Panic List for Distress Tolerance

continued. . .

Distress tolerance options for when

These suggestions are meant as you feel craving sensation, feeling
alternates to Self-Injury in times of depersonalized, dissociating, feeling
dire crisis and overwhelming urges. unreal
They are what I call “Intermediate
coping strategies,” designed to help  Do something that creates a sharp
you move into a less emotionally physical sensation:
volatile state. They are NOT DBT  Squeeze ice hard (this really hurts).
skills! (Note: putting ice on a spot you want to
burn gives you a strong painful sensation
The source of this material is from and leaves a red mark afterward, kind of
many people with BPD sharing what like burning would.)
has worked for them. This is a  Put a finger into a frozen food (like
compilation of their answers. ice cream) for a minute.
 Bite into a hot pepper or chew a
These suggestions for dealing with panic
piece of ginger root.
are not a replacement for the Distress
Tolerance skills. They are about being  Rub liniment under your nose.
effective in the moment - which means  Slap a tabletop hard.
doing what it takes to be safe. Believe it  Snap your wrist with a rubber band.
or not, even the ones that sound stupid  Take a cold bath.
usually help a little, and the best skill of  Stomp your feet on the ground.
all is to wait 15 min, and then ask  Focus on how it feels to breathe.
yourself if you can wait 15 more, and so Notice the way your chest and stomach
on. If 15 min is a long time for you, try move with each breath.
5. The point is, self-injury urges usually
 Claim your breath and body parts,
hit and you want to do it "right now". If
like “this is my hand, this is my nose.”
you can wait, then maybe you don't
Touch those parts and notice how they
have to do it at all. Emotions come to us
feel as if you’d never touched them
in waves. The longer you wait, the more
before.
likely the urgent need will dissipate. As
you go along in life without self-injuring,
 Cover your arms with a layer of
one day you will think about doing it and Elmer’s glue and let it dry (or dry it with
a little voice says, "Ouch! That would a hairdryer if you are impatient). Slowly,
hurt! That's not going to make me feel gradually pick the glue off your skin.
better." Self-injury can be addictive but
over time, with practice, you'll find other Distress tolerance options for when
ways to tolerate distress and it will you feel wanting focus
become more manageable.
 Do a task (a computer game like
Distress tolerance options for when tetris or minesweeper, writing a
you feel angry, frustrated, restless computer program, needlework, etc.)
that is exacting and requires focus and
* Try something physical and concentration.
violent, something not directed at a  Try to balance an egg on it’s short
living thing: side.
 Eat or drink something you really
like, but do it slowly and notice every
 Slash an empty plastic soda bottle or sensation - taste, texture, aroma, etc.
a piece of heavy cardboard or an old  Memorize a poem or prayer.
shirt or sock.
 Make a soft cloth doll to represent NOTE: Some people report that
the things you are angry at. Cut and being online while dissociating
tear it instead of yourself. increases their sense of unreality; be
 Flatten aluminum cans for recycling, cautious about logging on to the
seeing how fast you can go. internet in a state like this until you
 Hit a punching bag. know how it affects you.
 Use a pillow to hit a wall, pillow-fight
style.  Eat a raisin mindfully. Pick it up,
 Rip up an old newspaper or phone noticing how it feels in your hand. Look
book. at it carefully; see the asymmetries and
 On a sketch or photo of yourself, think about the changes the grape went
mark in red ink what you want to do. through. Roll the raisin in your fingers
Cut and tear the picture. and notice the texture; try to describe it.
Bring the raisin up to your mouth, paying
 Make Play-Doh or Sculpey or other
attention to how it feels to move your
clay models and cut or smash them.
hand that way. Smell the raisin; what
 Throw ice into the bathtub or against does it remind you of? How does a raisin
a brick wall hard enough to shatter it. smell? Notice that you're beginning to
 Break sticks. salivate, and see how that feels. Open
your mouth and put the raisin in, taking
Sometimes these things work even time to think about how the raisin feels
better if you rant at the thing you to your tongue. Chew slowly, noticing
are cutting/tearing/hitting. You how the texture and even the taste of
could start out slowly, explaining the raisin change as you chew it. Are
why you are hurt and angry, but you there little seeds or stems? How is the
might end up swearing and crying inside different from the outside? Finally,
and yelling. It helps a lot to vent swallow.
like that.  Choose an object in the room.
Examine it carefully and then write as
 Crank up the music and dance. detailed a description of it as you can.
 Clean your room (or your whole Include everything: size, weight, texture,
house). shape, color, possible uses, feel, etc.
 Go for a walk/jog/run.  Choose a random object, like a paper
 Stomp around in heavy shoes. clip, and try to list 30 different uses for
it.
 Play handball or tennis.
 Pick a specific subject and research it
 Play an intense computer game.
on the web. Don’t go off in any direction
except your specific research.
Distress tolerance options for when
you feel sad, melancholy,
If you still have the urges for self-
depressed, unhappy
injury, try answering these
questions in a journal.
 Do something slow and soothing, like
taking a hot bath with bath oil or
 Why do I feel I need to hurt myself?
bubbles.
What has brought me to this point?
 Curl up under a comforter with hot
 Have I been here before? What did I
cocoa and a good book.
do to deal with it? How did I feel then?
 Baby yourself somehow. Do
 What I have done to ease this
whatever makes you feel taken care of
 and comforted. discomfort so far? What else can I do
 Light sweet-smelling incense. that won't hurt me?
 Listen to soothing music.  How do I feel right now?
 Smooth nice body lotion onto the  How will I feel tomorrow morning if I
parts of yourself you want to hurt. hurt myself?
 Call a friend and just talk about  Can I avoid this stressor, or deal with
things that you like. it better in the future?
 Make a tray of special treats and  Do I need to hurt myself?
tuck yourself into bed with it and watch
TV or read.
 Visit a friend. If you can’t get your mind from
 Play a friendly, easy computer game. remembering traumatic events or
 Make a list of the things you are feel like you are in a flashback, try
grateful for. Start with the easy things. changing perspectives.
Thich Naht Hahn suggests you begin
with “I’m grateful for my non-  Write about your situation as if you
toothache.” Then go wild. “I’m thankful were another person or a piece of
that I can walk” or whatever is furniture or a pet looking at it from a
appropriate to you. distance.
 Write letters to people who you’d like
to say something to. Be bold. Don’t hold
Distress tolerance options for when back. Then rip it up or dissolve it in
you feel overwhelmed or obsessed water. Journal about your experience.
with negative thoughts.  Find an old photo of yourself and
make up a completely new fictional story
 Watch a funny movie. about what is happening in the picture.
 Watch a cartoon movie. Write a story where the subject is
empowered.
 Watch children’s programs.
 Write your life story as if you had the
 Watch educational programs.
happiest, most unique life in the world.
 Watch programs about nature. It doesn’t have to be fiction, use real
 Avoid watching violent television. examples but pretend you see it from a
different point of view. Leave out all the
bad stuff. The more trauma you leave
out, the funnier the story starts to seem.
 In your mind, play out your life
worries as cartoon characters. Make the
characters ridiculous and give them silly
voices.
 Read a children’s story or any other
story that’s not too complex out loud as
if you were a storyteller.
 Color in a coloring book.
 Draw pictures with heavy crayons or
oil pastels that allow you to distort and
mesh the picture by smudging it with
your fingers.
Core Mindfulness

Let’s start at the very beginning. . .

In DBT there are three primary ways we use to refer to our states of mind.

They are:

 (1) Emotion Mind,

 (2)Reasonable Mind, and

 (3) Wise Mind.

[Link] mind occurs when our thoughts are being controlled by our emotions. If
  the emotions are fear, or anger they may keep our thoughts so volatile that we have
trouble being reasonable.

[Link] mind is when we can think logically, be rational about what is

 
occurring.

[Link] mind is the interception between emotion and reasonable mind. Wise mind is
  part reason and part emotion and what makes us know we’re in this mind is often a
sense of intuition. It can sometimes be described as that “aha” moment.

When I experience wise mind, I have a sense of stepping back from the situation. Like I
might look at a person and be able to see how they’re struggling, but I’m not taking their
struggles personally. Rather, I have a sense of compassion that makes me want to be
validating toward them.

Here’s an example: I have a relative who is extremely self-centered. When I talk to him he
goes on and on talking about himself. Occasionally, he might ask me a question, but he
never remembers the answer. The only times he remembers what I have told him is when I
talk about him. For many years, I took this personally. I thought he didn’t really care about
me at all and only wanted an audience.

Then one day it hit me. He was talking, but I had put up a bit of an emotional shield
because I was tired of being disappointed. I suddenly saw how sad it was that he couldn’t
listen to me or anyone else, that his self esteem was so damaged that in all his social
encounters he tried over and over again to prove that he was okay. I could understand what
that felt like and I saw him with more compassion and didn’t get caught up in caring about
whether he ever listened to me.

I saw his desperation and without thought or effort, I began to be more [Link]
of walking away wounded, I congratulated him for his achievements. When he talked about
problems, I didn’t give him suggestions or advice, I just said, “That must have been very
difficult for you.” He stopped trying to pull a response out of me and said. “That’s right. It
was. I’m glad you understand.”

That realization and acceptance without taking it personally is an example of wise mind.

COMMENTS

Wise mind can be an experience that you have when listening to someone else and realizing
that you can relate to their behavior. Wise mind is sometimes experienced in the center of
the body (belly) or in the center of the head, or between the eyes.

 Sometimes a person can find it by following their breath in and out.

 Some people experience wise mind when making a decision that they know is absolutely
know is the right thing to do. They know they are in wise mind because they don't have any
sense of dread or anxiety. They just "know" they are doing the right thing. There is
absolutely no doubt.

 Sometimes wise mind is like the calm that follows the storm, something experienced
immediately following a crises or enormous chaos. It’s about suddenly getting to the heart
of the matter, seeing or knowing something directly or clearly. It is grasping the whole
picture when only parts were previously understood. It is "experiencing" the right choice in
a dilemma, when the feeling comes from deep within rather from a current emotional state.

