Building Distress Tolerance

Learning to handle difficult emotions is not about making them disappear. It is about developing the capacity to stay present without reinforcing avoidance or overwhelm. In this talk, you will explore practical distress tolerance strategies, how to recognize the difference between being overwhelmed and avoiding discomfort, and why timing matters when using calming techniques. Discover how thoughtful emotional support can strengthen resilience, improve emotional awareness, and help build confidence in facing life's challenges with greater flexibility and self-compassion.

Please note: This talk is intended for supportive purposes and does not replace professional mental health care.

Transcript

Today I want to talk a little bit about distress tolerance skills. The best ones really is to let kids sit in their emotions, You know, Whenever everyday sort of situations and challenges come up, Just be there with them, Create that space where you're just like, You know, You feel the heaviness, You can validate it, But not try to fix it. There are some very specific skills that are often taught. That I'm going to talk about. I will say they're often overused or misused or most commonly mistimed. Meaning it's just being used at the wrong time that actually reinforced the very patterns that we're trying to shift. So today, I want to make sure that we're understanding their function. Because a lot of these skills are valuable. When we're using them at the right time. Before using any distress tolerance skill or any skill. Whatever we're going to be using, We always need to ask ourselves. One of the questions is, Is this child completely overwhelmed or are they trying to avoid something? They might still be upset. They might still be frustrated. The anxiety is still there, But they're coming from the place of avoidance versus they're completely so overwhelmed, They're shut down and not even you know, Responsive or anything like that because we do need very different responses depending on what's going on. With that very overwhelmed child, You know, That emotional intensity is so high that there is absolutely no thinking. They're not responsive at all. They're not aware of what's going on around them. That body is so full of the stress response. There's no way that they can hear us. Let alone access any problem solving or redirection or anything like that, Okay? So that's the completely overwhelmed, Shut down kiddo, Almost like dissociated kiddo. With avoiding, The task is uncomfortable, It's uncertain, It's effortful. They still could engage, But they don't want to because they are very uncomfortable. We still might see big emotional reactions here. No, No, No, But they're still engaging and they're still responding to us. Their urge, Their behavioral urge is to escape, To delay, To reduce any discomfort. If we're using distress tolerance skills in an overwhelm moment, Those are helpful to stabilize the system because we got to get them back online, Their prefrontal cortex back online. But if we're using them in an avoidance moment, We're strengthening the escape. So timing, As with anything, Is very critical here. So I do talk about, You know, Being careful with these and having, You know, Using them as fear, Fear blockers, False fear blockers. But sometimes they can be helpful, Especially if we're looking at stabilization. Now, Distress tolerance is not about feeling better. It's about getting through that pain. Such intensity emotional state that we have without trying to make things worse. So we're not trying to remove the feeling. We're not trying to suppress it. We're not trying to make them feel better. We're not avoiding the challenge. We really need to focus on staying intact long enough for the system to come back online, That self-regulating prefrontal cortex. What I teach in my workshops is really just about. Time, Timing, Right? And even time in the passage of time. Really, We just need kids to ride that wave of emotion. I often share different examples of kids who go into full-blown panic attacks. And it's like, Okay, I'm here. I can see, Like, It's tough, Right? I validate with an adjective, It's tough, And I'm right here. Let me know when you're ready. And I just let them ride that wave of the panic attack. Us yapping at them or trying to do all of these different strategies is not going to be helpful. But a lot of these skills often become a pre-task ritual. OK, Let's calm down before you go in. And then we start seeing almost OCD-type behaviors. I have to do my 10 breaths. And I have to do my jumping jacks. And I have to do this. And now it's like this whole hour-long routine. And I have to feel calm before I go in. And then they never just get in to do the thing. Time's our enemy. So we don't want to have these lengthy pre-rituals. Sometimes these become exit strategies. Let's distract you so you don't feel this. Right? Oftentimes that's what we're doing. Oh, You're feeling stressed out? Okay, Let's calm down. Let's do all our calming strategies. And then we're teaching them, Of course, That feeling is bad and you can't, There's no way you could handle this situation. There's no way you could do this task unless you're completely calm. Or we're maybe using it as, It becomes this emotional avoidance loop. Every time this shows up, We have to soothe it away. So over time, Whenever