DBT: Take a Sad Song and Make It Better
As we come up on the holiday season, distress tolerance skills will probably be very helpful. When you don’t have the opportunity to self-soothe, as we talked about last week, you might try improving the moment, which is this week’s skill. Improving the moment is for the times when you can’t necessarily change a distressing situation that’s happening around you, but you can take some internal steps to make it easier to put up with. IMPROVE is the skill for taking a moment that is utterly sucky and making it mildly less sucky. The more you practice it, the less sucky you can make it. Amazing.
IMPROVE is of course an acronym, with the I standing for imagery. Bear with me since a lot of this can seem very woo woo spiritual, and we’re probably going to drop the P entirely. This skill is definitely one that it took me some time to get used to, but I have found it helpful since then, if only for jolting my mind out of the tracks that it’s playing and sending it to a new place. Imagery is a lot like making a happy place in your head. This sounds trite. It is not. For some people it’s frustrating to just imagine a place that is calming, but it can be a fairly effective technique. If the world around you is really not going so well, take a few minutes to very vividly imagine yourself in a situation that would be great. See the details of the room or the setting. The more you can convince your brain that nice, soothing things are happening, the more your body will calm down and your emotions will lessen.
My therapist gave me some useful images with which to manage my depression and anxiety. My depression is like an oversized cat that always wants to sit on my keyboard because it needs my attention RIGHT NOW to tell me that things are wrong. So when I feel it taking over, I imagine setting out a little comfy box for my depression cat and tricking it away from me so that it goes to explore the box. Stupid? Maybe, but it certainly distracts me and gives me a different way to approach my emotions.
The M is for create (or find) meaning. The easiest way to go about this is if you’re religious and you take the “suffering is always for something” mindset, but even the secular among us can try to understand how hard situations are moving us towards meaningful results. Maybe you’re feeling hurt by a friend or family member and you choose not to fight with them at this instant, but rather to let the painful feelings sit because you don’t want to embarrass them in front of others. The meaning here is the value you find in relationships. Meaning comes from all kinds of places. You’re stuck in traffic. No meaning? WRONG! You are being a law abiding citizen because you find meaning in participating in a society.
P is prayer. Let us move on.
R is relaxation. This seems obvious, but more than just trying to calm yourself down it focuses on physical ways of calming your body, especially through breathing. One evidence based technique for this is to time your breaths and make your exhale longer than your inhale. You can do this by counting (one longer on the exhale) or by choosing two words that you find relaxing, one more syllable than the other, and repeating them to the inhale and exhale. Another option is progressive muscle relaxation.Mayo Clinic has some other suggestions for relaxation and with some Google searches you can probably find something that feels good to you.
Once again DBT is the worst at acronyms because the rest of “improve” stands for “one thing in the moment”. Someone really needs to tell these people how words work. This doesn’t require much explanation as we’ve already gone over it: mindfulness! Unfortunately, because these techniques are about working with your emotions in the moment without actually changing your situation, a lot of them feel like nonaction. Good catch my friends: that’s because they really are. They’re just about noticing how your body and mind are bringing up certain emotions and trying to adjust what your body is doing or how your mind is thinking.
So this holiday season if your drunken relatives are berating you about your college plans for the twentieth time, imagine your happy place. You got this.