Distress Tolerance Handout 1B


Crisis Survival Strategies


Five Senses:

With Vision:

Buy one beautiful flower; make one space in a room pretty; light a candle and watch the flame. Set a pretty place at the table, using your best things, for a meal. Go to a museum with beautiful art. Go sit in the lobby of a beautiful old hotel. Look at nature around you. Go out in the middle of the night and watch the stars. Walk in a pretty part of town. Fix your nails so they look pretty. Look at beautiful pictures in a book (or online). Go to a ballet or other dance performance, or watch one on TV. Be mindful of each sight that passes in front of you, not lingering on any (driving).

With Hearing:

Listen to beautiful or soothing music, or to invigorating or exciting music. Pay attention to sounds of nature (waves, birds, rainfall, leaves rustling). Sing to your favorite songs. Hum a soothing tune. Learn to play an instrument. Call 800 or other information numbers to hear a human voice. Be mindful of any sounds that come your way, letting them go in one ear and out the other.

With Smell:

Use your favorite perfume or lotions, or try them on in the store; spray fragrance in the air; light a scented candle. Put lemon oil on your furniture. Put potpourri in a bowl in your room. Boil cinnamon; bake cookies, cake, or bread. Smell the roses. Walk in a wooded area and mindfully breathe in the fresh smells of nature.

With Taste:

Have a good meal; have a favorite soothing drink such as herbal tea or hot chocolate or coffee (no alcohol); treat yourself to a dessert. Put whipped cream on your coffee. Sample flavors in an ice cream store. Suck on a piece of peppermint candy. Chew your favorite gum. Get a little bit of a special food you don’t usually spend the money on, such as fresh squeezed orange juice. Really taste the food you eat; eat one thing mindfully.

With Touch:

Take a bubble bath; put clean sheets on the bed. Pet your dog or cat. Have a massage; soak your feet. Put creamy lotion on your whole body. Put a cold compress on your forehead. Sink into a really comfortable chair in your home, or find one in a luxurious hotel lobby. Put on a silky blouse, dress, or scarf. Try on fur-lined gloves or fur coats in a department store. Brush your hair for a long time. Hug someone. Experience whatever you are touching; notice touch that is soothing.

Distress Tolerance Handout 1A


Crisis Survival Strategies


“Wise mind ACCEPTS

With Activities:

Engage in exercise or hobbies; do cleaning; go to events; call or visit a friend; play computer games; go walking; work; play sports; go out to a meal; have decaf coffee or tea; go fishing; chop wood; do gardening; play pinball…

With Contributing:

Contribute to someone; do volunteer work; give something to someone else; make something nice for someone else; do a surprising, thoughtful thing…

With Comparisons:

Compare yourself to people coping the same as you or less well than you. Compare yourself to those less fortunate than you. Watch soap operas; read about disasters; others sufferings…(this creates a sense of gratitude; reminds me that things can always be worse and that I am not the only only one in a distressful situation; this takes the power out of the situation)

With opposite Emotions:

Read emotional books or stories (Bible Study); old letters; go to emotional movies; listen to emotional music. Be sure the event creates different emotions. Ideas: scary movies, joke books, comedies, funny records, religious music, marching songs, “I Am Woman” (Helen Reddy); going to a store and reading funny greeting cards.

With Pushing Away:

Push the situation away by leaving it for a while. Leave the situation mentally. Build an imaginary wall between yourself and the situation. Or push the situation away by blocking it in your mind. Censor ruminating. Refuse to think about the painful aspects of the situation. Put the pain on a shelf. Box it up and put it away for a while.

With other Thoughts:

Count to ten; count in another language; count colors in a painting or tree, windows, anything; work on puzzles; watch TV; read… (Mantra: I’m okay and I am where I am supposed to be right now.)

With Intense other Sensations:

Hold ice in hand; squeeze a rubber ball very hard; kneed silly puddy in hand; stand under a very hard and hot shower; listen to very loud music; sex; put rubber band on wrist, pull out, and let go…

Learning That Feelings Are Normal


Learning that feelings are normal.

