Distress Tolerance Lesson 5a - Improving the Moment
Manual: p. 99 (paragraph 1a); p. 167 (1st paragraph), p. 179
The four basic kinds of skills for learning to tolerate distress.
Distraction
Self-soothing
Improving the Moment
Thinking of Pros and Cons
See page 165 in the manual for a list of Distress Tolerance skills.
Improving the Moment.
At times when you can't or don't want to use distracting or
self-soothing skills, when you are in a difficult time or a stressful
situation, there are a number of skills you can use for improving the
moment. These will reduce your distress, sometimes just for a short time
(though you can always repeat them), and sometimes for longer. We can learn
to make ourselves feel better. If we can't change the situation we are in,
or the struggles we are having, we can change the way we feel. I think that
it takes some practice to learn these skills, so I am going to present them
one at a time.
IMAGERY
See p. 99 (paragraph 3a) of the manual, and Distress Tolerance Handout
1, p. 168 (first paragraph).
Using imagery, you can create a situation or a scene that is different
from the one that you are now in. In a way, you can leave the situation.
Envision in your mind a place that you would like to be - a safe place, a
relaxing place, a beautiful place. Focus on this place. Relax, and let
yourself feel that you are in this place. It usually helps to notice
details of the place that you are in. See that safe place, maybe a room,
that is fixed up just the way you want it. Or imagine that spot along the
ocean, or being with a good, safe friend.
Imagine things going well for you. Imagine that you know how to take
care of the situation you are in. If you practice doing this, you will find
that it begins to work for you. Things DO go better, and you CAN cope
better. You can deal better with the crises in your life, if you practice
feeling like you can take care of things.
Create a safe, comfortable place for yourself. It will help if you do
this in a quiet room or a quiet spot outdoors. Try to relax, and close your
eyes if you feel safe. Settle into this comfortable, safe, beautiful place.
Let your hurtful feelings drain or wash out of you, relieving you and making
you more comfortable. Breathe slowly and gently as you do this.
1. Picture a place in your mind where you feel good and safe. Look at what
is around you. This may be a cozy room, an outdoor spot, a place with a
friend.
When you feel distressed this week, picture this place. Hold on to the
image. Feel yourself there, safe and comfortable. Stay there as long as
you need to.
2. If you are having a problem or conflict, picture yourself dealing with
it effectively. Tell yourself that you can handle the situation.
These skills need to practiced when you are not in a crisis, in order to be
effective during a crisis. Try to practice for at least a few minutes each
day.
Prayer
Prayer to a supreme being, God, a higher power, or to your own wise mind.
In moments of great distress prayer can relieve distress or help you to
tolerate it better.
Using prayer as a distress tolerance technique is discussed on page 99,
column 2, in your manual. Marsha Linehan talks about several kinds of
prayer.
Linehan talks about the "Why me?" prayer and the "distress" prayer, in both of
which you are asking for something, perhaps rather desperately, maybe asking
to be relieved from your distress or asking for something particular to
happen or asking whomever you are praying to to have pity on you.
There is another way of using prayer that she calls acceptance prayer. This
is a lot like radical acceptance. You open yourself to what is, whether you
are praying to a God or higher power or to your own wise mind. This is not
begging to have suffering taken away, and it is not a "Why me?" prayer.
Prayer can be a way of being present with your distress, of not fighting it,
while at the same time not saying it is okay.
IMPROVING THE MOMENT: RELAXATION
(Manual, bottom of p. 99)
Use of relaxation and stress reduction exercises is an excellent way to
help ourselves feel better in the moment. Many of us are tense, and become
more tense when we are in distress. Relaxing changes that response. The
goal is to accept reality with the body, not to fight against it or try to
push it away. The body and the mind are closely linked. Relaxing the body
also relaxes the mind.
Some of the relaxation techniques that you might try are listening to a
relaxation tape (can be found in book stores, health food stores, sometimes
gift shops), exercising hard (think of how relaxed you feel after a good run
or swim or a long walk), taking a hot bath, massaging your neck and scalp,
legs and feet, breathing deeply, drinking some hot milk, cocoa or herbal
tea, sitting in a hot or cold tub until the water becomes tepid, listening
to music.
Short Relaxation Exercises
Note: All of these exercises involve breathing, most of them deep
breathing. Some people find that this causes panic. A couple of people
have suggested to me that reversing the sequence, that is, breathing out
first and then in, instead of in and then out, does not cause the same
panic. So give that a try. If it does not help, then just go ahead with
the rest of the execise.
Breathing Awareness
Lie down on the floor with your legs flat or bent at the knees, your arms at
your sides, palms up, and your eyes closed. Breathe through your nose if
you can. Focus on your breathing. Place your hand on the place that seems
to rise and fall the most as you breathe. If this place is on your chest,
you need to practice breathing more deeply so that your abdomen rises and
falls most noticeably. When you are nervous or anxious you tend to breathe
short, shallow breaths in the upper chest. Now place both hands on your
abdomen and notice how your abdomen rises and falls with each breath.
Notice if your chest is moving in harmony with your abdomen. Continue to do
this for several minutes. Get up slowly. This is something you can do
during a break at work. If you can't lie down you can do it sitting in a
chair.