My Personal Notes Taken on Mindfulness in DBT Classes

 Mindfulness is to be aware of what is going on within myself, switching energy (and my

attention will follow).

 Wise mind is a balanced place of creativity, inspiration, intuition, and letting go.

 I go to wise mind so that I can switch to another state of mind.

 A certain sensation occurs in wise mind – it has a quality of calm and peacefulness about
the moment.

 Sometimes I have to let go of emotional action temptation and use all willingness to go to
a difference place so that I can anchor myself.

 Mindfulness isn’t so much a change in thoughts and images as a change in awareness of

thought.

 The practice of mindful meditation, over time, increases concentration so that when PTSD
memory images come, I can separate from them like I would with thoughts.

 When the image or thought or emotion comes in, do deep breathing to stay in the
moment and tell yourself that the reaction was appropriate in the actual situation but not
appropriate at this moment.
 After mindful concentration, if the flashback continues, go to distraction,
then radical acceptance.

 Suffering is about fighting the pain. When I observe and describe the experience of the
moment, suffering makes the pain seem bigger because I’m always saying, “I can’t stand
this. It never goes away.” But if I stop telling myself these things and stop fighting the pain,
then I could view it from a mindful perspective, without judgments. The pain comes, I
acknowledge it, don’t fight it. Then the pain dissipates without suffering.

 I can intervene between stimulus and response in order to enter wise mind if I practice
finding wise mind using mindfulness meditation. Achieving intervention (thus changing my
mind state) can become an option, a choice in the way I respond to certain situations. But if
my history is such that I have no experience for alternative ways of responding, then there
is no option because I have no frame of reference for it.

 need to build skills to have more options.

 Mindfulness can continue to build in layers. For instance: first, maybe I become mindful of
the sounds around me. Then, I become mindful of the sounds and the descriptions I use to
describe the sounds. So, I observe them both. Next, I may become aware that I am making
judgments about the sounds. So, I observe the sound and the way my mind describes it
and the judgment my mind places on it. Gradually, I learn to observe and let go,
empowering my mind to choose its own course in regards to how it will react or not react to
the sound.

 Ultimately, what should I be mindful of? Whatever is effective.

Discussion

Using the above as a description of being in wise mind can anyone relate their own
experience of wise mind?

What has it taken for you to reach wise mind? For example, sometimes a person may reach
wisdom only when suddenly confronted by another person. Or someone else may say
something insightful that unlocks an inner door.

What similar experiences or other examples have any of you had in experiencing wise mind?
Can you think of a situation in your life in which using this skill might have been helpful?
How do you think the outcome would have been different? Can you make a plan to use it in
a situation that is upcoming and might be difficult?

Exercise

Set an alarm clock for a certain period of time each day (like every hour). When the alarm
goes off, check in with yourself. How are you experiencing the moment? Observe your
thoughts and emotions. Don't judge them as right or wrong, just observe and describe it by
writing it down. At the end of the day, do you see a pattern? Have you learned anything
about yourself? No matter what the experience you had, allow yourself to let go of all that
happened. Let go of the judgments. Be in the moment. What is this like for you?

STOPP
Learn this one key skill !
STOPP is CBT in a nutshell.

Learn this ONE KEY SKILL and you can start to take control of your emotions and your
life.

"Between stimulus and response there is a space. In that space lies our freedom to
choose our response. In our response lies our growth and our freedom". Viktor Frankl.

How to use STOPP

STOP !  
Just pause for a moment

TAKE A BREATH  
Notice your breathing as you breathe in and out. In through the nose, out through the
mouth.
OBSERVE
 What thoughts are going through your mind right now? 
 Where is your focus of attention? 
 What are you reacting to? 
 What sensations do you notice in your body?

PULL BACK - PUT IN SOME PERSPECTIVE

 DON'T BELIEVE EVERYTHING YOU THINK!
 What's the bigger picture? 
 Take the helicopter view. 
 What is another way of looking at this situation? 
 What advice would I give a friend? 
 What would a trusted friend say to me right now? 
 Is this thought a fact or opinion? 
 What is a more reasonable explanation? 
 How important is this?  How important will it be in 6 months time? 
 It will pass.

PRACTISE WHAT WORKS - PROCEED

 What is the best thing to do right now? 
 What is the most helpful thing for me, for others, for the situation? 
 What can I do that fits with my values? 
 Where can I focus my attention right now? 
 Do what will be effective and appropriate.

Pros and Cons

DBT Pros/Cons are different from mainstream Pros & Cons in that DBT Pros/Cons looks at
the Pros and Cons of tolerating vs. not tolerating distress.
 Tolerating Distress Not Tolerating Distress

Pros Cons Pros Cons

       

       

In otherwords, it�s the pros and cons of tolerating the DISTRESS of a situation and the
pros and cons of not tolerating THE DISTRESS of a situation.

When examining the pros and cons, you are looking at the consequences of potential
actions. For example, one time, when I was in a yoga class, the instructor said something to
me that reminded me of something my father used to say to me in a negative way. I knew
she didn�t mean what my father meant but I still reacted emotionally and felt those old
sensations of betrayal and invalidation. Many times in the past, when I experienced a
�trigger� situation like this, I would let it overwhelm me and I would never even stop
to think about the fact that my life was different now. I would let it build up. In the past, I
might have tolerated the feelings throughout the yoga class so I wouldn�t make a
disruption, but by the time I went home, I would be out of control.

I knew I wanted to live my life differently and use the skills to help me. I thought about
some ideas about what I might do to tolerate this distress:

I could �ride the wave� of emotions, reassuring myself that my feelings wouldn�t kill
me, that I was strong enough to feel the emotions without acting out on them.
When I went home, if I was still feeling those triggered negative emotions, I could distract
myself by watching TV, playing computer games or reading a book.

On the other hand, I thought about what I would do if I didn�t tolerate the distress.

I could stand up, yell at the instructor and walk out.

I could go home and engage in self-harming behaviors.

Next, I began to think about the consequences of tolerating versus not tolerating this
distress

Tolerating Distress Not Tolerating Distress

Pros Cons Pros Cons

 Feeling of success that I  I would have to put effort  I would be able to My instructor might not let
was able to use my skills into self control continue to feel what I me come back to class or
was used to feeling, at least, there would be
which sometimes brings tension between us 
comfort

I might be able to change I wouldn�t get that high I could experience a  I would experience
my state of mind and feeling of creating drama temporary satisfaction of  regret, pain and shame
continue my life normally and making others pay having punished myself  the next day or maybe
without using up my attention to me.  even right after acting out
energy

When I look at this from a distant point of view, the correct thing seems obvious. But when
I was �mired� in the emotion, all options seemed equally possible.

Ultimately, I decided to ride the wave of emotion. Nevertheless, it turned out that my
instructor had sensed that something was wrong and asked me about it after class. I told
her that I was experiencing an emotional trigger from my past and that I needed to go
through these emotions and work it out by myself.

By the time I got home, my emotions were less intense. I turned on the TV and found a
show I wanted to watch. I allowed myself to get caught up in it and when it was over, I
realized I had actually forgotten about the incident.

Since it�s best to practice in less intense situations, when you�re not emotionally
invested, write out some pros and cons for things you don�t care about as much. Like
right now, I could stomp on the floors or throw my cats in the bathtub. I have no reason to
do these things. They really are ridiculous, but by practicing writing it down, I know I�ll
be better at it when I�m done.

Think about a situation from your recent past. Don�t go for the big, heavy things like
when you were attacked or something. Think about something like an argument you got in
or when you were in your car and yelling at people around you. You already know what you
did, but imagine you were still back at that time and the prompting event just happened.
Use the pros and cons to think of some other ways you might have behaved. Ask yourself if
the same thing happened in the future, would you act differently? There's no right or wrong.
You're just practicing thinking in a way that is different.

Validation
What does validation mean?

 To confirm, to verify, to authenticate.

 Validation can be verbal or nonverbal.

What are the different types of validation?

1. Focus on listening and observing; staying aware; be in the moment

Your mom is upset about her cat dieing.  When she is talking and crying, you are
nodding your head and holding her hand.

2. Focus on accurate reflection; restate what the person had said.

Your brother is upset about not getting a raise at work. He said he is furious and it
looks like he has 'steam' coming out of his ears. You say, 'You are furious about
this.'
 
3. Focus on observing and stating the unspoken; restate what the
person's  nonverbals are.
You sister is talking about how she does all the housework and her husband only
spends 20 minutes a week cutting the grass. Now her husband wants her to cut the
grass too. You say to your sister, 'You're thinking it's unfair and that you shouldn't
be asked to do that.' 

4. Focus on causes of behaviors including past and present; restate past

and connect it to current issue.
Your friend was raised by alcoholic parents; she put up with constant lies and
raising her siblings.  When she got old enough and was dating, she said she would
never put up with drinking in her immediate family.  It's been 25 or so years now
and she just found out her 17 year old was at a party drinking.  You say to her,
"Hearing your outlook, based on your home environment when you were raised, it
makes sense you'd respond so angrily."

5. Focus on person's history and point out how current response is not
helpful; restate the past and connect it to current issue and their choices
Your friend was raised in a home with a physically violent father and a neglectful
mother. Your friend is in his forties and has never hit his children. He saw his fiance
threaten to hit his children. The scene brought back a lot of memories for him so
he threatened his fiance. You say to your friend, "Because others have treated you
badly in the past, it makes sense that you'd be angry, but threatening to harm
someone only prevents your progress and makes you miserable." 

6. Focus on treating the person as an equal; hope for the person;

genuinely believe the person is capable of change
Your friend has been divorced for 3 years. He feels uncomfortable doing activities
with other couples because he is the only single person in the group. You say, ?It's
normal; most people feel this way.? 

Discussion Questions

When someone validates you, how do you feel?

Why do you think it is important to validate ourselves and others?

Are there times when we should validate people and other times we shouldn't
validate people?

When you are in a difficult situation, who can you rely on to be there for you?  In
your support network, who validates you?

Invalidation
What is invalidation?

 Negates or dismisses behavior independent of the actual validity of the behavior.

 To weaken, to nullify, to cancel, to reject, to dismiss

What are examples of invalidating responses?

