1. Session 3: Advanced Distress Tolerance
Humber
Recovery College
Humber
Recovery College
Humber
Recovery College
Coping with Emotions
Session 3: Advanced Distress Tolerance

2. Quick Review of Last Week
In last week’s Distress Tolerance session, we learnt a range of important skills that you can use in a crisis:
Began to identify ineffective coping strategies
Discussed what radical acceptance is and began to think about using it
Distraction techniques to distract yourself from difficult thoughts and overwhelming emotions
Began to develop ideas about how to self soothe
Quick Review of Last Week

3. Aims of the Session By the end of this session, you will have:
Developed strategies for visualisation, cue- relaxation, higher power thinking, taking time out and living in the moment
Learnt some self-encouraging coping thoughts
Learnt how to use self-affirming statements
Consolidated your learning by drafting some new coping strategies
Aims of the Session

4. Safe Place Visualisations
Powerful stress-reduction technique
Soothe yourself by imagining a safe place
Body and brain can’t always distinguish imagination from reality
Create a soothing place in your mind, and your body will respond
Visualisation exercise (p32-33)
Safe Place Visualisations

5. Cue-controlled Relaxation
Quick and easy way to reduce tension
Use a word like ‘relax’ or ‘peace’
Train your body to release muscle tension when thinking about your cue-word
Initially, you’ll need guidance to practice after practicing for a few weeks, you’ll be able to relax your whole body
Begin by choosing a cue word
Cue-controlled Relaxation

6. Cue-controlled Relaxation Exercise
(p34)
Cue-controlled Relaxation Exercise

7. Rediscovering Your Values
These are the ideas, concepts and actions that fill your life with worth and importance
Remembering what you value helps you to tolerate stressful situations
It can help when you get upset about the same situation or person again and again
Let’s explore what you value in life

8. Valued Living Questionnaire
Identify how you value 10 components of your life
How important are each of them to you?
Rate their importance from 0-10
Be honest, show your true feelings!
Valued Living Questionnaire

10. Create a more fulfilling life by formulating your intentions and commitments based on your values
Identify the areas of your life you rated 5-10 in the Valued Living Questionnaire
Fill these in on the Committed Action worksheet
Identify one intention for each of these valued components which will help make life more fulfilling
Commit to several actions that will move this forwards, and when you will begin
Having a more fulfilling life can help you feel stronger during tougher times and give you something to look forward to when you have to do things you don’t like
Committed Action
e.g. A higher score for ‘education’ might make your intention to start studying again

11. Empowerment: Higher Powers
Make yourself feel more powerful
Think about the bigger picture
Unexpected situations can hurt us or the people we care about
If your spiritual tradition no longer gives you peace and strength, re-examine that faith
Empowerment: Higher Powers

12. Empowerment: Higher Powers
What are your beliefs about a higher power that give you strength and comfort?
Why are these beliefs important to you?
How do these beliefs make you feel?
How do they make you think about others?
How do they make you think about life in general?
How do you acknowledge these beliefs in everyday life?
What can you do to remind yourself of your beliefs on a regular basis?
What can you do to remind yourself of them next time you are distressed?
Empowerment: Higher Powers

13. Considering Higher Powers
Remember your higher power can be something other than God:
Look up at the stars
Go to the beach and look out to sea
Think about Planet Earth
Get out into nature, think about the trees, the birds, the landscape
Go to a place that you find awe-inspiring
Go to a crowded place and see all the people going in their own directions
Think about the human body & human life
Considering Higher Powers

15. Next time you are in a distressing situation, ask yourself:
Where am I right now?
Am I time-travelling in the future, worrying about something that may not happen?
Am I time travelling in the past?
Am I in the present, really paying attention to what I’m doing, thinking and feeling?
Bring your focus back to the present moment; notice how you are breathing, how your body feels and observe any tension or pain. Notice any painful emotions you may be experiencing as a result of your time travelling.
Listening to now exercise (p45)
The Power of Now

16. Self-encouraging Coping Thoughts
These are reminders of how strong you have been in the past when you’ve survived distressing situations
When you start to feel agitated or distressed, the early stages, self-encouraging coping thoughts can be particularly useful in soothing yourself before things spiral
From the next page, select a few that you might adopt and write them down
Self-encouraging Coping Thoughts

17. Self-encouraging Coping Thoughts
This situation won’t last forever
I’ve already been through many other painful experiences and I’ve survived
This too shall pass
My feelings make me uncomfortable right now, but I can accept them
I can be anxious and still deal with the situation
I’m strong enough to handle what’s happening to me right now
This is an opportunity for me to learn how to cope with my fears
I can ride this out and not let it get to me
I can take all the time I need right now to let go and relax
I’ve survived other situations like this one before, and I’ll survive this one too
My anxiety/fear/sadness won’t kill me, it just doesn’t feel good right now
These are just my feelings, and eventually they’ll go away
This situation sucks, but it’s only temporary
It’s OK to feel anxious/sad/afraid sometimes
My thoughts don’t control my life, I do
I can think different thoughts if I want to
Self-encouraging Coping Thoughts

18. Self-affirming Statements
These are useful for building a healthier self-image
Their purpose is to remind yourself of the good qualities you possess to give yourself strength and resilience in difficult situations
They will remind you that underneath your overwhelming emotions is a caring, loving person who is capable of handling a distressing situation in a healthier way
Self-affirming Statements

19. Self-affirming Statements
I might have some faults, but I’m still a good person
I care about myself and other people
I accept who I am
I love myself
I’m a good person, not a mistake
I’m good, and nobody’s perfect
I embrace both my good and bad qualities
Today I take responsibilities for everything I do and say
I’m becoming a better person every day
I’m a sensitive person with rich emotional experiences
Each day I do the best I can
Even though I forget sometimes, I’m still a good person
There’s a purpose to my life even though I may not always see it
I radically accept myself
Self-affirming Statements

20. Creating New Coping Strategies
Now you’re familiar with distress tolerance skills, you can create new coping strategies for your future
Examine distressing situations from the past and identify how you’ve coped with them
Also think about what the unhealthy consequences were
Identify new coping strategies that you’ll use in the future and what the healthy consequences might be
You’ll need different ones for when you’re alone and when you’re with others
Creating New Coping Strategies

21. Homework: Coping Thoughts & New Coping Strategies
Using the sheet provided, and the list of new coping thoughts, develop a list of new alternative coping thoughts to the distressing situations you are likely to face over the coming weeks, months or years
New Coping Strategies
Complete the two worksheets and bring them to the next session
Homework: Coping Thoughts & New Coping Strategies

22. Course Overview Date Session 4th October
Introductory Session – Psychology & DBT Approach
11th October
Basic Distress Tolerance Skills
18th October
Advanced Distress Tolerance Skills
25th October
Basic Mindfulness Skills
1st November
BREAK WEEK – NO SESSION
8th November
Advanced Mindfulness Skills
15th November
Basic Emotional Regulation Skills
22rd November
Advanced Emotion Regulation Skills
29th November
Basic Interpersonal Effectiveness Skills
6th December
Advanced Interpersonal Effectiveness Skills
13th December
Putting it All Together

23. Well Done! You’ve completed Session 3! Next Week:
Humber
Recovery College
Well Done! You’ve completed Session 3! Next Week:
Session 4: Basic Mindfulness Skills