Growing up in dysfunctional families, transcenders usually learn that feeling are not only, not okay, they have seen feelings acted-out in horrible, crazy, terrifying ways which usually brought more trauma and pain. They fear that they are going to act like their parents if they feel their feelings.

In therapy, a major learning is that all feelings are normal, okay and important. The awareness and acceptance of the feelings are the most important elements in healing, growing, and getting to know their authentic self. Feelings can be fused together, that is, the feeling of anger may also have fused with it, jealousy, hurt, etc. These feelings must be identified and a more appropriate way created to express them.

Here is an example:

Tiffany: “In my family, anger and happiness were the only feelings allowed. So, every heavy feeling fused with anger, and the lighter ones were happiness. I worked really hard at separating my fused feelings to figure out what I was really feeling. I loved learning about me and whatever fears I felt. I quickly worked through, because I knew my feelings were the ‘me’ I had been looking for so many years.

“I still remember learning for the first time about feelings, that feelings are not good or bad but just are part of being human. We don’t have to judge them, make them wrong or try to do away with them. We do have to accept feelings and learn about ourselves from them. I further learned that no one can be responsible for anyone else’s feelings but that we were totally responsible for our own.

“I faced many fears about accepting my feelings, especially the ones that surprised me: ‘What would my parents thing?’ ‘How would people respond to having real feelings and having opinions that come from those feelings?’ ‘Would I still be loved if I didn’t care about others’ feelings?’ and the questions run on. What the feelings taught me was to treat myself and to work with myself gently and lovingly. The abuse had already been done.”


  • Feelings need to be felt so they are not acted out and decisions are not based on them. They need to be felt appropriately and have absolute priority in therapy because they are the road map to healing. The therapist/other must make feelings the priority in therapy. This helps and enables them to accept themselves and everything that was and it.
  • For transcenders, it is vital to learn that feelings are normal and how to express them appropriately. This is sometimes difficult since they have seen these feelings acted-out in such dysfunctional ways, especially anger.
  • It’s important to help the transcender overcome the fear of feeling their feelings and learn how to express them appropriately.
  • Teach clients they can trust themselves with their feelings.
  • It takes diligent detective work by the therapist and transcender to begin to separate and identify fused feelings.

Training Webinar



This is a link to resistance depression training. If you or a loved one are suffering from depression even after being treated, learn more here. It’s free, it’s an hour long and the registration form is quick and easy. Sign up online. At the end of the registration save the free fact sheet and share the link with others. 
-Much love and support,


Distress Tolerance Skills


Pain and distress are part of life. They can not be entirely avoided of removed. The inability to accept this fact leads to increased pain and suffering. Distress Tolerance, over the short run, is part and parcel of any attempt to change oneself. Impulsive actions, otherwise, will interfere with efforts to establish desired change. Distress tolerance skills constitute a natural progression from Mindfulness skills. They have to do with:

  1. ) The ability to accept, in a non-evaluative and nonjudgmental way, both oneself and the current situation
  2. ) The ability to perceive one’s environment without putting demands on it to be different.
  3. ) To experience your current emotional state without attempting to change it.
  4. ) To observe your own thought and action patterns without attempting to stop and control them.

Do not confuse nonjudgmental as approval.

Acceptance of reality is not equivalent to approval of reality.


  1. ) To temporarily stop you from thinking about your pain
  2. )To give you time to find an appropriate coping response
  3. To help let go of the pain by helping you think of something else
  4. To buy you time so that your emotions can settle down before you take action to deal with a distressing situation.

Do not confuse distraction with avoidance.

Avoiding a situation means that you choose not to deal with it.

Distracting yourself from a distressful situation means that you choose to deal with it in the future when your emotions have settled down to a tolerable level.


Distress tolerance skills are concerned with tolerating and surviving crises and with accepting life as it is in the present moment. People struggling with overwhelming emotions often deal with their pain in very unhealthy, very unsuccessful ways because they don’t know what else to do. When a person is in emotional pain, it’s hard to be rational and to think of a good solution. Many of the coping strategies used by people with overwhelming emotions only serve to make their problems worse and lead to even deeper emotional pain because they offer temporary relief that will cause more suffering in the future.