we're doing this, The brain's learning when discomfort shows up, We have to do something about it or we need to leave. Instead of what they should be learning when discomfort shows up, I can stay. I don't need to do anything. And I can handle it. And I can get through this. Okay, So that's just really important that we think about that before I go into these, Because they can be valuable, But I just want to make sure that we have that caveat set out from the beginning. So when I go through these, Just have that groundwork, That foundation in the back of your mind. So one skill, And a lot of these that I'm taking from are from dialectical behavior therapy, Or DBT. So one skill is called accept. DBT loves acronyms, So there's different ways. Using that acronym. Now this is really a distraction. I personally do not love distraction because Usually, It's used at the wrong time. But if it is so distressing, They're dissociating and we need to get them grounding, Right? Then maybe we can use them. I like a lot of these just to use them proactively. Doing these things are probably good for our health in the first place. And when we do a lot of the breathing relaxation proactively throughout the day, We're going to lower our overall arousal level. Like I just think of anxious kids, You know, It's almost like they're, I'm very visual. So I just see them, You know, With just their nose out of the water. They're just, They're just, Enough to breathe, But they're really struggling, Like it's crisis. But if we do these self-regulation activities, That water level comes down, Right? And so now they've got more room to breathe and more room, You know, To do different things. So, But four accepts. A is activities. Finding an activity like a game or a hobby or exercise or reading to do, Especially when those big emotions are coming up. C is contributing. Okay, Do something good for someone else, A good deed. Pay it forward, You know, Acts of kindness. Yes, So good. Any time of day. This is really good. The second C is comparisons. Compare to a harder time you got through. Okay, This is just like last year when I went through this situation or this is just like the physics test that I just did last week and this is how I got through it. Okay, So it's comparing to how was I able to handle other things. E is emotions, And we're looking at the opposite emotion, Right? So create a different emotion. It could be looking at funny videos, Having uplifting music, Right? Those types of things. P is pushing away. I personally would never teach this, But it's part of these skills. It's just using imagery to push away the problem temporarily. But the problem is we got to make sure we're always coming back to the discomfort or we're always coming back to the task at hand or to the situation at hand, Because we all need to deal with You know, Life isn't always easy. We can't always push away and suppress, But here you go. Nonetheless, Here they are. I just want to make sure that I do cover them and just with the understanding of when to use them. T is thoughts. So, Thinking about something else. It could be counting, You know, And a lot of people say something cognitive like counting backwards by sevens from a hundred, Right? Maybe it's thinking in categories or doing puzzles or something like that. S is sensations, So focusing on intense sensations like strong smells, Maybe it's holding some ice. Or cold water, Just being able to focus on those things. Like I said, I don't love distraction because it can usually make things worse because we're usually trying to push things away. And that's the problem because whatever we resist persists and usually becomes bigger. So we just need to be really careful. I like those things, Except I feel it's great just proactively throughout our day doing those things, Right? And again, Just always remember, Push away is only meant to be a temporary containment of the distress. It's not complete disengagement. So that's really important. It's just about maybe right this second, I don't have to solve it, But I am gonna come back to it later, Okay? It's not, I'm never gonna deal with it at all ever again. That's not what pushing away is, Okay? And I think that's really important for kids who ruminate Okay, We're not avoiding, We're sequencing. There you have it. There's accepts. Just know that these should really be used very rarely, Okay, When kids are so dissociated, So you know, Zoned out that they can't even be here to even fight with us sort of thing. So that's when that emotional intensity is just too high and they just can't engage. Sometimes though, Maybe we don't have time and we have to just let kids ride out the wave because we can use those then on those rare occasions as a temporary attentional shift. We just don't want to make it a habit that we're doing that all of the time. Because otherwise, It is going to become, Let's distract you so you don't feel this. And then later on, And I see it as adults, Every time I feel distress, I'm going to grab a bottle of wine, Or I'm going to smoke my joint, Or I'm going to do some other unhealthy, Maybe it's eating, Or binge watching TV, Or scrolling, Right? We end up trying to distract ourselves with other things and it just makes it worse. It just makes our worries or stress bigger. So we're really thinking, You know, My brain just is so overwhelmed right