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DBT - Distress Tolerance Skills

DBT is a skills-based therapy that outlines many skills for dealing with and responding to difficulty.

Some examples:

Self-soothe with the 5 senses

Vision – Seek colors, images, views that are pleasing and calming. Take in nature, have pictures around, etc.

Hearing – Utilize sounds that help to relieve distress. This includes music, recorded meditations, nature sounds, etc.

Smell – Have smells nearby that aid in relaxation. Bring awareness fully to food that is cooked, nature smells. Light a candle or incense, use oils and lotions.

Taste – Notice mindfully the foods you intake.

Touch – Experience enjoyable touch experiences. Snuggle with a blanket or pet, notice your feet in the puddles, warm water while washing dishes.

Create a self-soothe box. Fill a box or bag with sensory pleasing items and keep it in a place where you often feel heightened anxiety – in a bedside table, in the car, by the bathroom mirror.


Activities – Know activities that commonly relieve your distress - taking a walk, doing yoga, cooking, cleaning, watching a movie, reading, etc.

Contributing – Care for someone else – take dinner to a new mom, volunteer, run an errand for a friend.

Comparison – Think about how far you have come and what you have been able to conquer in the past.

Emotions – Care for yourelf on an emotional level through avenues that reach your emotion mind – listening to music, reading poetry, journaling.

Pushing Away – Put energy into something else for a time.

Thoughts – Challenging unhelpful thought patterns.

Sensations – Self-soothing through the 5 sense (above).

IMPROVE the moment

Imagery – Visualizations. Visualizing yourself facing the challenging situation and it going well. Visualizing a safe place.

Meaning – Finding meaning, for example what you learned from going through something difficult.

Prayer – Connect and talk with God

Relaxation – Notice where you hold stress in your body and actively release that tension. Common places are in the forehead, shoulders, neck, and back.

One thing mindfully/at a time – Being fully present and giving something your full attention. Actively bringing your awareness to what you are doing and who you are with.

Vacation – Take a temporary true or mental vacation. This can mean taking a break to do something relaxing and enjoyable or can be visualizing a mental vacation, or happy retreat.

Encouragement – Harness positive self-talk.

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