1. Reject self-description as inaccurate

You just passed a difficult math test. You said that you feel like Einstein. Your dad
says, "You don't know what you are talking about."

2. Reject a normal response.

You are really into watching your favorite show and don't feel like doing your
[Link] mom says, "He doesn't want to do his chores because kids are just
brats."

3. Reject response to events as incorrect or ineffective.

Your favorite teacher yelled at you today and you just told your sister what
happened. She said, "That's stupid to feel that way. She's just a teacher."

4. Dismiss or disregard.
Your beloved dog just was hit by a car.  Your brother says, "Oh well, stuff
happens."

5. Directly criticize or punish.

You are at your grandpa's birthday party.  Grandma cut the cake and you are
passing out the cake.  You accidentally drop a one of the plates. Grandma says,
"You idiot. You don't need birthday cake if you just smear it all over my floor."

6. Reject and link responses to socially unacceptable characteristics.

You are helping your grandpa in the garage.  One of the bigger tools just fell on
your fingers. Your grandpa says, "Crying means you are weak. Suck it up."

How does invalidation impact us?

1. Confusion about self: learns not to trust self and relies on social environment for
the correct response.

2. Problems regulating emotions: Ignores or withholds emotions or is extremely

emotional.
3. Oversimplification: Highly sensitive to failure, perfectionism, and forms
unrealistic goals.

4. Responses to and view of the world are not accurate.

5. Look to others to tell you how to do things.

Discussion Questions

Have you ever felt invalidated before?

What does invalidation feel like?

Why do you think invalidation is so hurtful?

How has invalidation impacted you?

If someone is invalidating you, what can you do? What are your choices?
Panic List for Distress Tolerance

continued. . .

Distress tolerance options for when

These suggestions are meant as you feel craving sensation, feeling
alternates to Self-Injury in times of depersonalized, dissociating, feeling
dire crisis and overwhelming urges. unreal
They are what I call “Intermediate
coping strategies,” designed to help  Do something that creates a sharp
you move into a less emotionally physical sensation:
volatile state. They are NOT DBT
skills!  Squeeze ice hard (this really hurts).
(Note: putting ice on a spot you want to
The source of this material is from burn gives you a strong painful sensation
many people with BPD sharing what and leaves a red mark afterward, kind of
has worked for them. This is a like burning would.)
compilation of their answers.
 Put a finger into a frozen food (like ice
These suggestions for dealing with panic cream) for a minute.
are not a replacement for the Distress
Tolerance skills. They are about being  Bite into a hot pepper or chew a piece
effective in the moment - which means of ginger root.
doing what it takes to be safe. Believe it
or not, even the ones that sound stupid  Rub liniment under your nose.
usually help a little, and the best skill of
all is to wait 15 min, and then ask  Slap a tabletop hard.
yourself if you can wait 15 more, and so
 Snap your wrist with a rubber band.
on. If 15 min is a long time for you, try
  Take a cold bath.
5. The point is, self-injury urges usually
hit and you want to do it "right now". If  Stomp your feet on the ground.
you can wait, then maybe you don't
have to do it at all. Emotions come to us  Focus on how it feels to breathe.
in waves. The longer you wait, the more Notice the way your chest and stomach
likely the urgent need will dissipate. As move with each breath.
you go along in life without self-injuring,
one day you will think about doing it and  Claim your breath and body parts, like
a little voice says, "Ouch! That would “this is my hand, this is my nose.” Touch
hurt! That's not going to make me feel those parts and notice how they feel as if
better." Self-injury can be addictive but you’d never touched them before.
over time, with practice, you'll find other
ways to tolerate distress and it will  Cover your arms with a layer of
become more manageable. Elmer’s glue and let it dry (or dry it with
a hairdryer if you are impatient). Slowly,
Distress tolerance options for when gradually pick the glue off your skin.
you feel angry, frustrated, restless
Distress tolerance options for when
* Try something physical and you feel wanting focus
violent, something not directed at a
living thing:  Do a task (a computer game like tetris
or minesweeper, writing a computer
 Slash an empty plastic soda bottle or program, needlework, etc.) that is
a piece of heavy cardboard or an old exacting and requires focus and
shirt or sock. concentration.

 Make a soft cloth doll to represent the  Try to balance an egg on it’s short
things you are angry at. Cut and tear it side.
instead of yourself.
 Eat or drink something you really like,
 Flatten aluminum cans for recycling, but do it slowly and notice every
seeing how fast you can go. sensation - taste, texture, aroma, etc.

 Hit a punching bag.  Memorize a poem or prayer.

 Use a pillow to hit a wall, pillow-fight
NOTE: Some people report that
style. being online while dissociating
increases their sense of unreality; be
 Rip up an old newspaper or phone
cautious about logging on to the
book.
internet in a state like this until you
 On a sketch or photo of yourself, mark know how it affects you.
in red ink what you want to do. Cut and
tear the picture.  Eat a raisin mindfully. Pick it up,
noticing how it feels in your hand. Look
 Make Play-Doh or Sculpey or other at it carefully; see the asymmetries and
clay models and cut or smash them. think about the changes the grape went
through. Roll the raisin in your fingers
 Throw ice into the bathtub or against and notice the texture; try to describe it.
a brick wall hard enough to shatter it. Bring the raisin up to your mouth, paying
attention to how it feels to move your
 Break sticks. hand that way. Smell the raisin; what
does it remind you of? How does a raisin
Sometimes these things work even smell? Notice that you're beginning to
better if you rant at the thing you salivate, and see how that feels. Open
are cutting/tearing/hitting. You your mouth and put the raisin in, taking
could start out slowly, explaining time to think about how the raisin feels
why you are hurt and angry, but you to your tongue. Chew slowly, noticing
might end up swearing and crying how the texture and even the taste of
and yelling. It helps a lot to vent the raisin change as you chew it. Are
like that. there little seeds or stems? How is the
inside different from the outside? Finally,
 Crank up the music and dance. swallow.
 Clean your room (or your whole  Choose an object in the room.
house). Examine it carefully and then write as
detailed a description of it as you can.
 Go for a walk/jog/run.
Include everything: size, weight, texture,
 Stomp around in heavy shoes. shape, color, possible uses, feel, etc.

 Play handball or tennis.  Choose a random object, like a paper

clip, and try to list 30 different uses for
 Play an intense computer game. it.

Distress tolerance options for when  Pick a specific subject and research it
you feel sad, melancholy, on the web. Don’t go off in any direction
depressed, unhappy except your specific research.

 Do something slow and soothing, like If you still have the urges for self-
taking a hot bath with bath oil or injury, try answering these
bubbles. questions in a journal.

 Curl up under a comforter with hot  Why do I feel I need to hurt myself?
cocoa and a good book. What has brought me to this point?

 Baby yourself somehow. Do whatever  Have I been here before? What did I
makes you feel taken care of and do to deal with it? How did I feel then?
comforted.
 What I have done to ease this
 Light sweet-smelling incense. discomfort so far? What else can I do
that won't hurt me?
 Listen to soothing music.
 How do I feel right now?
 Smooth nice body lotion onto the
parts of yourself you want to hurt.  How will I feel tomorrow morning if I
hurt myself?
 Call a friend and just talk about things
that you like.  Can I avoid this stressor, or deal with
it better in the future?
 Make a tray of special treats and tuck
yourself into bed with it and watch TV or  Do I need to hurt myself?
read.
  Visit a friend.
If you can’t get your mind from
 Play a friendly, easy computer game. remembering traumatic events or
feel like you are in a flashback, try
 Make a list of the things you are changing perspectives.
grateful for. Start with the easy things.
Thich Naht Hahn suggests you begin  Write about your situation as if you
with “I’m grateful for my non-
were another person or a piece of
toothache.” Then go wild. “I’m thankful
furniture or a pet looking at it from a
that I can walk” or whatever is
distance.
appropriate to you.
 Write letters to people who you’d like
to say something to. Be bold. Don’t hold
Distress tolerance options for when back. Then rip it up or dissolve it in
you feel overwhelmed or obsessed water. Journal about your experience.
with negative thoughts.
 Find an old photo of yourself and make
 Watch a funny movie. up a completely new fictional story about
what is happening in the picture. Write a
 Watch a cartoon movie. story where the subject is empowered.

 Watch children’s programs.  Write your life story as if you had the
happiest, most unique life in the world.
 Watch educational programs. It doesn’t have to be fiction, use real
examples but pretend you see it from a
 Watch programs about nature.
different point of view. Leave out all the
 Avoid watching violent television. bad stuff. The more trauma you leave
out, the funnier the story starts to seem.

 In your mind, play out your life worries

as cartoon characters. Make the
characters ridiculous and give them silly
voices.

 Read a children’s story or any other

story that’s not too complex out loud as
if you were a storyteller.

 Color in a coloring book.

 Draw pictures with heavy crayons or

oil pastels that allow you to distort and
mesh the picture by smudging it with
your fingers.

Ways to Deal with People in

Crisis

Top 25 Things NOT to Say (or do) to

Someone in Crisis
By Lisa Dietz

 1. Tell them to stop thinking about the

past.

 2. Try to relate to them by comparing

what they are telling you to your own
experience like the time when your purse
was stolen or you went through your
divorce.

 3. Use what they are saying as an

invitation to talk about how bad you're
feeling.

 4. Tell them that everything happens for a

reason.

 5. Walk away, hang up the phone, or

laugh.

 6. Tell them how strange/foolish/crazy

they are to feel or think such things.

 7. Invite them to have sex.

 8. Interrupt them to tell a funny story

about your cat.

 9. Tell them they couldn't possibly be

feeling or doing or thinking whatever they
just told you.

 10. Tell them that their feelings are silly,

meaningless or inappropriate.

 11. Try to solve their problems for them.

 12. Tell them to pray to Jesus.

 13. Ask them lots of questions about their

past.

 14. Tell them to "pick themselves up by

the bootstraps" and get on with life.

 15. Tell them to talk to a psychiatrist (so

you don't have to listen).

 16. Try to cheer them up by telling jokes

or uplifting stories.