Four sets of crisis survival strategies are taught:

  1. Ways to distract yourself from the situations that are causing you emotional pain.
  2. Self Soothing. Skills to bring you some amount of peace and relief from your pain so that you can figure out what you’re going to do next. They help you learn to treat yourself compassionately, lovingly, and kindly. Many people with overwhelming emotions have been abused or neglected as children. As a result, they were taught more about how to hurt than to help themselves.
  3. Improving the moment and thinking of pros and cons.
  4. Radical acceptance to increase your ability to tolerate distress by learning to look at your life in a new way, changing your attitude, and acknowledging your present situation without judging the events or criticizing yourself. It means, seeing the situation as it really is. It means you stop trying to change what’s happened by getting angry and blaming the situation. It means refocusing your attention on what you can do now. This allows you to think more clearly and figure out a better way to cope with your suffering. Choosing to accept reality as it is.

20 Stress Management Tips


1. UNDERSTANDING. Examine the cause of your anxiety and stress. Understanding is the first step. Know and accept your limits.

2. LET IT GO. Concentrate on the things you can change. Let go of the things that are beyond your control.

3. LET IT OUT. Communication is ventilation. Don’t put off discussing problems. A good cry is okay and healthy.

4. GET ORGANIZED. Focus on the most important tasks first, not just the easiest. List your goals. Follow through.

5. SEEK HELP. It’s okay to ask. Needing help is not a sign of weakness. Learn to delegate. (personal note: we ALL need help. It’s when we try to handle everything on our own that things fall apart)

6. PLAN YOUR TIME. Set realistic goals. Allow enough time to complete tasks. Learn to say no when your schedule is full. Take time for yourself.

7. EXAMINE EACH SITUATION. Don’t automatically slip into old responses that are not effective for you.

8. CHANGE NEGATIVE BEHAVIOR. Approach tasks in a positive manner. Target situations and people that support positive behavior patterns.

9. BE PATIENT. Take a deep breath instead of losing control. Learn and practice relaxation techniques.

10. HAVE FUN. Laughter is the best medicine. Take the time to find humor in stress situations.

11. GET REST. Replenish your energy. Change your environment. Vacations are important for both body and mind. Don’t wait until you are “burned out” before scheduling a break. (personal note: WAY easier said than done for me)

12. EXERCISE REGULARLY. Let out that built-up stress. Improve your overall health while building your self-esteem and stamina.

13. AVOID NON-PRESCRIBED DRUGS AND ALCOHOL. These substances will decrease your capability to handle stress. Seek professional help if you or a family member has a problem. (take prescribed medication as written, don’t abuse it just because you get refills and have access)

14. EATING HABITS. Eat regular well-balanced meals. Keep healthy snacks available for those busy times. Reduce the caffeine and fat in your diet.

15. QUIET TIME. Spend a few moments everyday to dream, relax and create a peaceful environment.

16. CHECK YOUR BODY LANGUAGE. (not one normally thought about but this does play a big roll in mood) Smile, smile, smile. Relax your shoulders and neck. Stand tall. Take a moment to stretch and reach.

17. COMPLIMENT YOURSELF. Recognize it when you handle a difficult situation. Accept praise from others.

18. TREAT YOURSELF. Monitor your schedule and budget. Spend some of your time, money and energy on yourself.

19. REMEMBER THAT WE ARE NOT PERFECT. Mistakes are part of growth. They happen to all of us. Forgive yourself for your imperfections.

20. STILL NEED HELP? For additional information, ask your physician or contact Foundation’s Health Education Department at (916) 631-5249.

Good Wishes


I just want to take the time and thank the people that follow and support this blog. I sincerely hope the entries help you.

I finally have internet again so now I will be able to post a lot more information. If you need information about something specific regarding mental health and addiction please let me know 🙂

Love you guys!

Identify and Label Cognitive Distortions


The following is out of a CBT (cognitive behavioral therapy) workbook.

