Distress Tolerance in Parenting: Lessons from Dialectical Behavior Therapy (DBT)
Aug 10, 2014 12:01 am | Mirel Goldstein
Although pain and distress are inevitable parts of life, many of us lack the skills to manage our pain in effective ways (Dialectical Behavior Therapy skills can be learned, so don’t worry if you need help with this!). Sometimes this comes from growing up with overprotective parents (who shielded us from having to learn skills to cope with discomfort), or from life experiences that were so painful that we learned to avoid pain because we were often overwhelmed by it.
Now, most people do not appreciate hearing about the benefits of learning to approach, accept, and manage their pain! After all, most people are looking for ways to get rid of their pain or distress, and they certainly don’t want to hear from a therapist that the answer is not to try to make the pain go away. (That’s why the emphasis on “acceptance” in dialectical behavior therapy is so radical!)
I don’t want you to get me wrong here though…there are plenty of situations in which it makes perfect sense to try to get rid of pain or a distressing situation. This is just part of having good survival skills and problem-solving instincts.
However, what I am talking about are situations in which it makes sense to accept some discomfort- either because it will help us reach a goal, or because we can’t make the pain go away (or at least not in a healthy way). So, when we lack the skills to cope with distress, we limit ourselves from being able to choose to accept pain when it makes sense to do so. (Hence, the emphasis on “distress tolerance” in dialectical behavior therapy).
Unwillingness to tolerate discomfort can also lead us to do unhealthy things to “make the pain go away” that actually make things worse in the long run (or even the short-run), like using drugs; or to avoid taking healthy risks.
(I define a “healthy risk” as a risk in which the possible negative outcomes are not severe or dangerous, while the potential benefits can contribute to a person’s health or quality of life. For example, going to a social event that might cheer you up or enhance your relationships, despite the risk of feeling awkward or shy, would be a healthy risk.)
So, going back to those things that we do to try to get rid of distress when we lack the skills to deal with it, what kinds of things am I talking about?
I’m referring to any activity, behavior, or substance that distracts or numbs us from the pain. It could be eating, shopping, drinking alcohol, or any number of other behaviors that very quickly take us out of our experience of discomfort.
These behaviors (often mindless) often have consequences of their own that lead to even more pain, or at the very least, don’t get rid of the original pain for long…once the effect of the distraction or substance wears off, the pain is often right there where it was in the first place.
On the other hand, healthy distractions would be actions that we choose to use that don’t have negative consequences, or that don’t stop us from focusing on the pain when we need to learn something from it (for example, constantly distracting ourselves from feelings of pain in a relationship might prevent us from evaluating whether there is a problem that needs to be solved or something we need to do differently to prevent future pain).e us out of our experience of discomfort.
These behaviors (often mindless) often have consequences of their own that lead to even more pain, or at the very least, don’t get rid of the original pain for long…once the effect of the distraction or substance wears off, the pain is often right there where it was in the first place.
On the other hand, healthy distractions would be actions that we choose to use that don’t have negative consequences, or that don’t stop us from focusing on the pain when we need to learn something from it (for example, constantly distracting ourselves from feelings of pain in a relationship might prevent us from evaluating whether there is a problem that needs to be solved or something we need to do differently to prevent future pain).
And when I speak of avoidance, I am talking about all the ways in which we try to control or prevent pain from happening, leading to a number of possible problems: not being able to make decisions because we’re too worried about what could happen if we do; avoiding social events, job changes, committing to relationships etc. because of the risk of discomfort involved; or simply being up at night worrying about things that could go wrong or lead to some form of pain.
In parenting, teaching our children distress tolerance skills is especially important. One thing that can help with this is trying to find a balance between keeping our children completely comfortable, versus abandoning them/failing to protect them from unbearable levels of pain.
The best time to help our children learn how to manage discomfort is when their discomfort is in a “window of tolerance” for them, meaning that they are uncomfortable enough to be practicing/learning something of how to deal with discomfort, but not so uncomfortable that they can’t think or reason, or allow themselves to be soothed or helped with coping. This might be saying “no” to a toy that the child wants, or to a play-date request, or allowing a child to struggle through a learning experience that is difficult (such as falling while learning to walk) without protecting the child from small failures involved in the learning process.
Our own ability to tolerate distress will influence how well we can cope with seeing distress in our children without feeling like we automatically need to “do” something to make it go away (of course, there are situations where we should try to stop the pain or protect the child).
The same holds true for ourselves. It’s best to practice different ways of coping with pain and distress by putting ourselves in bearable painful situations on purpose. This means pushing ourselves out of our comfort zones so that we get used to being somewhat uncomfortable, but not so far beyond what’s comfortable for us, that we feel overwhelmed by the experience.
Some examples of uncomfortable situations that we can put ourselves in to practice distress tolerance skills are: noticing an itch without scratching it; holding ice in one’s hand until it hurts and just noticing the pain/sensation; expressing a difficult emotion in a safe relationship; making a mistake on purpose (such as a spelling error in an email); thinking about a painful memory and just noticing the images, feelings, and sensations that come up with it; or going to a social event where we don’t know anyone.
Healthy distress tolerance is about knowing how to choose to approach situations that might be uncomfortable, but aren’t dangerous (or are unavoidable), as well as knowing how to distract ourselves, soothe ourselves, or simply “bear” painful feelings mindfully when we find ourselves facing the inevitable discomforts that life sends our way.
The important thing is to look at uncomfortable situations as opportunities for building up tolerance, which will make us more flexible and more confident about being able to handle situations that might be difficult, and trusting that we can cope when challenges come up.
Which of your favorite “distress avoidance” methods are you willing to give up?? (For more help with this, you may want to contact a therapist or coach who teaches dialectical behavior therapy skills!)
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