Eating disorder recovery is a process that involves addressing underlying emotional issues, challenging deeply ingrained thought patterns, and learning new coping mechanisms while navigating societal expectations. As a result, it is not uncommon for individuals to experience emotional distress throughout the recovery process.
Dialectical Behaviour Therapy (DBT) is a therapeutic approach originally developed for the treatment of borderline personality disorder, but has since been adapted to aid in the treatment of other mental health conditions, including eating disorders. One of the core concepts in DBT is distress tolerance, which refers to the ability to manage emotional distress during difficult situations without turning to maladaptive coping strategies. By learning and practicing distress tolerance skills during the recovery process, individuals can develop more positive ways to manage emotional distress, which can be a triggering factor for disordered eating behaviors.
This article will discuss the basics of understanding distress tolerance, common distress tolerance skills and how to put these skills into practice.
Understanding Distress Tolerance
Before we can learn to tolerate distress, we need to be able to recognize when we are experiencing emotional distress. Emotional distress may look different for each person, but may include strong emotions such as anger, depression, anxiety, shame and guilt. Individuals may experience racing thoughts, critical self-talk, or even feel emotionally numb. These emotions can be overwhelming and make it difficult for an individual to function. It is important to acknowledge the distress, remember that all emotions are valid and to make space for them. Once we are able to recognize and acknowledge the distress, we can implement positive coping skills in lieu of maladaptive behaviours.
Common Distress Tolerance Skills
Radical Acceptance
Radical Acceptance involves accepting the reality of the current situation without judgment, even if it is undesirable. In eating disorder recovery, this could involve acknowledging that recovery is a challenging, but temporary process, and accepting the emotions and thoughts that arise during that journey with compassion. Acknowledging and accepting the things we cannot change frees up mental energy and allows us to focus on taking those small steps towards healing.
Self-Soothing Techniques
One way to manage emotional distress is to engage in comforting and enjoyable activities that can help distract us from distress, reduce tension and help with emotional regulation. Examples might include reading, taking a warm bath, listening to relaxing music, watching a funny television show, or cuddling with a pet. Creating a list of activities ahead of time can be helpful in times of emotional distress by reducing the need to make decisions in that moment.
Grounding Techniques
Grounding techniques aid in emotional regulation by helping us focus on and engage in the present moment, instead of getting caught up in our thoughts and emotions. Grounding techniques usually involve engaging the senses or describing our surroundings. Examples include deep breathing, mindfulness meditation, 5-4-3-2-1 technique, smelling essential oils, listening to relaxing music or touching a textured object.
Turning Knowledge into Practice
Like any skill, distress tolerance becomes easier with practice and repetition by incorporating them into our day-to-day life and routines. Experiment with different techniques to find which ones work best for you and create a distress tolerance “toolkit” with coping skills that you can easily access in moments of emotional distress.
You also do not have to navigate emotional distress on your own – it’s okay to reach out for additional support. A mental health therapist or counsellor can guide you through the process of distress tolerance and walk with you on your journey towards recovery and healing.
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