 17. Offer them a drink (alcoholic).

 18. Tell them how much better you would

have handled the situation.

 19. Tell them that whatever they're upset

about or whatever they have experienced is
God's will.

 20. Dramatize their pain by being shocked

at everything they say.

 21. Give them unsolicited advice.

 22. Pretend they're not really in crisis and

change the subject.

 23. Tell them that they're letting their

imagination run wild.

 24. Compare what they're telling you to

other people you know who are crazy,
hospitalized, manic, schizophrenic, and/or
dead (especially when they've committed
suicide).

 25. Tell them that someday they'll look

back at this and laugh.

How to Recognize if Someone is in

Crisis

First, do you already know that they suffer

from:

 1. Manic depressive or bipolar disorder

 2. Chronic depression

 3. Post-traumatic Stress Disorder (PTSD)

 4. Obsessive Compulsive Disorder (OCD)

 5. Borderline Personality Disorder (BPD)

 6. Suffered the death of a loved one in the

last two years
 7. Working a 12-step program

 8. Does not have a diagnosis that you

know about but is clearly depressed,
agitated, upset, anxious, grieving or had a
traumatic childhood or suffered a traumatic
event.

If you already know this about the

person, then the following comments are
almost certainly "a cry for help," which
means that they need someone to listen,
acknowledge their pain, and witness their
process.

 "I'm having a hard time."

 "XYZ experience brought up a lot of things

for me."

 "I'm depressed."

 "I can't talk or think right now because

I'm too upset."

 "I had a triggering experience."

 "I want to go out and drink (or do

something dangerous, or hurt someone, or
hurt themselves).

 "I wish I was dead."

 "I'm having a breakdown."

 "I can't take it anymore."

This is your cue to stop and listen by

following up with an affirming statement
like:

 "What happened?"

 "Are you okay?"

 "Can you name (or be more specific

about) what you're feeling?"

 "I'm listening. Tell me more."

Things to Say (or do)  to Help Someone
in Crisis

 Acknowledge their feeling

 Witness their process

 Affirm their right to speak

 Validate their experience

 Listen without judgment

 Allow them to process what is going on

 Let them cry

Be sensitive about holding their hand or

putting your hand on their shoulder, but do
not offer any more physical contact without
their initiation. (Remember that for people
who have suffered trauma and abuse,
physical contact may be upsetting rather
than comforting.)

Say things like:

 "That sounds really difficult."

 "Is there anything I can do to help?"

 "It sounds like you're in real distress."

 "It sounds like you're having a crisis."

 "It sounds like you're very upset."

 "I hear how awful that must be for you."

 "I'll bet that brought up some difficult

feelings."

 "It's okay to cry."

 "I'm here for you."

Ideas for Alternate Rebellion

The following ideas were generated by DBT participants to offer nondestructive
ways to express rebellion. Choose ideas appropriate to the situation. Choose
ideas that will not be harmful to someone else in your environment.

 Give an honest response instead of a polite one

 Speak out rather than staying quiet

 Dress in a countercultural style

 Challenge statements when you disagree

 Choose mediocrity rather than drama

 Drop out of things that are not effective

 Follow your passion rather than your expectation

 Wallow in creativity

 Give yourself time to play

 Explore

 Say no to family when they ask for a favor

 Leave the light on all day

 Get a butterfly tattoo

 Write a letter to the editor

 Run instead of walking

 Turn up the volume

 Food fight

 Roll down all the windows

 Play a different style of music

 Leave things out of place

 Shout or scream alone

 Cheat on a food plan

 Kiss your dog on the lips

 Wear clothes that don't fit right

 Express unpopular political views

 Sleep late on Saturday

 Wear jeans to church

 Throw out plastic containers

 Get your ears pierced

 Fly a gyrocopter

 Turn up the bass on rap music

 Look into alternative religions

 Buy something impractical

 Break out of roles expected of you

 Change your color preference of clothing

 Do things out of order

 Do things out of character

 Seek your own interests

 Don't cook

 Don't clean house

 Buy a bird

 Go against a suggestion from another

 Be yourself with an attitude of "if you don't like it, don't look."

 Print a slogan on a T-shirt

 Buy a bumper sticker

 Develop your own web page

 Express a diversified viewpoint

 Make up your own. . . .

Non-Judgmental Stance

Nonjudgmental stance is the last of the �What� skills in the Mindfulness Module of DBT.

First was Observe, in which we paid attention to ourselves, our environment, and others
around us. When observing, the trick was to just notice things like, �I notice I�m
thinking about the future,� or �I notice my pulse is faster when I�m talking to my
mother.�
Next was Describe, in which we would put words on the things we observed. Some people
described very simple things like washing the dishes or going for a walk, but found that by
describing, they felt like they were better able to pay attention to the present moment.

Next was Participate, where we allowed ourselves to be completely immersed in the

moment, focusing in a way that made us forget everything else.

Nonjudgmental Stance, I think, really pulls it all together. We are very conditioned to
placing judgments on our observations. To use the examples above, I may notice that
I�m thinking about the future, but it�s likely my next thought will be something like,
�I�m not doing DBT correctly since I�m thinking about the future. Therefore I am
bad or wrong or incompetent.� This is a judgment of the observation and it is not at all
helpful.

The point of taking a nonjudgmental stance is to give ourselves an opportunity to observe

the same old things that we always observe in our minds or in our environment or about
other people, but open ourselves to thinking about it in a different way. So if I withhold my
judgment about what my thought means, but simply observe it, note it and let the thought
move away, I have an opportunity to treat myself more gently. Even if I still have the
judgmental thought, I can observe that I had the thought, then let it go. That�s the
beauty of nonjudgmental stance; all the negative garbage we�re so accustomed to telling
ourselves is suddenly cut off and a gentleness takes over so that healing becomes possible.

I was recently reading the book �Writing as a Way of Healing,� by Louise DeSalvo and
in it she said, "In the end, isn't healing just another way of seeing?" When I thought about
it, one reason that statement is true is because I�m backing off from taking a judgmental
stance and opening myself to another way of thinking (which is where many of the other
DBT skills come in � offering suggestions for alternative ways to behave/react/think about
any given situation).

If you look at the second example of an observation above, �I notice my pulse is faster
when I�m talking to my mother,� we can see how the nonjudgmental stance can
change a potentially volatile situation into a healing moment in which I can learn something
about myself. My temptation is to think, �my pulse is faster because she�s a bitch and
I can�t stand listening to her and now she�s yelling at me because she hates me�
and so I react and yell back. This has happened to me many times.

But sometimes, in the midst of the moment, I notice my pulse and let�s say I resist
making a judgment about WHY my pulse is fast or what my mother is doing. Instead I
notice that the pitch in my mother�s voice is higher and I resist making the judgment
about WHY her voice is higher or what it means to me. Or, if I can�t resist the judgment,
I just observe it and let it go. Then I notice that my face is becoming red and that I feel the
impulse to react and I force myself to simply observe and withhold judgment. And slowly, I
find I�m regaining my composure, freeing myself from the prison of emotional pain. I feel
less need to react. As my feelings of anger dissipate, I begin to hear the pain in her voice
and I don�t judge that pain. Instead, I let her have her pain and I just listen. I don�t
take it on, I merely observe. And somehow, the entire situation feels different. ï¿½Healing
is just a different way of seeing.�

I am especially aware of the impact of a nonjudgmental stance when I use it on the more
complex observations and descriptions of EMOTIONS! Nevertheless, I think it�s good to
practice with more benign things like taking a nonjudgmental stance about my walk in the
park.
I can practice by not making a judgment about the guy who just walked past me and pulled
his dog in closer to him quickly and sidestepped my path. I might be tempted to think he
was avoiding me because he thinks I�m ugly, dangerous or any number of things. But if I
notice myself doing so and consciously make a decision not to judge my observations, I am
able to practice this skill and gain some competence with it. In this way, later on, when that
argument with my mother happens, I will have practiced observing and describing without
judging. In so doing, I�m in a position to gain even more actual healing.

What exactly does it mean to judge an observation?

Observation = I notice that I am feeling sad.

Observation and Description = I notice that the corners of my mouth are turned down,
my jaw muscles are tense, my eyelids seem heavy. I notice that I am tired and feel like I
could cry. I notice that there is an uncomfortable feeling in the pit of my stomach.

Judgment = Sadness is a bad emotion. When I am sad I am bad. Something is wrong with
me because I feel sad.

Nonjudgmental Stance = Sadness is an emotion. It is not good or bad. The fact that I
exhibit the symptoms I associate with sadness does not make me a bad person, nor is
experiencing the emotion a good or a bad thing. It simply is. Right now, I am experiencing
sadness, that�s all. It�s okay to feel sad.

Possible results = When I judge the sadness, I am more likely to react negatively to it by
acting out with destructive behavior. When I do not judge the sadness, I am more likely to
experience the emotion until it dissipates.

Exercises

1. The next time you do a mundane task, try observing and describing as you complete the
task. Notice when your mind begins to make a judgment. Do not get caught up in the
judgment or the fact that you�ve made one. Just notice that your mind is judging and let
the judgment go. See if you can continue to pay attention in more circumstances, like when
you judge an observation, like when you see someone at the office or across the street or
your dog greets you at the door. Whatever. The point is to begin noticing when you
�judge what you observe� so that you can begin to see what it feels like and gain skill
in catching yourself in judging observations.

2. See if you can observe and describe in more emotionally charged situations. Remember
to notice your judgments, but not get caught up in them. Notice the judgment in the same
way that you notice tone of voice, for instance. See if it is easier to let go of volatile
reactions when you withhold judgments. Part of observing is also withholding assumptions.
Describe your observations to the other person. "I'm noticing that you are raising your
voice. Why are you doing this?" Does the situation seem different to you? Are you seeing it
in another way? Is the other way more healing?

Interpersonal Effectiveness

In the Interpersonal Effectiveness module,

all the skills come together in a synergistic
way. In this lesson, therefore, I will take
you through the journey of my thinking
process, including whichever skills came to
mind as I sought to solve the problem.