Learning about your pattern of thinking can help you catch, modify, or change any distortions or negative thinking errors. Since our thoughts have a strong impact on our feelings and behaviors, there are positive benefits to correcting distorted thinking habits. Listed below are some common cognitive distortions. After reading each description, review your own thinking habits and then answer a simple yes or no if you have ever noticed yourself using the cognitive distortion. Remember, it’s not about good or bad or right or wrong it’s about becoming more mindful of your thinking patterns.

Cognitive Distortion:

Filtering: focusing only on the negative.

Polarized thinking; all or nothing thinking.

Overgeneralization: One negative event means everything is negative.

Mind-reading: Thinking others are thinking negative things about you.

Catastrophizing: Expecting disaster.

Magnifying: Magnifying the size of your problem.

Should statements: Feeling like you should or must do or not do something.

Blaming: Attributing blame to yourself.

Emotional reasoning: Feeling that something is true, therefore it must be true.

Personalization: Seeing yourself as the cause of a negative event.

Fortune telling: Making negative predictions.

Disqualifying the positive: Positive experiences are minimized.

Labeling: Putting negative labels on self or others.


From The Feeling Good Handbook by Dr. David Burns

Why boundaries?


“If we don’t know what we feel, we can’t know who we are. If we don’t know who we are, we cannot tell someone else who we are. We will be false selves.”

Most of our problems in life have to do with relationships, and the source of these problems in relationships are most likely tied to boundary issues. We will continue to have problems in relationships if we do not establish healthy boundaries for ourselves. Learning about boundaries and learning how to practice healthy boundaries takes time. We will always have to pay attention to them in order to maintain them; otherwise, we may revert back into old boundary habits. They are not established automatically.

Boundaries tell us what is our business and what is not our business. It is our business what we think of ourselves and what we think of other people, but it is none of our business what others think of us (unless we have violated their boundaries and owe them amends). Many of us allow our lives to be manipulated by the fear of what others think of us.

This fear of what others think of us is an indication that we have created false selves. These false selves are the people we were led to believe others would accept and nurture. If anyone appears not to like us or accept us, we we feel threatened because we fear rejection. We fear rejection because we’ve been rejected. We were rejected and our feelings were shamed during our development years. We were shaped by those no-talk rules in our non-nurturing, dysfunctional family: “It’s not OK to say that.” Dad’s drunk and the child says, “Dad’s drunk!” “No, Dad’s not drunk, Dad’s sick.” “Well, he fell down and passed out on the bathroom floor!” “He likes to take a nap about this time of the evening, and that’s just the way it is. He’s not drunk and your father’s not an alcoholic.”

In other words, we didn’t see what we saw, we didn’t hear what we heard, and what we thought was going on, was not what was going on. Those are crazy-making messages for a child and contribute to the creation of a false self.

The child says, “I’m tired of Dad not being here because he works all the time. It makes me angry.” “Shame on your for feeling that.” “Well, OK, Mom, what feeling would you like me to have?” “You should feel grateful.” “Oh, OK, I’ll be grateful that Dad’s never here because he works all the time and drinks the rest of the time.”

The child is made to believe that Dad is working so much and working so hard because of the family’s needs-that’s what makes him drink too much. “OK, now I’m supposed to feel grateful that he works, and guilty because it makes him drink, and ashamed because I feel angry, and rejected because what I think is going on is not what’s really going on.”

The little four or five-year-old is learning how to create a false self. When he’s grown, his feel hit the floor every morning and it’s “HEYYYYY, Mister False Self is here. How are you?” “Just fine, no problems at all.” “How ’bout some feelings?” “No, thank you. All that stuff is too confusing for me.”