now, Or your brain is so overwhelmed right now, There's no way it can think about anything. So we're just stepping out briefly, But we're going to be coming right back. And that coming right back is very essential, Because otherwise that distraction becomes escape conditioning. So I think I've laid, I think you understand where I'm coming from. Okay. The next is self-soothe. So five senses. This is about nervous system settling. It can be really powerful if we've just put forth a lot of effort, So having some recovery after effort. It could be downshifting after we've been highly activated. It could help, Again, Building that baseline regulation capacity, So bringing kiddos from that crisis, Just barely surviving, Down to, Okay, Now I'm just sort of waiting on the surface of the water, Okay? Where it becomes problematic when it's used, Right before a demand. As a reinforcement for engagement. As a way to remove discomfort before action. Again, Whenever we're trying to make kids feel better, Make things easier or anything like that, Right? We're gonna teach kids, I need to feel calm before I can try and that's a problem. We want them to know that I can feel this. And I can still begin. And I can still do whatever it is that I need to do. Another is improve the moment. So improve skills. Again, There's an acronym here. It just helps us cope with the current moment by changing our experience of it. So I is imagery. We're using imagination to create a peaceful scene. Again, This is something I do regularly. My scene is a little cabin. Everybody has their own place. It could be on a beach. It could be a real place. Mine is a little cabin in the middle of the woods. It's just a tiny one-room stone sort of place. Or with a stone fireplace, And there's like one armchair. It's not a real place. It's just in my imagination that I've created one armchair by the window. And usually, Almost always, When I'm in this imaginary imagery peaceful place, There's usually a storm going on outside. But I'm warm with this huge fire going, And there's blankets all around this huge armchair that I sit in. So that's mine. M is meaning, Finding purpose or meaning in the crisis. What can you learn from the situation? P is prayer, And you don't have to be religious. It's just, You know, Connecting with spirituality. It's connecting with, You know, The awe going to an ocean or just looking at the horizon or just, You know, Looking out and considering the whole of the universe, Right? We're just turning worries Over almost to just remembering where we are, You know, There's a higher power and higher energy whatever you believe in. It does not have to be religious, It does not have to be spiritual, But just looking at sort of the bigger universe that we're in. R is relaxation. Again, Proactively. This is all great. Deep breathing. I'm more of just focusing on exhalation. I myself get really stressed out with trying to focus on breathing, Which I know a lot of neurodivergent individuals do, But I do try to focus on long exhalations intermittently throughout the day. It can be muscle relaxation, It can be calming activities, Whatever is relaxing. O is one thing at a time, So focus on getting through this moment only. And that was something I will say, Actually, That I did use a lot getting through my my PhD program. My husband every day would just be like, You know, Every night he'd tuck me in and he'd kneel at the side of the bed and he'd say, You got through today. We just need to get through one more day because every day I was overwhelmed and I can't do this because I keep getting overwhelmed with like how much more I had to do. But it was just focusing on one thing at a time, One thing at a time, One day at a time. So that's one at a time. These vacation, Having a brief break, It could be a short mental break, A short physical break, Having those breaks throughout the day. Is really important. I try to do every 90 minutes if I can, It doesn't always happen depending on how busy and where things are at, But I do try to have those breaks. And we do know even like having a 15 minute break at some point in the day, It doesn't have to be during the workday, But some point where you can just be, That can make all the difference in the world too. E is encouragement, Being your own cheerleader, Right? Giving yourself a pep talk, Having some good self-coaching, You know, One-liners that you have. So you can see this improve the moment, This set of skills includes a lot of the imagery, It includes meaning making and relaxation, All of those things. So they're cognitive strategies, Right? So we're only going to use them when we have access to that thinking brain. So if a child is highly activated, If they're flooded, If they're in panic, They probably won't be that helpful. Okay, So once the system is regulated enough, Then they can help with shifting perspective, Increasing that tolerance, Sustaining their effort. So we're really supporting endurance here, Not avoidance. And so that's why I wanted to make sure we talk about that. Half smile, I do love half smile. It's a bottom-up strategy. It works through facial feedback loops and that can influence the emotional state. And we know that there's research, You know, If you put a pen or a pencil in your mouth and just your mouth is kind of open in that smile, It does, It creates different changes in