There’s a lot of information out there about preventative measures for relapse into a mental health crisis. There are also great resources on what to do in a crisis situation. But what do you do when you’re just having a really hard time? What if you’re feeling completely overwhelmed, but you’re not posing any threat of serious harm to yourself or others?
I’ve learned a lot in the past few months about distress tolerance skills. These tips and tricks have been immensely helpful for me in my recovery. Tonight, I’d like to share with you my Top Five skills for dealing with negative, overwhelming emotions.
If you’ve been following my story, you know that I live with Complex Post Traumatic Stress Disorder. Included in the PTSD gift basket are things like dissociation, panic attacks, and flash backs. Each of these events are about as fun as getting your tooth drilled without Novocain (this happened to me once at the hands of a very incompetent dentist, so I feel justified in making the comparison). You may have heard of different variations on this particular grounding technique, but my favorite method is this: look around the room you’re in and pick a color. Now, find five different shades of that color, or, if you can’t find different shades, just find five different objects of that color. Once you’ve done this, find five things you can touch. If you can, physically reach out to objects around you. Are they hard or soft? Are they smooth or rough? Are they warmer or colder than your hand? Etc. If you cannot manage to reach out, consider things you can feel without moving. What does the fabric of your shirt feel like against your shoulders? If you’re sitting – what does the chair or couch or bench feel like against your thighs and back? If you’re standing, what does the floor feel like against the soles of your shoes? How does your hair feel against your ear or neck? And so on until you’ve hit five. Finally, what are five things you can hear? This one really helps bring me back to the present, because you have to really focus to find five unique sounds. It can be challenging, and it may take a few minutes of intense listening, but I have yet to be in a place that I could not, with concentration, find five different noises. If you are still not grounded after going through these steps, repeat. In my experience, this is nearly 100% effective when I need to get back to the present and back to my center ASAP.
Sometimes, you’re so overwhelmed by your emotions tolerating them feels impossible. Everything starts to close in and your anxiety or depression seems to be consuming your entire being. When I’m really overwhelmed with depression, it feels like there’s a gaping hole in the middle of my chest and everything “good” about me is seeping out. It physically hurts. When I’m overwhelmed with anxiety, it seems as though the entire world is folding in on me and it’s suffocating. How can you sit with such intense emotions? Often, the mere thought of being “in your body” anymore seems impossible. You almost wish you could just crack your rib cage open and shrug off your skin and muscles for a few minutes to get some relief. These intense feelings tempt many of us to revert to old, unhealthy, maladaptive coping techniques, such as: self injury, binge eating, or substance abuse. In these moments, sometimes the best thing you can do is remember that the discomfort is temporary and find some way to distract yourself until the intensity of the feelings decreases a bit. It’s important to note that there is a difference between distraction and avoidance. Avoidance is complete neglect of your feelings, unwillingness to get curious about the causes of your distress, and, in the long run, it is not conducive to mental wellness. Distraction, on the other hand, can provide a healthy, temporary reprieve from those feelings until the intensity has diminished enough for you to sit with them and consider what may have triggered you. I’ve found it very helpful to keep a list of easy-access distraction techniques on me at all times. I keep mine in my smartphone, but I have friends who carry theirs on actual pieces of paper in their wallets. Some people I know also have a list posted somewhere in their house. Whatever method you feel will work best for you is the one you should use. When you’re not in distress, compile a list of short distraction activities you can utilize. My list includes playing a few rounds of Galaga or Tetris on my phone (10-15 minutes maximum), doing dishes, playing the “Wikipedia game” (pick two completely unrelated topics, start at one, and click links in each article to see how few clicks you need to get from the first topic to the second), and going outside for 5 minutes of fresh air and a change of scenery. Your distraction list will be unique to you, but it’s important to choose activities that will take a short time to complete to decrease the intensity of what you’re feeling until you can face it and deal with it. Choose things that you enjoy; choose things that will help clear your head.