As with all the DBT modules, practice using

the skills for small, less intense encounters.
Don�t wait until you are in a crisis and
then expect yourself to suddenly remember
the skills and know how to use them. That
would not be very effective.

Overview
Let�s start with an abrieviated reminder
of the (action) skills in the module.

Situations for Interpersonal Effectiveness

Attend to relationships Balancing priorities Balancing Master & Self Respect

�should�s�

Goals of Interpersonal Effectiveness

Objective Relationship Self Respect  

Factors Reducing Interpersonal Effectiveness

Lack of skill Worry thoughts Emotions Indecision

Environment      

Options for Intensity of Asking or Saying NO

Intensity rating Priorities Capability Timeliness

Guidelines for Getting What You Want (Objective) (DEAR MAN)

Describe Express Assert Reinforce

Stay Mindful Appear Confident Negotiate  

Guidelines for Keeping The Relationship (GIVE)

Be Gentle Act Interested Validate Easy Manner

Guidelines for Keeping Your Respect for Yourself (FAST)

Be Fair No Apologies Stick to Values Be Truthful

Situation:
I lived in a fourplex apartment building. In the back of the building were 4 parking places
with numbers corresponding to the apartment number. My number happened to be the
closest one to the building.

Problem:
After moving in and settling down, I found myself irritated by the fact that the other
residents of the building parked their cars wherever they wanted, including in �my�
spot. Therefore, I often had to park my car on the street or in the parking lot of the next
door apartment building. It was not long before I became fuming with anger over the
situation.

Using DBT:

The first thing I had to do was find a way to tolerate my distress. I did this by
being mindful. I tried to observe the situation without judgment, knowing that I would
soon have a solution. I tried to push thoughts away, focus on being one in the
moment and doing one thing at a time.

A part of me wanted to avoid conflict and try to live with the situation. I thought about what
would happen if I did and realized it would ncrease my anger and irritation, I might harbor
resentment, or generalize by associating their behavior with who they are.

I decided it was clear that I needed to talk to them. I felt very fearful of this. I was afraid of
angry reactions and possibly even retribution. I decided to ride the wave of these emotions,
which proved helpful because when I tried to run from the emotions, they seemed to grow in
intensity. By observing that I was feeling fearful, I could let myself feel it for a while (sort of
wallow in it), but it wasn�t long before the emotion dispersed and I was distracted by
other things.

Next I needed to assure myself that I had a right to say something. So I went through
the factors to consider in deciding to ask for what I wanted.
Factor Consideration Intensity

Priority I considered which was most important to me � my objective, the n/a
relationship or preserving self respect. I decided it was my objective.
We didn�t have much of a relationship and I figured I�d
preserve my self respect better if I didn�t avoid.

Capability I decided they were definitely able to give me what I wanted. increase

Timeliness This could be a bit tricky. I didn�t know my neighbors well uncertain
enough to know what time would be good. I had no idea about what
was going on in their lives. I thought the best I could do was talk to
them on the weekend rather than during the week when they might
be tense from working.

Homework The only homework I could think of doing would be to get to know decrease
them better before talking to them, but I wasn�t willing to wait.

Authority I had no authority over them. We were equals. I could talk to the uncertain
apartment manager and let him talk to them, but I didn�t want to
be perceived as a �tattle-tale.�

Rights I decided I had as much right to ask them as they had to ask increase
something of me. Since the parking spots were already marked, I felt
justified in asking them to follow the rules.

Relationship What I would be asking was certainly appropriate to the relationship. increase
Reciprocity I didn�t know my neighbors well enough to have established any increase
kind of give and take. However, if I were parking in one of their
spaces, I would be willing to discontinue.

Long vs. short term There could be more general peace in the short term  if I didn�t increase
ask. But in the long term, my peace would significantly decrease and
harboring resentments could only stir up trouble. I knew I
wouldn�t regret speaking.

Respect There was no doubt that my self respect would increase by asking. It increase
was possible as well that their respect of me would increase if they
appreciated my asking instead of stewing.

When I added up all the increases in intensity, I got 6 with one decrease, so I was at 5.
According to the chart below that meant I should ask firmly, and resist taking a no.

Ask firmly, insist. . . 6 . . .Refuse firmly, don�t give in

Ask firmly, resist no. . . 5 . . .Refuse firmly, resist giving in

Ask firmly, take no. . . 4 . . .Refuse firmly, but reconsider

Ask tentatively, take no. . . 3 . . .Express unwillingness

Hint openly, take no. . . 2 . . .Express unwillingness, but say yes

Hint indirectly, take no. . . 1 . . .Express hesitancy, say yes.

Don�t ask, don�t hint. . . 0 . . .Do what other wants without being asked

Next, I had to consider how I was going to ask for what I wanted. I decided that over the
weekend, I would try to catch one of my neighbors hanging around and if I didn�t run
into them, I would knock on the door and ask if I could speak to them for a minute.

But what would I say? I was very angry at that point. I wanted to say, �would you keep
your *&!)%# car out of my parking spot.� But I doubted I would be very effective. So I
considered the DEAR MAN skills which I had used in the past with great success. I wrote
down my answers to each acronym in the skill.

Describe I wonder if you have noticed that in the parking lot, there is a single spot assigned
to each apartment. I�m the newest resident and I have noticed that everyone
seems to park wherever they want. Sometimes I have to park my car in the street
or in the next apartment building parking lot.

Express I have been feeling very disappointed and annoyed that the parking spot assigned
to my apartment number is frequently full.

Assert I would like it if I you could avoid parking in my allotted spot.

Reinforce I think we could all get along better and avoid misunderstandings by following the
 posted parking rules.

Stay Mindful I resolved myself to stay focused on the subject if the other person steered away
with something like "well everyone parks in my spot as well." I could say, "Isn't
that irritating? I'm planning to talk to each resident about the situation. Are you
willing to comply with the posted parking number?"

Appear I knew I would not feel confident. I hated conflict and I was terrified of people
Confident being angry with me. A part of me felt I would crumble and cry if they didn�t
immediately agree to my solution. I decided to use a trick I had learned from a
previous therapist. Before encountering each person, I would close my eyes and
remember a time when I was very confident about something. I would re-
experience those feelings and make my body posture and facial expression look
like it did then.

Negotiate This didn�t really apply to the situation. It seemed pretty black and white to me
� either they complied or not.

The Outcome

Despite all my preparation, I couldn�t catch anyone at home during the next weekend.
Therefore, I decided to write down what I wanted in the form of a letter, apologizing for
contacting them through writing, but I was finding it difficult to catch people at a convenient
time.

Within a few days, people stopped parking in my place. When I encountered one of my
neighbors, I would say, �did you get the note I put under your door? I wanted to speak
with you directly but the timing was off.� Two people responded by saying that they were
glad someone finally dealt with the issue. The other person just mumbled something under
his breath.

About a month later, my parking spot stopped being available again. I didn�t think it would
be appropriate to repeat my previous actions. I began to notice that only one of the tenants
wasn�t complying. I asked the manager if she would speak to the individual. She did, and
for the most part the issue went away.
Discussion Questions

Have you ever experienced a similar situation? Most people have. Discuss how you handled
the situation and how you could have handled it differently using the DBT skills.

As a group, make up a fictional circumstance. Role play with one another (like a director
giving instruction to actors) ways in which the conflict could be resolved.

Discuss the challenge of describing a circumstance without judging it. Pay careful attention to
the difference between observation words like �his face became red, his eyebrows
furrowed and the tone of his voice increased to a higher pitch� (all observations) as
opposed to �he became angry� (a judgment). Observe how you feel about using (or
receiving) observing words as opposed to judging words.

Practice Exercises

Think of a difficult situation in your life that occurred in the past. Don�t start with an
important major crisis, rather with an annoying circumstance. Go through the Factors to
Consider in determining what you could have thought about. Write out your answers to the
�DEAR� acronym.

Consider what behavior is difficult for you. Do you avoid conflict? Do you blow up and behave
in a reactionary way? Do you feel justified in anything you do or do you feel you don�t
have the right to stand up for yourself? Do you have difficulty making eye contact or do you
look at others intensely when there is conflict? Use this exercise (along with your own
questions) to ascertain the things you feel you need to work on in relationships. Talk to your
therapist about these things.

Consider an important conflict that occurred in your past. For each conflict you think over,
write a letter using the rules of �DEAR MAN.�

Mind States

The central concept of DBT is mindfulness. The concept of mindfulness comes from both
Western and especially Eastern (Zen) meditation and spiritual practices.

Mindfulness means being in the present, being aware of what is happening and what you
are doing, observing what is going on, participating fully in what is going on around you. It
is a skill that is practiced and learned throughout DBT, little bit by little bit.  By learning to
live in the present, you can have a life that is more in tune with your feelings and your
activities.

The three primary states of mind are:

 Reasonable Mind

 Emotion Mind

 Wise Mind

Reasonable Mind

A person is in Reasonable Mind: when they are approaching things intellectually, thinking
logically, planning behavior, paying attention to empirical facts (facts that can be observed
or measured or counted), focusing their attention, and when they are "cool," that is, not
emotional in their approaches to solving problems.

Some examples of Reasonable Mind might be:

 calling the bus station to find out the bus schedule, instead of just walking over and
hoping to find a bus

 planning for an outing several days before

 measuring the ingredients to bake a cake

 asking a saleswoman the details about something you want to buy

 studying for a test

 looking up information on the Internet

Consider:

Have you done any of these things?

What are some other examples of the way you use Reasonable Mind?
How can Reasonable Mind be helpful?
Can you think of any times when it is not helpful to be in Reasonable Mind?

Emotion Mind
A person is in Emotion Mind when their thinking and behavior are controlled mostly by their
emotions.  Logical thinking and planning are difficult, facts may be distorted or made larger
or more important, thoughts and behaviors might be said to be "hot," and the energy of the
behavior tends to match the intensity of the feelings.

Some examples of emotion mind might be:

 having a fight with someone you disagree with

 going on a trip on an impulse, without planning

 cuddling a puppy

 making love

 going out to fly a kite just for the fun of it

 snapping at a salesperson because they don't have the item you want

 putting an expensive item on your credit card just because you like it

Consider:

Have you done any of these things?

