Now that we’ve covered mindfulness, there’s something that everyone needs to know.

There are times when mindfulness skills alone won’t do the trick.

That’s right! The core of DBT isn’t always the answer. In a highly emotional state, it’s difficult to access and properly use mindfulness skills. In those situations, it’s best to arm ourselves with distress tolerance skills.

Many problems can’t be solved immediately; some can’t be solved at all. Distress tolerance helps us tolerate the situation and unpleasant emotions that come with it. These emergency skills are used when you’re in the emotional “red zone” — a heightened emotional state when you’re ready to explode. To illustrate, I use a thermometer numbered 0–100. When your emotional temperature is lower — in the 0–70 range — you can and should use other skills. Once your emotional mercury registers over 70, it’s unlikely you’ll be able to use other skills effectively; it’s time to cool down quickly!

There are two categories of distress tolerance skills: crisis survival skills and reality acceptance skills.

Life is not pain-free, and we can’t expect it to be that way. Avoiding pain often creates more problems than it solves and may lead to impulsive actions. We need to have ways to cope with the distress in order to survive and thrive in tough situations; that’s what crisis survival skills are for (reality acceptance skills help us accept the hard things in life that cannot be resolved).

We start the module with crisis survival skills. These skills are for exactly what they sound like they’re for: surviving a crisis situation. The goal of distress tolerance is not to solve problems; it’s to tolerate the current situation and prevent it from getting worse. If the situation improves a little bit, that’s awesome, but it’s not the purpose of these skills; it’s also not a long-term solution, so don’t overuse it.

In a dangerous situation, panicking impulsively can make the situation worse. Imagine this: someone falls out of a boat into the ocean. Screaming and flailing around increases the risk of drowning; floating as calmly as possible — though it doesn’t feel good! — increases the chance of rescue. Crisis survival skills are the skills that keep us “afloat” in precarious situations.

Since crisis survival skills are used in the heat of the moment and many of us live highly emotional lives, we may need them a lot until we learn to effectively use other skills; that’s why it’s one of the first modules. Sometimes we need to use several skills (there’s a large selection, so we often have to try a bunch to find the ones that work) until our “temperature” goes back to normal and we feel regulated.

Imagine this: you get into a heated argument with your mother and you’re furious. Without skills, you know how it’ll go: you’ll act on your unhelpful urges to scream, slam doors, or make inappropriate statements. And you know what comes next: you’ll have to apologize and deal with the consequences. When you use your distress tolerance skills, you can make the situation end very differently. (Excerpted from Mishpacha Teen, Issue 671)