I’ve mentioned this one before, but I want to expand a little on it here, because it really is a wonderful tool! Whether you’re living with a mental health diagnosis or not, every single one of us gets overwhelmed from time to time. For some of us, it’s completing that big work project or research paper for school; for some of us, it’s getting out of bed or doing the laundry. Whatever the task at hand, if you’re feeling stuck, the 10 minute rule can help. It’s pretty self explanatory – you set a timer for ten minutes and work on whatever it is you need to work on until the timer goes off. If you’re seriously depressed and feel like you can’t get out of bed, set a timer for 10 minutes and walk around your apartment for that time. When the timer goes off, you can go back to bed if you feel so inclined. If you’re writing a paper for school, set the timer for ten minutes and write until it goes off. If you feel the need to, stop once the timer goes off. I say “if you feel the need to” because often times, I’ve found, action precedes motivation. Once you actually start moving around or start writing, you might find that you’ve gained some momentum to keep going. Or, you may be completely exhausted after the ten minutes. But either is fine! You’ve done something. In those ten minutes you are tolerating a task that you thought you absolutely could not do. And you can be proud of that!
Mindfulness is invaluable. Truly. I don’t care what your diagnosis is, or if you even have one – in this rushed, consumer driven, plugged in, instant gratification culture of ours, mindfulness can save your life. Mindfulness takes many forms. You can mindfully eat an apple by focusing on the texture of the fruit on your teeth and lips and tongue, the flavor, the juice, the smell, and the crisp snap of each bite. You can mindfully take a walk by considering your feet against the ground, the feel of the air on your face and hands, the sounds of traffic or nature around you, and the way the sunlight reflects off your surroundings. Mindfulness is simply being present. Not considering the future or the past. Traditional mindfulness practice involves things like deep breathing and guided meditations, but practice is definitely not limited to these things. Some people prefer traditional mindfulness practice, and that’s fantastic! If you’re moving through a busy work day and need a few minutes of guided meditation on your lunch break, I’d recommend checking out the Headspace App, if you haven’t already. As a trauma survivor living with PTSD, though, I struggle with traditional mindfulness. Focusing on my body and breath tends to trigger a panic attack, and if I’m doing it with my eyes closed, I’m in for a full-blown flashback. So, I’ve needed to get creative in my mindfulness practice. Doing the 5-5-5 technique mentioned above when I am not triggered is great mindfulness practice, and, it keeps the method fresh in my mind for easy access when I really do need it! Choosing to walk away from my phone to engage with my daughter, focusing solely on whatever game she wants to play, the details, the characters, and the inevitable laughter, is mindfulness practice. Completely devoting my attention to learning to play a new song on my guitar is mindfulness practice. Photography is mindfulness practice, as you need to really take in your surroundings, consider the person or object you’re shooting, evaluate the lighting, and position yourself in relation to that person or object to best capture the message you wish to convey with the photo. Opportunities for moments of mindfulness are everywhere. And practicing mindfulness every day can really help you access those skills when you are feeling distressed.
Self soothing is intrinsic in the fabric of our beings. Self soothing skills are some of the very first things we learn as tiny, brand new humans on this planet. When things are really bad, though, we have to remind ourselves to get back to the absolute basics. We need to feel warm, safe, secure, and comforted. My favorite self-soothing techniques are wrapping up in a heavy blanket or wearing a baggy hoodie that I can burrow into and away from whatever it is in my environment that is overwhelming me. I also like to light candles or burn incense with comforting scents. Sometimes, I will put on some music, either calming or songs that bring up good memories of time spent with friends and loved ones (I have a special playlist for these moments). Occasionally, I’ll take a very warm bath. I also like to snuggle my cats. Tactile. Real. Sense-based. Basic. These are the essence of self-soothing. These techniques are for the really bad moments. I use them most when I’ve just had a flashback and I’m grounded and present but need that extra level of feeling secure and comforted. I use them when I’ve just woken up from a terrible nightmare and I’m not ready to even attempt to go back to bed yet. I use them when that gaping hole of depression in my chest feels like it’s going to swallow me up entirely. I use them when anxiety is making the world collapse on me and I feel like I’m being crushed. Self-soothing is very literally about just holding on and riding the wave of intense emotion until it passes. No goal in mind afterward. Just getting through the moment as comfortably as you can.
There you have it! My personal Top Five distress tolerance skills. What do you do to get through a bad situation without making it worse? Do you have any favorite grounding techniques, healthy distraction methods, motivational tricks (like the ten minute rule), mindfulness techniques, or self-soothing activities or items you like to use? If so, I’d love to hear your tips and tricks in the comment section below, on Twitter (@paradichotomy), or on Facebook!