What do you do when you are in Emotion Mind?
In what ways can it be helpful or good to be in Emotion Mind?
What are ways that it might not be helpful to be in Emotion Mind?

Wise Mind

Wise Mind is the coming together, the overlap of Reasonable Mind and Emotion Mind. But
when they come together or overlap, they produce something bigger than either of them
were separately. What is added is intuition, a feeling of "knowing" what's right, a felt sense,
a sense that some people feel in their body (head, heart, stomach or somewhere else) that
something is just right, the right thing to do or the right way for things to be.  You can
experience intuition about what's right or appropriate without thinking about it, without
knowing it intellectually, just feeling it.

Consider:
Do you ever have this intuition that something just "feels right?" The right thing to do or
say or plan for? Could you give us an example?

Do you have this sense of knowing somewhere in your body?  Where?  (I feel it in my
midsection, around my belly. Something there tells me that I am doing what's good for me,
what's effective, the best thing in the moment.)

Do you have other ways of knowing this? This is what we mean by Wise Mind. It takes into
account your logical thinking and planning and your emotions, but it's something more, a
place of calmness and wisdom.

Practice

Everyone has this Wise Mind. Some of you may not have found it yet.  But it is important
that you learn to find a place of calmness inside you, to let go of the intense emotions, so
that you can sense the wisdom inside you.

Some of you will experience Wise Mind after a crisis. It is like the calm after the storm.

Sometimes you may suddenly see something in a new way that makes sense to you.

Sometimes you may "feel" the right choice in some dilemma, when the feeling comes from
deep inside you.

Exercise

Breathe in and out gently. Follow your breath as it comes in and goes out.  After a while, let
the focus of your attention settle down into your breathing, into the very bottom of your in-
breath, into your physical center. This very centered point is Wise Mind. Practice this
exercise daily, so that you can get a sense of what Wise Mind feels like.

Part Two: Distract Skills -- Actitivities, Contributing & Comparison

DISTRACT SKILLS Contributing

Distracting is a skill that a lot of people The next one starts with C.  C,
already know about because distracting contributing.  So what's contributing?
is when you throw your mind off of the It's where you distract from pain and
problem. In other words, you think about suffering by focusing your mind on
or do something else.  You know people someone else or something else that you
when they say, 'I threw myself into my can contribute to, somehow make
work'. That's when people are better. 
distracting.
The idea here is to distract, that's the
I've got seven distract skills I'm going to good part. And the second good part is
teach you. The way to remember them is you try to distract in a way that will
the first letter spells out the word actually make you feel better about
'Accepts'. Let's start with A. yourself.  To make it even better, you
try to distract in a way that will actually
Activities make the world a little bit better.  So
A means activities.  Now the idea here is even if you're suffering at least you're
to just throw yourself into activities.  You doing some good in the world. 
can't do activities that you can do
mindlessly.  You know how sometimes You could do volunteer work. Lots of
you do things and while you're doing people do volunteer work as a way to
them all you're doing is thinking about kind of get your mind off themselves -
your problem? This is not a good idea. get their minds off their troubles. 
That's not an activity for distracting. You
need a distracting activity; one that will Could do something nice for someone. If
just fill up your whole mind.  What are you're in the middle of a crisis you could
some examples?  think, 'Well, what would someone else
like?  What could I do for them?'  Maybe
Reading is a really good activity. It's one you could give them a call.  You could
of my favorites but you can't do reading call people you haven't talked to in a
if you can't concentrate.  So you could long time who might be missing you. 
try reading if you can get yourself You could do something surprising for
involved or you've got some great book someone else.  There are lots of things
and you're dying to see how it goes. you can do that are contributing.  You
That's a really good one if you can get just have to think of something. Think
involved.  It's always a good thing to back in your own life, what's something
keep a few books around that are really that you do that contributes to other
involving. That's why I like junk novels. people, makes someone happier that
Really serious novels, serious reading - I you could do in a crisis. 
like to do that sometimes. Well, actually,
I mostly do that at work.  But at home I If you can think them up, write them
keep spy stories and novels. I keep the down.  Now's the time. Write them down
kind of stuff you can just really get your now.
mind into.
It's really important to remember that
Or, if you can't concentrate and just contributions don't have to be big.  The
reading's out, how about exercise? Now facts of the matter are, in the middle of
with exercise, you've got to do an crisis when you are just trying to
exercise that will really get your mind survive, you're probably not going to do
involved.  So the best kind are the kind something really big.  That's probably
that are really hard exercises.  Involving not the time.  So, what you want to do is
exercises. Ones that focus the mind.  try to think up small things you can do.

Maybe you're a person who has hobbies. For example, there's a grocery store two
That's what lots of people do. They throw blocks from my house.  I go there, I
themselves into their hobbies to distract don't know, a couple of times a week. 
from their problems.  That's always a So, I always think to myself whenever
good idea.  You have any hobbies? things really get me down, I'm really in
trouble, having a bad day.  I say,
I have friends who throw themselves into 'Alright Marsha. All you have to do to
cleaning their house.  I really do.  I've make this day worthwhile is walk down
got a friend she says, 'Well, whenever to the grocery store. Get in line. And
I've got troubles I clean my house'.  smile at the checkout lady.'  I figure
Now, I do that too.  Sometimes if I just they have really difficult days.  Have you
can't solve a problem, especially at work, ever noticed how rude people can be to
I start cleaning my desk. You can always check out people in grocery stores?  So,
tell when I've got lots of problems - my you can just make the whole world
desk is very neat.  better by going down and smiling. 
That's what I do. 
You could go to an event.  You could go
to a movie or concert. Open the paper; Now, you may be one of those persons
try to find something to go to.  Movies who, when you get in a crisis and then
are good.  you think of contributing, you start
thinking, 'Oh, it isn't going to make a
Lots of people distract from their difference.  It's really not worthwhile.
problems by getting together with their It's not my time.' In a crisis sometimes
friends. Now, the trick here is if you get we start putting ourselves down thinking
together with friends to distract, what we're worthless, thinking that whatever
would you not want to do?  You guessed we have to do doesn't contribute.  So,
it.  Don't spend the whole time talking this is my advice. Stop that. That's not
about your problems. effective. Go ahead and do it.  Even if
you don't think it's going to help, try it
So that's the list.  Now you should add to anyway. 
it.  Think of all the activities that have
ever done you some good and add them Well, what if you've already tried it. You
to the list. You'll probably be able to either tried it and it didn't work or you
think up lots of them. The trick is, think decided 'I'm not doing it. I'm the one in
up the activities when you're not in a trouble. I'm not giving something to
crisis.  It's really hard to think them up in someone else.  I need someone to give
a crisis.  If the crisis is really bad, you something to me.'  Ok. Give it up. 
want to be able to just open your list, go You're not going to contribute.  Let's go
down it, do the first thing on the list, that to the next one.  
doesn't work, go to the second. If that
doesn't work, go to the third, just keep Comparison
right on going. The next letter in 'Accepts' is C again,
but this time it's C for comparisons. 
What do you do if you don't have any When you're trying to distract by using
activities to fill up your mind? You comparisons, what you're trying to do is
need... can't think of anything to do or trying to compare your current situation
everything seems boring or every time or the current crisis to a situation that's
you try to do something all you do is worse than the one you're in now. 
think about your problems anyway. 
Move to the next skill.   So for example you could compare
yourself to people who have less than
you have.  Or you could compare
yourself to people who maybe have the
same thing you have but they have a lot
harder time coping with it.  Or, you
 could look at your own life and you could
think about times in your life when
things have been a lot harder or you
didn't have the same resources you have
now.

The whole idea is to try to feel better by

comparing yourself to a time when you
could feel worse.  In other words you're
trying to get yourself to sort of say in
your mind, 'Could be worse'.

So how does this work? Well when it

does work it's probably generating a
sense of gratitude or a sense of feeling
lucky or even a sense of relief. So, that's
when it works.  It works. You feel
relieved.  You feel better about yourself.
Feel a little more competent.  Maybe
you're not quite as incompetent as you
thought.

