Stress and Anxiety Management the DBT Way

Anxiety and stress appear to be the next pandemic. I see so many people who are anxious, overwhelmed, edgy, panicky, full of worry, and always tense. If any of these words describe you and leave you with a constant feeling of uneasiness to all-out panic, you could be suffering from poor stress management.

Dialectical Behavioral Therapy, or DBT was developed by Marsha Linehan in the 1970s. She had her own experiences with mental illness that perhaps gave her a unique view of the subject. DBT combines many tools to create a unique network of skills. These skills help restructure thinking or negative self-talk, teach mindfulness skills, and teach us to stay in the moment. The skills also help to balance acceptance of oneself and life situations and changing oneself and life situations. The Distress Tolerance chapter comes to mind to help deal with tolerating stressful events and emotions in your life without making things worse. How often do we have something stressful happen, experience extremely difficult emotions, not choose a helpful coping skill, and make it worse? Some of the tools from the Distress Tolerance chapter can help.

DISTRACTION SKILLS: This skill set has many ideas.

• Activities– Some things you may already enjoy, movies, games, sports, reading, building something, exercising, and talking to friends.
• Contributing– Doing volunteer work, surprising someone with something nice, or doing something thoughtful.
• Utilizing Different Emotions– Such as reading emotional books, or shows to elicit an opposite emotion, listening to emotional music, or reading funny blogs
• Pushing Away– Leave the situation for a bit mentally or physically
• Other Thoughts– Try counting to ten, doing puzzles, or games watching TV, or movies or anything that makes you think
• Sensations– Take a warm or cold shower, hold ice in your hand, squeeze a rubber ball, or go outside in the cold2.

SELF-SOOTH SKILLS

• With Vision– go outside and take in the night sky, lie on your back and look at the clouds, look at the flowers and nature, go to a performance, watch a sunrise or sunset
• With Hearing– listen to soothing or invigorating music, play an instrument, be mindful of all the sounds around you
• With Smell– use your favorite soap or body wash, burn a candle, smell the roses
• With Taste– Eat some of your favorite food, treat yourself to dessert, chew your favorite gum, eat mindfully, really tasting your foods.
• With Touch– Take a long hot bath or shower, pet your cat or dog, treat yourself to a massage or put on and notice fresh sheets, a weighted blanket or anything that feels soothing.

This is only a partial list of Marsha Linehan’s DBT Distress tolerance skills. Many other skills can be helpful for anxiety or stress. If things feel very overwhelming please consider inquiring about a DBT Intensive Out Patient Program (DBT IOP) for total immersion into all the DBT skill sets.

Cathryn E. Knezevich, M.Ed., PCC
Therapist and DBT IOP Director
The Behavioral Wellness Group