Deep Breathing
This exercise can be practiced in a variety of positions. However it is
most effective if you can do it lying down with your knees bent and your
spine straight. After lying down, scan your body for tension. Place one
hand on your abdomen and one hand on your chest. Inhale slowly and deeply
through your nose into your abdomen to push up your hand as much as feels
comfortable. Your chest should only move a little in response to the
movement in your abdomen. When you feel at ease with your breathing, inhale
though your nose and exhale through your mouth, making a relaxing whooshing
sound as you gently blow out. This will relax your mouth, tongue and jaw.
Continue taking long, slow deep breaths which raise and lower your abdomen.
As you become more and more relaxed, focus on the sound ansd feeling of your
breathing. Continue this deep breathing for five or ten minutes at a time,
once or twice a day. At the end of each session, scan your body for
tension. As you become used to this exercise, you can practice it wherever
you happen to be, in a standing, sittimg or lying position. Use it whenever
you feel tense.
One Thing in the Moment
(page 100, col. 1)
One thing in the moment is the same thing as One-mindfully, or Mindfulness,
which we talked about when we discussed the Core Mindfulness skills. It
means focusing on the one thing that you are doing right now, in the present
moment. This can be very helpful if you are in a distressing situation or a
crisis. It can give you some time to settle down and calm down. Often our
suffering is made more intense by remembering past suffering and worrying
about future suffering. If we can stay in the moment and focus on what is
happening in the here and now, our suffering will be greatly reduced.
You might try this exercise, suggested by Marsha Linehan in the manual.
Close your eyes and get in touch with some current discomfort or anxiety.
one that you are experiencing right now. Notice your level of discomfort.
Now start thinking about times in the past that you have had to endure such
feelings, and think about how many more times you are going to have to
endure such feelings. Notice your level of discomfort.
Now let your mind refocus on this moment, letting all the past and future
thoughts and feelings go. Take some tme to focus again just on this present
moment. Notice your level of discomfort.
To get a sense of what "in the moment" or mindfulness feels like, I invite
you to try the following exercises. Just breathe slowly and gently through
each exercise, and concentrate fully on what you are doing right then.
Awareness Exercises
1.Breathing Awareness
Close your eyes, put your right hand on your abdomen, right at the
waistline, and put your left hand on the center of your chest. Without
trying to change your breathing, notice how you are breathing. Which hand
rises most as you inhale, the hand on your chest or the hand on your belly?
If your abdomen expands, then you are breathing from your abdomen or
diaphragm. If your belly doesn't move, or moves less than your chest, then
you are breathing from your chest. The trick to shifting from chest to
abdominal breathing is to make one or two full exhalations that push out the
air from the bottom of your lungs. This will create a vacuum that will pull
in a deep diaphragmatic or adbominal breath the next time you breathe in.
Focus on your breathing in this way for a few minutes.
2. Body Scanning
Close your eyes, and starting with toes and moving slowly up your body, ask
yourself "Where am I tense?" When you discover a tense area, exaggerate it
slightly, so you can become aware of it. Be aware of the muscles in your
body that are tense. Then, for example, say to yourself, "I am tensing my
neck muscles...I am creating tension in my body." At this point, be aware
of anything that is creating tension in your body and what you might do to
change it.
3. Using Your Breath
Use your breath in helping you to become more aware in your everyday
life. Cue into the process of mindful breathing in all different
situations - waiting for the bus, watching the sunset, sitting in church,
eating an ice cream cone, playing with your dog, listening to your favorite
music.
Ask what is my body doing?
Where are my thoughts taking me?
Who is the person I'm talking with?
What does this food feel like in my mouth?
Why is my shoulder feeling so tight?
This awareness is the verbalized appreciation of the way things are -
the experience of "just being with" the flower, the other person, the
movement of your body as you dance. You are in the moment, enjoying and
appreciating what is.
4. Awareness of Sound
a) Close your eyes and stand very still. Listen carefully. What is the
furthest sound you can hear? Concentrate on that one. Hear it with the
"ear" of every cell of your body.
b) Stand very close to a tree or bush. Listen only for the sound of the
wind playing with the leaves or branches. Experience yourself as a tree.
Listen for what the wind does to your body.
c) Locate a source of running water - a river, a stream, a waterfall.
Close your eyes and allow the sound of moving water to fill you. Try to
attend to nothing else. Hear the water with your whole body. Imagine that
it is running through you - the channel. Allow it to cleanse and refresh
you. Become a part of the water.
d) Most large buildings have an air-conditioning system or heating
systemwhich makes a continual background noise. Close your eyes and listen
for this sound. Use the sound to relax yourself.
6. Tangerine/Orange Meditation
Sit at a table with a tangerine or an orange in front of you. (You may
also use a grape.)
Look at the tangerine. Look at the color and the shape. Notice any
markings. See the dimple at the center. Is it exactly round? Hold the
tangerine in your hands. Feel the skin. Smell the skin. Imagine the
grove where the tangerine grew, and see it hanging on the tree. See the
othern trees in the grove. Now begin to peel the tangerine. Feel the
oiliness of the skin. Notice the inside of the peel. Notic the color and
shape of the section. See the white strings on the section of tangerine,
Hold it to your nose and smell its frangrance. Bite into th tangerine.
Feel its texture. Notice its taste. Are there seeds? Is it juicy? Does
the juice run down your chin or get on your fingers? Continue to eat the
pieces of tangerine - how many slices are there? Notice how you feel after
eating the tangerine. How was the experience of really taking notice of how
it looked, smelled, tasted? This is mindful eating.
Try eating some other foods in this way, really paying attention to the food
and the experience of eating it.