Part One: Crisis

Hi.  I'm Marsha Linehan. I'm a professor at This program is going to assume for the
the University of Washington and a moment that you've got a crisis; it's got a
researcher there.  The kind of research I do problem in it that you can't solve.  So
is on behaviour therapy. And in my we're going to focus not on how to solve
research over the last, well frankly, a lot of the problem 'cause we're assuming that
years, I've been developing behavioural even though you may be able to solve it
skills. And I've been developing these skills another time, you can't solve it now.  So
and then I do research to see if the skills we're going to assume that.  So what we're
work. And the good news is most of the going to focus in is how to actually survive
skills that I've developed work.  At least for it.
some people some of the time. 
How in the world would you do that?  I
So there are lots of different sets of skills mean, how do you survive times of trauma
but the skills that I'm going to teach you on and stress when all you want to do is run
this program are called Crisis Survival away, hide, get in bed and pull the covers
Skills.  over your head, or do other things?  Well,
in this program I'm going to focus in on
Now, if you happen to have my book or if two different kinds of skills. The first set of
somebody has given you pages from my skills are going to be the Distract skills. 
book, then you're going to want to open And the second are going to be the Self
your book or get out your pages. And the Soothing.  Two of my favorite sets of
ones you're going to be looking for are skills. 
called Distress Tolerance Handout I Crisis
Survival Strategies and the first one is Now, before I get going on these I just
called Distracting. So we're going to review want to say a couple of things about them
all those skills.  And then the second one is before I tell you how to do them.  First
called Distress Tolerance Handout I Crisis thing is, have you been told by somebody
Survival Strategies Self Soothing. And we're that you distract too much?  And you're
going to go over all those skills too. thinking, 'Hey, wait a minute what is she
doing teaching me how to distract! This is
So that's what we're going to do in this ridiculous!' My therapist, or my friends, or
program. We're going to work on how to my mother, or my partner, or somebody
survive a crisis without making it worse.  tells me, 'Stop distracting.'  Alright. 
That's the basic idea.
If you distract when you can solve the
Now, there are a few things I have to tell problem - not a good idea. The time to
you before we get going. These are really distract - when you can't solve the
important. problem. So we're going to talk about that.
But just remember I'm not advising you,
The first thing is the skills I'm going to don't go telling everybody I'm saying this
teach you in this particular program are not either, to distract all the time. 
the skills that are going to solve all your life
problems.  And they're really not going to Now the second set of skills... I don't know
be enough skills to build a life worth living.  lots of people I work with have loads of
They're not even going to be enough to problems with them, they're self soothing
figure out how to change everything about skills.  So you may be thinking to yourself.
yourself you don't like. Or how to change 'Well, I'm going to listen to Distracting and
your life and all the things in your life you I'm not planning on paying attention to
don't like.  I'm all for solving life's Self Soothing.' People say that who think,
problems; I'm sure you are too.  I'm for 'I don't deserve to self soothe.  I'm not
building a life worth living; I'm sure you are worth self soothing.'  If you're saying that,
too.  And, well, I'm all for changing every well, just put that thought on the shelf. 
single thing about yourself that you don't You're going to be surprized. You could
like.  If it's possible, I'm for it.  The problem actually learn it.
is, is that in order to do that, in order to
build your life up, well, it's just not going to Ok, I just have one last thing to say before
work out if you don't stop tearing your life I get going. I know you're wondering if I'm
down. In other words, if you're a person ever going to get going but don't worry,
who sometimes makes things worse, well, I this is the last thing I have to say before I
hate to give you the bad news here right at get going. I've got a lot of information. In
the beginning of the program, but I'm fact, most people learn this information
telling you right now, you're going to have best if they take notes. So my advice to
to stop that.  You cannot continue to make you is to get paper and pencil and take
your life worse. notes while you're listening.  Now if you
don't have paper and pencil right now...
So, the question of course is how would you well, if I were you, I'd get up, go to the
do that? How would you stop making your program, switch it off, put it on pause, go
life worse?  Most people only make their get your paper, get a pencil, come back,
lives worse in dire situations.  That is to say get yourself all comfy, turn the program
in crises, times of terrible trauma. Are you on, and we'll get going.
one of those people? Think about it for a
minute.  And just think back on your life. Are you the kind of person who, if a crisis
Do you do things that actually make things hits, you usually make things worse? If
worse instead of better? Maybe you go for you're the kind of person who does that,
the bottle.  Maybe you eat too much. Take either a lot of the time or some of the time,
drugs. You think about killing yourself - this is the program for you. This is a
some people do.  If you're one of those program about how to get through a crisis
people these skills are for you. without making it any worse than it already
is. 
CRISIS
So when do you need crisis survival skills? 
The first thing we're going to ask is what a You should look at the situation and see if
crisis is. I mean if you're going to learn it fits three criteria. 
crisis survival strategies, it'd be a good idea First, it needs to be a real crisis. That is,
to know what a crisis is.  So what is a it's highly stressful, short term, and there's
crisis? a pressure to resolve the problem quickly.
Second, it needs to be a crisis that can't be
Well, first a crisis is a stressful event. Often resolved in the short term. In other words
it's a traumatic moment. Usually there's a you can't solve it right this minute.  And
lot of emotional stress in a crisis. That's the third, has to be a situation you can't afford
first characteristic. to make worse than it already is.

The second characteristic is they're short

term.  I mean, crisis don't last forever.  If
it's something that lasts forever and you
think it's a crisis, it's your life, not a crisis.

Third, what goes on in a crisis, you want it

resolved right now.  Generally there's a
sense of urgency like 'Ah, I've got to get it
solved!' or 'I've got to get out, I've got to
get out, I've got to get away!'

 If you put it all together, the basic bottom

line is you need crisis survival skills when
you're in a crisis and you've got to tolerate
it until you can make it better. So that's
what these skills are for. That kind of
crisis.    On this program I'm going to focus
on two different kinds of skills.  The first
set of skills are going to be the Distract
Skills and the second are going to be the
self soothe. So we're going to start with
So that's what a crisis is.  There are two distract.
main rules of crisis survival. The first rule
is, if you are in a crisis and you can solve
the problem now, solve it. Ok.  Rule 1:
Solve the problem if you can solve it.

Alright. The second rule of crisis survival is

if you can't solve the problem, survive it. 
Got that?  What are they?  The first rule:
solve it.  The second rule:  survive it.
Part Three: Distract Skills -- Emotions and Pushing Away

Emotions So, I pulled my car over to the side,

E is for emotions. The idea is to distract they're turned out to be a little
from one emotion by figuring out a way indentation where you could take your
to create another emotion.  So how in car. So I pulled my car over and I
the world would you do that? thought, 'I've got to get through this.'
So what did I do?  I put my comedy
Well, one really effective way, that you tapes on.  And I started listening to
are probably already using anyway, is comedy tapes.  Now I had finally got
music. The secret to using music as myself back over onto the road, I'm
distraction or crisis survival is to pick listening to the comedy tapes - they
your music so that it changes your took my mind off the edge of the
emotion. You'd be surprized at the highway where I could have fallen off.
people I know who when they're sad, And I started, well I didn't start laughing
what do they do? They put sad music on. actually, but I did start smiling. And sure
How do you think they feel? Do you think enough, I got through the drive.
the get less sad?

No.  So the idea is if you feel sad, what Now that's a really good example of
kind of emotion would you like to have? crisis survival skills. You can do it with
Well you probably want to feel energetic humour.
or even happy if you could.  So you've
got to put some energetic happy music What else? Well, you could go to
on.  emotional movies.  Movies are like
reading though, if you're going to go to
Now what's happy for one person may an emotional movie, make sure you
not be happy for another.  That's really don't go to a move that's going to
important. I was once running a group of intensify the emotion you've got.  So if
people who all had drug problems.  And you go to a movie, don't go to a sad
in the groups before that we'd always movie if you feel sad.  Don't go to a love
used music at the end of group to sort of story if someone just broke up with
rev everybody up; make them feel you. 
better. So in this group, I said 'Alright,
let's put the music on'. They said, 'No. 
No. No'. I said, 'Why not?' and they said. Pushing Away
'Well every song we like makes us think What's the next letter?  P.  P is for
of using drugs.'  I said, 'Fine.  Good. pushing away.  It's really a good set of
We're not doing that.  Don't put that on.  skills to do when you just can't cope.
This is really hard. So I'm going to give
Now if you're feeling really anxious and you a couple of things to do that can
tense you could try putting music on make it a lot easier. 
that's soothing and calming. Sort of soft
music. Maybe background music; maybe The first step is get yourself a piece of
classical music. That might help. paper. Get something to write with. The
second step is to make a list: 1, 2, 3, 4,
So think about what kinds of music 5... You're going to want to make a list
change your mood.  That's what you of the main problems that are on your
want to do.  You want to get that kind of mind right now.  So for example you
list going and then when you are in a might say, 'One: my mother. Two: my
crisis, first what do you do?  Check out bills. Three: none likes me at work.'  And
how you feel.  Second, pick your music.  so on. Ok.  So that's the first thing.  You
Third, put it on.  Fourth, make sure it's make your list - put a number beside
loud enough that you can hear it, even each one of them.  Alright. 
low background music. 
And the second thing is you go back
What else could you do?  Well, you could over your list, one at a time, and for
try reading. The most important thing each item on your list, you ask yourself
though about reading is that you've got the following questions. Question 1: 
to find a book that's emotionally Can I do anything about that right now? 
involving. No newspapers, no magazines. And question 2:  Is this a good time to
Nothing scholarly. Nothing informational. work on it? Now if the answer to both
You can't read the encyclopedia. You've those is yes, I can work on this problem
got to find a story that's emotionally now and this is a good time to work on
involving. it, ok, skip pushing away. Go to the first
rule of crisis survival - solve that
So it all depends on what's emotionally problem now.
involving. For me it's spy stories. So I...
if I really find myself worrying, kind of in However, lots of times you'll say no, I
a crisis, and I'm just making things can't do anything now, it's midnight,
worse by all the stuff I'm thinking, I'll what can I do about my mother?
often just get up and try to read a book. Nothing. Is this a good time to work on
But I try to pick a book I can become it?  This is not a good time to work on
engaged in.  I get all involved in the my work problem because I need sleep. 
story and when I close the book, I try to If I work on it now I'll be exhausted
keep my mind in the story. So I try to tomorrow.  So if you say no to both then
keep that emotion somewhat excitement. what you do is put a check mark next to
it.
What else could you do?  You're trying to
get another emotion going. Well one way Say... let's say you've got the first one,
is to try to find some humour. I did that my mother, you've got that checked. 
once.  I was driving cross country and I Now you go to the next problem.  And
was driving all the way from Washington you ask the very same questions. You
DC to Seattle. So I had to drive across say, 'Is there anything I can do about
the middle of the country. So I was this problem now and is this a good time
thinking as I drove across the middle of to work on it?'  And if you say no to
the country I figured I was going to be either one of those, you put a check by
 really bored because, you know, what do it.  And you just go one down your list.
they have in the middle of the country?  Now the idea is to use the first rule of
That's how I was thinking at that time in crisis survival strategies on any problem
my life. I figured, 'Alright, they're going on your list where the answer to both
to have cows and cows and cows'. And I questions is yes.  And where the answer
thought that's not going to be to either one of those questions is no,
interesting. I'm going to get really bored then you can use the pushing away skill.
so I'm going to take my comedy records,
put them on tapes - you can tell it was So what is the pushing away skill? What
records- this was quite a while ago. Put you do is you go through each one of
them on tapes then I was going to listen the items on your list and in your mind
to them as I was going across the middle you imagine picking the problem up,
of the country when I had nothing to putting that in a box and putting it up on
look at but cows. the shelf. You want to do this for each
one separately. 
So, as it turns out, going across the
middle of the country turned out to be The trick is you're trying to send a
really interesting.  And I actually didn't message to your brain that says, 'Brain,
listen to my records.  But, after I got cut it out.  Stop dealing with this
across the middle of the country, I came problem. Put this on the shelf.'  You're
to mountains.  You know how sometimes really trying to send a message to
when you go up mountains and you can yourself that says, 'This is not effective. 
be on the side of the road that's near the This is ineffective. This won't work. I
mountain or you could be at the side of have nothing to gain by working on this
the road that's right near the ledge?  problem now.' And when that's true,
Now if you're on the side of the road pushing away can be a really good skill.
near the mountain, you're not going to So that's the skill. It's blocking,
be so scared.  But if you have fear of censoring, shutting off, putting away,
heights - I have fear of heights - and getting rid of.  But remember you can
you're driving your car on the side that's only do that, this only works when you
on the ledge, you're going to get afraid.  can convince your mind that it's not a
good idea, that you can't do anything if
Well, take it from me, I not only got you work on it now.  Because if your
afraid, I got panicked.  I kept seeing the brain keeps thinking that somehow it's
edge so I started thinking that I was going to get somewhere with this, you're
going to go over the ledge.  I couldn't going to actually solve the problem if
even concentrate.  There was nothing I you keep thinking about it, you won't
could do.  What was I going to do? You get it on the shelf.  It just won't work.
just can't stop your car and get out - I Alright. So that's that skill.  Shall we go
thought of doing this though.  Stopping it onto the next?
and getting out and saying, 'I'm too
scared to drive! Would you drive my
car?'  But I didn't think that would work
out too well.
Part Four: Distract Skills -- Thoughts and Sensations