We become who we think we are supposed to be and shame the person we really are. We live out our lives from behind those masks. Then, we go find another false self to have a relationship with. We are incapable of having an intimate relationship with another person who is real. We are threatened by the prospects of intimacy. Our relationship is like two pieces of a puzzle. We find a perfect fit and it feels close because we fit so well. We’re in LOVE. But there is no real intimacy. We’re really “in sick” or “in heat.” Together we seem to make one whole unit. But two half-people won’t make a full person. After a while the heat dies down between these two false selves, and she turns to him and says, “Well how do you feel?” And he says, “Well, I think…” “No, I didn’t ask what you thought, I asked how you felt.” “It doesn’t matter how I feel.” Well, I don’t think you love me.” “Of course I love you, I’m here, aren’t I? I haven’t left yet, have I?” Eventually this couple may end up in counseling on their way to the divorce court. The counselor may ask, “Tell me about yourself, Mr. Jones. Who are you?” “I work down at the mill over there, and I build these little widgets, and that’s what I’ve done for the last twenty years, and I’ll be retiring next year, and that’s what I do.” “No, no, Mr Jones. I asked who you are. You told me what you do.“”What do you mean, ‘who am I?'” “What do you like?” “What’s to like? You work, you pay bills, you sleep, you eat, you go back to work again.” “What do you do for fun?” “I’m fifty five years old. Fun is for kids. We don’t do fun.” “What was the last thing you and your wife did for fun?” “It was probably the year before we got married when we went to…”

Neither one of them can tell what they feel, think, want, or who they are. Their identities have been defined by this enmeshed, sick relationship they’ve been in for twenty years. All he knows is that he is sick and tired of her trying to fix him since the day they got married.

“I thought I was gonna, you know, get married and have a wife, and she’d have a husband. I didn’t know I was gonna be a project. And I can’t seem to get it right now matter what, so I don’t even try anymore.”

The more he retreats, the more frustrated she gets and that harder she tried to bring them closer by trying to be who and what he wants. Eventually, she gets so frustrated that she gives up and retreats also. Sometimes she’ll retreat to an affair, but eventually to a place of indifference toward him in order to avoid the pain associated with the relationship.

These situations involve boundaries. If we don’t know what we feel, we can’t know who we are. If we don’t know who we are, we cannot tell someone else who we are. We will be false selves.

Here, then, are some of the reasons we need healthy boundaries.

Healthy boundaries define who we are.

Healthy boundaries can help us to know who we are. They can help us to have a better sense of our separateness from others: where we end and others begin. Knowing who we are helps us to maintain a sense of reality. We will know who we are and are not, what we believe and don’t believe, what we think, feel, like and want.

Linda came in for counseling one day exasperated over her new-found revelation, “I just realized that I don’t know what I like to eat. I have been buying food and cooking all of these years out of habit, and I’ve suddenly realized I don’t even like the things I’ve been cooking and eating. I buy things in large volume just to save money, and I eat things I don’t like, thinking it is the frugal thing to do. I know I don’t like what Ive been eating, but I don’t know what I do like.”

Knowing who we are, what we believe, what we think, feel, like, and want means that people can no longer walk in and out of our lives at will-using and abusing us.

Complete the sentences below describing, as much as you can, some of the most basic things you know about yourself-thoughts, beliefs, opinions, likes, dislikes, wants, etc. Add to this list as you think of things in the future. Make up your own sentences.

I am a…(in relationship to others; for example, mother, father, brother, sister, etc.)

I am a…(things you do; for example, coach, painter, photographer, hunter, swimmer, teacher, student, writer, dreamer, etc.)

I am…(attributes and faults; for example, kind, helpful, selfish, stingy, pretty, ugly, stubborn, a push-over, etc.)

My best friend is…

The things I like are…

My favorite food is…

My favorite restaurant is…

My favorite color is…

My favorite clothes are…

My favorite TV choices are…

The things (or people) I hate are…

I believe God…

Healthy boundaries define who we are in relationship to others.

Healthy boundaries are intended to help us have good relationships. Some relationships are of our choosing and some are not. Often times we are stuck with relationships that are not of our choosing whether we like it or not. Some teenagers feel like they are stuck with their parents. You may be stuck with people you don’t like on the job, in the neighborhood, or in your religious group. Boundaries that define who we are help us to maintain our sanity in these unpleasant relationships. They help us to know what the extents and limits are with those with whom we are connected-how to let in what is good and keep out what is bad.