your body and in your brain, Right? It's influencing that emotional state. So half smile, For me, I like imagining my whole body. I used to do this with my girls, Like their whole body, And they're like, Mom, Don't tell me that my tummy is smiling. But even if you just had a little tiny half smile on your face, You don't have to show teeth, Right, Just a little bit. I myself like imagining my whole body smiling. But we know it's used well when you're in low to moderate distress. We want to make sure we're practicing outside of the stress response first. That's important for all of these, Right? So that we've mastered the skill. We're not trying to master the skill when we're also stressed out. So we want to make sure we're practicing all of these outside of stress. But this is really a support. It's not a solution, Right? It's just helping the system soften just enough to stay. And everything that I do, All of the strategies that I have, It's never to calm us down. It's to keep our prefrontal cortex online so that we can make good decisions. On what to do next so that we can stay with it and do the things that are hard and show that resiliency. Creative outlets, I always say creativity is the basis of all happiness. These are really helpful when we're using them properly. We're never using any of these strategies to avoid, To suppress, To escape. It's about moving emotional energy through the system. Any sort of art or movement or music that gives the emotion somewhere to go. But again, You know, Timing matters. If it's replacing the challenge, Then we're allowing avoidance. We really want it to support recovery, Support processing, And then we're supporting regulation. So with all of these, You can see how important the sequence is. It's really about sequencing. The pattern that we want to build is first, Notice the state you're in, Right? Are we overwhelmed? Are we avoiding? Acknowledge it. Name it. Remember that when we are able to acknowledge how we're feeling and what's coming up, That helps tame the amygdala. Then. . . Are we needing to stabilize? If we need to stabilize, Then we're going to use those distress tolerance very briefly. If that system is so offline, We need to bring it back online. But we're always making sure we're reengaging with the challenge. We're always coming back to the challenge. That's really important. And when we're working with kids, Whether it's in the classroom or wherever we're at, We got to let them know. Beforehand, OK, We're going to be practicing these skills. And you're going to find which ones you like when Frustrated Fred shows up. You can start using these, But you've got to remember, We're always coming back to the hard tasks. So let's practice. I'm going to give you a really hard math problem or a really hard worksheet. It's pretty easy. Maybe impossible, Right? And so when frustrated Fred shows up. Ideally, Well, Ideally, If it was a learning activity, I would say, Yes, Frustrated Fred shows up. We got to set the timer. Next seven to 10 minutes is optimal learning time. So we don't want to keep, I definitely would not want to use these if they are able to keep working, Because that's when the brain is online and activated, Right, For that learning. But if no learning is going to be possible, We just want to make sure we're coming back to that learning. And then we're processing and building capacity. So we're reflecting, We're learning, We're expanding. Our tolerance over time. All of those things are really important. So when we're using these well, The distress tolerance skills can really teach kids, I can survive this. Without making things worse. And that's the goal here. We're just doing what we need to do to make things better. Make things so that we can get through without making it worse. Okay, Just not making it worse. Most of the time though, When big emotions come up, We just need to give them space. We don't need to do anything. Because it's really easy to misuse these. And when we misuse these, Again, We're teaching kids, I need to get away from this feeling. And that's making it worse. That's worsening the anxiety. It's worsening the anxiety trajectory. It's increasing those avoidance patterns. It's minimizing their confidence. It can affect their identity. So we're always asking, Is this helping them stay? Or is it helping them leave? That's always gonna guide our timing. It's not about the strategy, It's not about the tool, It's about how and when we're using it, Okay? So hopefully, Like I've said that enough, Hopefully you're getting it here. And I know I get pushed back sometimes. I know I was just at a workshop one day recently and someone's like, Well, I teach breathing and blah, Blah, Blah. Yeah, Breathing's great, We all need it. It's just about timing and what is the message that we're sending when we're using the breathing, Okay? So we just don't wanna fall into the trap of comfort. Because distress tolerance is about building capacity under strain, Right? It's not about trying to be comfortable all the time. So when we're using the skills at the right time, We're allowing kids to learn how to cope with those big emotions and they can learn I can do hard things, I can handle hard, And I can still move forward, Right? So those things are really important. In the meantime, Help those kiddos be bold and courageous, And I will see you next time.