Thoughts Sensations
The next letter in "Accepts' is T. And T The last letter in the word 'Accepts' is S. 
stands for thoughts. This one is the skill And S stands for sensations that will
of distracting yourself from a crisis by distract the mind. This is a fabulous
focusing your mind on thoughts.  skill.  It's really helpful if you are in
extreme emotional pain or you have
Has anyone ever told you to count to ten physical pain or you're overwhelmed
when you're angry? The idea is that if with an urge to do something not in your
you count to ten you won't yell or best interest.
scream or do something you'll regret. I sometimes tell people I work with, if
Most of us have been told that at least they're really feeling overwhelmed or
once. Well, that's this skill. I know it they have an urge to do something
sounds sort of silly and like not really an destructive, try a hot bath. Or, a cold
important skill but it can really work.  It's shower.  Another thing people
especially good in some situations. And sometimes do especially if they have an
the situations it's really the very best in intense desire to do something
is when your emotions are really intense destructive and they don't want to do it
and you're trying to keep yourself still.  but they feel like they're about to lose
In other words you are just trying to control, have you ever had that feeling?
keep yourself from doing anything until Like you really want to do something
the crisis passes. destructive, you really don't want to do
something destructive and you're afraid
Or you could start naming things.  Like if you're losing control, and you're going to
you're with your boss and he's being do it. Go to the refrigerator and open it
really really critical of you. You could be up, get a piece of ice, hold it in your
sitting there and in the back of your hand and keep it in your hand while it
mind you could just be looking at him melts.
counting and naming the various things
he has on. You could say, 'Tie, shirt, Take it from me, this will distract the
jacket, hands.'  Just about anything that mind.  And, it really works. I... I don't
occupies your mind is good when you are exactly know why that works so well -
in an overwhelming crisis and you're I've been kind of amazed.  I got people
trying to keep yourself from doing doing this and I figured, 'Ok, it was a so-
anything else.  You're trying to get your so skill'.  But lots of people have told me
mind busy with something. it's the most effective thing they do.

Thoughts, thoughts will work.  What's important is that you distract

Sometimes you could use just the same your mind with the sensation that does
thought over and over.  Because if your not harm you.  The idea here is to make
mind is empty, what do you think will things better not worse.
happen? Crack! The crisis will go right
into the middle of your mind. Take it Those are the Distracting Crisis Survival
from me, you'll never make it. So, what Skills. You can remember them by just
do you do? You focus your mind on a going through A-C-C-E-P-T-S.
word. That can be any word.  All depends
on what words work for you.

When we work with our clients we

sometimes say breath in the word 'wise',
breath out the word mind.  'Wise mind'. 
What's good about that is you... you're
trying to get into a wise mind.  When
you're in a crisis the whole idea is to act
 wisely not unwisely. So you might try
that.  Why don't you try it right now
while you're listening?  Breath in 'wise'.
Breath out 'mind'.

You're going to really want to make the

mind go for a long time. Now the idea
when you do this is try to become the
words. So you want to just throw
yourself into the words. You want to try
to fill your whole mind, your entire self,
up with the words. It's often hard to do
at the beginning.  It's hard to keep your
mind focused on one thought. If your
mind gets distracted, you start thinking
about something else, don't worry about
it.  The minute you notice it just come
back to the thought, or the counting,
what you're doing. Just bring your mind
back, start over again. 

If you practice this a lot it actually gets

better.  You'll get really good at it.
Part Five: Self-Soothe

SELF SOOTHE Smell

So, we've gotten through the Distraction So what's the next sense?  Smell.  Now
Skills now we're going to move to a new if you're going to use smell to soothe,
set and these are the Self Soothing you've got to think about what smells do
Skills.  Now self soothing has to do with you find soothing.
nurturing yourself, comforting yourself,
being kind to yourself.  That's exactly A lot of people find flowers soothing. You
what you need in a crisis. In a crisis could put on a little bit of perfume - I
you're going to try to soothe yourself love putting on perfume. When they sell
through it.  new houses they often put things on the
stove so that the house will smell really
There are lots of ways to soothe good. You just want to try to get smells
yourself.  But almost very way has from the kitchen wafting all through
something to do with one of your five your house.  It's really nice. Most people
senses.  Vision, hearing, smell, taste, find smells from the kitchen really
touch. So let's talk about each one of comforting. Some people just like the
them.  smell of fresh air.  That's good if you are
in a crisis and it's stuffy. Go outside,
smell the air.
Vision
The idea of self soothing with vision is So, smell. Try to surround yourself with
you want to do something that soothes soothing smells.
the eyes.  Something that soothes your
sight. What could that be?  Well lots of
people think flowers are beautiful.  It's Taste
one of the reasons we plant them in our What's the next sense? Taste. Some
yards. And it's really wonderful to have a people only use food to comfort. I hope
flower.  You could get just one flower on you're not one of those people, but if
a really awful day when you're in total you are plug your ears up while I talk
crisis.  Go to the store, find one really about food.  This is not going to be the
beautiful flower.  skill for you.

Just because I knew we were going to be You might want to go to the store and
doing this, I brought a beautiful flower.  get some tea, like a special tea.  Some
So I'm going to keep that here just to people carry candy around. Now my
remind you of soothing through beauty. mother always carried around
peppermint candy. I swear any crisis
Another way to soothe through beauty or that showed up in her life, my mother
through your eyes or through vision is to would pop peppermint candy into her
try to make something nice in your mouth. She put so much peppermint
house.  Have you ever noticed how when candy in her mouth in so many crises
you walk into the house and just see a that we all told her, 'When she died,
mess that you can feel that you're in we're putting peppermint candy in her
more of a crisis than you were before? casket.' And that's exactly what we did. 
So the idea here is to make one part of We went and put a whole bag of
your house beautiful. peppermint candy right in her casket.

Now I'm not adverse, you could clean

your whole house up, I mean you could Touch
make the whole thing beautiful but that's How about touch. Touch is unbelievably
kind of a big task - probably not what important when it comes to soothing.
you want to do in a crisis.  So in a crisis There's been a lot of research on this
the thing to do is just find one nice place. and a lot is being done. And it turns out
In fact, if your whole house is a that touch can really soothe, relax and
catastrophe, you could clean up one lower stress.  Getting close to someone
corner.  In fact you could take everything or holding someone's hand, having
from that corner that's a mess, put is someone put their arm around you can
somewhere else, put a flower.  Have be very comforting. 
your chair face that corner and try to find
a way so that you just see the beauty. Sounds great doesn't it. What if you
don't have anybody to touch you? You
If you like pictures or art, go to an art can put your hand on your hand.  You
museum. You can go to a bookstore and could soothe your hand.  You could
look through art books.  You could have soothe your arm. You could rub your
art books at home and look through arm. Massage can be very soothing. 
them. There might be a magazine where Another way to soothe with touch is to
you really like the pictures, that's always put lotions on.  You know you can by
a good thing to do.  creams and salt rubs and things like
that.
But you want to remember is that your
environment counts.  And if you can Touch I really love. I love clean sheets. I
improve the environment around you, love the feel of clean sheets. I like them
make the environment more beautiful, sort of starchy.  You could put clean
it'll make a crisis easier to get through. sheets on your bed. 
 One of the most common things people I
Hearing work with do when they're in a crisis and
The next sense, hearing. Music soothes they want to soothe themselves with
the mind.  Sometimes you'll have a song touch is they go and find their animals
that a favorite song that's really and hold them and pet them and stroke
soothing, like a lullaby.  You could sing it them.  Pick up a dog.  Pick up a cat. 
to yourself. Stroke the cat.  Stroke the dog. This is a
great skill because you like it, the cat
Have you ever noticed how some people likes it, the dog likes it.  In fact this
when they get really stressed, they start seems so important that they now have
humming. You could hum. Humming can animals in a lot of care facilities for older
be a very soothing sound.  people.

If you know how to play an instrument

like the piano, guitar, violin, you could
plan music. 

Now lots of people find another human

voice soothing.  This is really good if the
crisis is that you're alone. So how could
you hear another human voice?  Well,
you could call somebody, listen to them
talk.  That's always good. 

I have some other ideas - you may think

these are silly but take it from me, in a
crisis you've got to do anything that
could help.  So, if you want to hear a
human voice, you could call 800
numbers; listen to the voice on the
number. Or you could call reservations
people, talk to them.  You could call your
crisis clinic, talk to someone there.

There are lots of places where there are

sounds of voices.  You could turn your tv
on, listen to the voices.  You know how
some people leave their tv on all the
time, no matter what they're doing, even
when they're not watching it.  Why do
they do that?  Because it's soothing. 
They just feel more comfortable with the
sound of voices in their house.  And if
you're that kind of person, turn it on. 
You don't have a tv? Turn the radio on.
Just keep it on. It can help.