Borderline Personality Disorder,  DBT

How to Get Through Crisis

Crisis response coping is crucial for individuals with poor emotion regulation

How to Get Through Crisis
~ 2 min read

Distress is a fact of life. It’s a wide range of triggers: it’s not always our turn, or we have bad luck, or we make a bad decision and have to suffer the consequences or we experience oppression and injustice and so on. How upsetting these different degrees of distress are depends not only on the magnitude of the event, it depends on us—the same event may be annoying to one person and catastrophic to another. Most of us have different ways of dealing with different levels of distress. People who are more emotionally vulnerable don’t differentiate as well, and actually experience any amount as intolerable.

How DBT teaches distress tolerance

This might be the most misunderstood skill set in evidence-based practice. Radical acceptance was initially a very challenging idea: that one must complete accept reality as it is without being driven to change it in order to move forward. This doesn’t mean that we can’t make changes or that we shouldn’t try, but that to do so we first must accept things as they are.

If this sounds familiar that may be because mindfulness has become a lot more popular in psychotherapy since the original DBT text was written. In fact, mindfulness has become the basis of more than one evidence-based therapy. But not all advances in evidence-based practice made understanding DBT helpful. In fact, a better understanding of anxiety is the source of objections to the other set of DBT distress tolerance skills.


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