading manga is a great way to take a break.

Smokey says watching Netflix or playing video games are enjoyable ways to distract himself, but he does not find them genuinely relaxing. For Smokey, the key to relaxation is doing something that gets him to live in the moment. He generally likes to relax by getting out of the house and into nature. This forces him to be more present. His ability to discern between distraction and relaxation is key to making plans for both.

In my case, I sometimes create situations where it’s almost impossible for me to truly relax because I’m avoiding something. I need to get out of my head as much as possible to relax if I’m going to break out of a cycle of perfectionism and procrastination. Inviting friends over for boardgames and a shared meal forces me into a deadline so I can put what I’m avoiding behind me, then the company keeps me from thinking about whether what I accomplished was good enough.

JRB wants to know:

How do you experience and deal with overwhelming emotions? Have you ever had a coping strategy that didn’t serve you well? What does self-care or relaxation look like to you? Feel free to respond by submitting something to the JRB blog in whatever way you like to express yourself—art, music, writing, whatever feels true to you!

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