Distress tolerance is a key skill for anyone dealing with mental health challenges. It’s a core part of Dialectical Behavior Therapy (DBT), because many people struggle with intense emotions and act impulsively when they’re upset. Learning to tolerate distress can help.
What exactly is distress tolerance? It’s the ability to cope with painful emotions without making things worse. Instead of reacting impulsively or trying to avoid the feeling, you accept it and find healthy ways to navigate the situation.
One of the best ways to learn and practice distress tolerance is through group activities. Group settings offer a supportive environment where you can learn new skills, share experiences, and get constructive feedback. You’re not alone, and you can learn from others who are going through similar things.
This article will explore some fun and engaging distress tolerance group activities that can help you build these important skills. These activities are designed to be interactive, supportive, and, yes, even a little bit enjoyable, as you learn to manage difficult emotions in a healthy way. Ultimately, distress tolerance group activities can help you to improve your mental health.
Understanding Dialectical Behavior Therapy (DBT) and its Core Components
What is Dialectical Behavior Therapy (DBT)?
Dialectical Behavior Therapy was created by Marsha Linehan, primarily to treat borderline personality disorder (BPD). But today, mental health professionals use DBT to treat a range of conditions, including anxiety, depression, and PTSD.
One of the key concepts in DBT is the dialectical approach, which is about finding a balance between acceptance and change. It’s about seeing the value in seemingly opposite ideas.
The Four Core Modules of DBT
DBT is structured around four core modules, each designed to help you develop specific skills:
- Mindfulness: This module focuses on paying attention to the present moment without judging it. You’ll learn to be aware of your thoughts, feelings, and physical sensations as they happen.
- Distress Tolerance: This is all about managing intense emotions and impulses in the moment. You’ll learn skills to get through a crisis without making things worse.
- Emotional Regulation: Here, you’ll learn to identify, understand, and change your emotional responses. The goal is to develop healthier ways to manage your emotions.
- Interpersonal Effectiveness: This module focuses on improving your communication and relationship skills. You’ll learn how to be assertive, set boundaries, and resolve conflicts effectively.
These modules work together to give you a comprehensive toolkit for managing your emotions, building healthier relationships, and improving your overall well-being.
Core Principles for Effective Distress Tolerance Activities
Distress tolerance group activities can be a powerful tool to help people cope with difficult emotions and situations. But to make these activities really effective, it’s important to keep a few key principles in mind.
Creating a Safe and Supportive Group Environment
First and foremost, you need to create a space where everyone feels safe and supported. This means setting clear ground rules for respectful communication, and really encouraging empathy, vulnerability, and non-judgmental listening. It’s so important for people to feel like they can be open and honest without fear of criticism.
Emphasizing Skill Development and Practice
The goal isn’t just to talk about distress tolerance; it’s to actually learn and practice specific techniques. Make sure the activities focus on concrete skills, and give participants plenty of opportunities to practice those skills in a safe, supportive setting.
Balancing Structure and Flexibility
It’s helpful to have a structured plan for each activity, but don’t be afraid to adapt to the needs of the group. Sometimes, the most valuable moments come from unexpected discussions or spontaneous sharing.
Encouraging Self-Compassion and Acceptance
Finally, remember to promote self-kindness and understanding. Distress tolerance is about learning to cope with difficult emotions, not about judging yourself for having them. Encourage people to practice radical acceptance of their current circumstances and to treat themselves with compassion during challenging moments.
Fun and Engaging Distress Tolerance Activities
Distress tolerance is all about getting through difficult times without making things worse. It’s a skill that can be learned and practiced, and group activities are a great way to do it. Here are some fun and engaging activities you can try:
Sensory-Based Activities: Get in Touch With Your Senses
Our senses can be powerful tools for managing distress. These activities use sensory input to help shift your focus and calm your nervous system.
Temperature Change: Shock Your System (Gently)
A quick change in temperature can interrupt intense emotions.
How to do it: Submerge your face in a bowl of cold water for about 30 seconds. (Don’t worry, you can come up for air!) Or, if that’s too intense, hold an ice cube in your hand until it melts. The discomfort will shift your focus.
Intense Exercise: Burn Off the Tension
Physical activity is a fantastic way to release pent-up energy and tension.
How to do it: Do some jumping jacks, run in place, dance to your favorite song – anything that gets your heart pumping. Even just a few minutes can make a difference.
Creating a Sensory Box: A Treasure Chest of Comfort
A sensory box is a collection of items that engage your senses and provide comfort. It’s like a personalized self-soothing kit.
How to do it: Fill a box with things like scented candles, soft fabrics (like velvet or faux fur), stress balls, aromatherapy oils, smooth stones, or anything else that feels good to you. When you’re feeling overwhelmed, explore the box and focus on the sensations.
Relaxation and Breathing Techniques: Find Your Center
These activities focus on calming your body and mind through controlled breathing and muscle relaxation.
Paced Breathing: Slow Down to Calm Down
Slowing down your breath can activate your parasympathetic nervous system, which promotes relaxation.
How to do it: Inhale slowly and deeply for a count of 4, hold your breath for a count of 2, and exhale slowly for a count of 6. Repeat this several times, focusing on your breath.
Muscle Relaxation: Release the Tension
This technique involves tensing and releasing different muscle groups to reduce overall tension in your body.
How to do it: Start with your toes. Tense the muscles in your toes for a few seconds, then release. Work your way up your body, tensing and releasing the muscles in your calves, thighs, stomach, chest, arms, shoulders, neck, and face. Pay attention to the feeling of tension leaving your body.
Guided Meditation for Distress Tolerance: Escape to Your Happy Place
Guided meditation uses imagery and relaxation techniques to promote acceptance and reduce distress.
How to do it: Find a guided meditation specifically designed for distress tolerance (there are tons of free ones on YouTube or apps like Headspace and Calm). These meditations often involve visualizing a safe and calming place, focusing on your breath, and practicing acceptance of difficult emotions.
Cognitive Distraction Techniques: Shift Your Focus
These activities help you take your mind off of distressing thoughts and feelings by engaging your cognitive abilities.
5-4-3-2-1 Exercise: Ground Yourself in the Present
This exercise uses your senses to anchor you in the present moment and distract you from overwhelming thoughts.
How to do it: Notice 5 things you can see around you. Then, notice 4 things you can touch. Next, notice 3 things you can hear. Then, notice 2 things you can smell. Finally, notice 1 thing you can taste. This exercise helps you to become more aware of your surroundings and less focused on your internal distress.
Mental Math Games: Give Your Brain a Workout
Engaging in mental math can be a surprisingly effective way to distract yourself from negative thoughts. It requires focus and concentration, leaving less room for rumination.
How to do it: Try counting backwards from 100 by 7s (100, 93, 86, 79, etc.). Or, try multiplying two-digit numbers in your head. The more challenging the math, the more effective it will be as a distraction.
Listing Favorite Things: Focus on the Positive
This activity helps you shift your focus to positive and enjoyable topics.
How to do it: Create lists of your favorite movies, songs, books, hobbies, foods, places to visit, or anything else that brings you joy. The act of listing these things can remind you of the good things in your life and help to lift your spirits.
Adapting Activities for Different Group Needs and Settings
Distress tolerance activities are most effective when they’re tailored to the specific needs of the group. A one-size-fits-all approach just doesn’t work when you’re dealing with complex emotions and different life experiences.
Considerations for Specific Populations
Adolescents
When working with teenagers, you’ve got to keep it relevant. Activities need to be age-appropriate and, frankly, interesting. Think about incorporating games, art projects, or even music. These can help teens engage with the material in a way that feels natural and less like “therapy.”
Individuals with Trauma Histories
Trauma changes everything. You have to be extra careful of potential triggers and create a space where people feel genuinely safe. Offer modifications or alternatives to activities so they can participate without feeling overwhelmed or re-traumatized. It’s about empowerment and choice.
Individuals with Cognitive Impairments
Clarity is key. Simplify instructions and provide clear, step-by-step demonstrations. Break down activities into smaller, more manageable chunks. It’s about making the skills accessible and building confidence through success.
Modifying Activities for Different Settings
Inpatient Settings
Space and resources are often limited in inpatient settings. Focus on activities that don’t require a lot of equipment or room. Prioritize skills that people can use on their own, even after they leave the hospital.
Outpatient Settings
In an outpatient setting, you can encourage people to create a “coping skills toolbox” of activities they can use at home. Incorporate activities that can easily be practiced in their daily lives. The goal is to make these skills a regular part of their routine.
Cultural Sensitivity
Always make sure your activities are culturally appropriate and respectful. Take the time to understand the cultural backgrounds and beliefs of the people in your group. What works in one culture may not work in another, and it’s crucial to be sensitive to these differences.
How to fit distress tolerance skills into your daily life
Distress tolerance isn’t something you just pull out when you’re in crisis. Instead, think of it as a set of practices you can integrate into your daily life. Here’s how:
Build a coping skills toolbox
Think of this as your personal “go bag” of distress tolerance techniques. It should include sensory items (like a favorite scent or a soft blanket), relaxation exercises you know well, and cognitive strategies (like positive self-talk or thought-stopping techniques) that you can use on the fly.
Practice mindfulness every day
Mindfulness isn’t just for meditation retreats! You can bring mindful awareness to everyday activities. Try mindful eating (really focusing on the taste and texture of your food), mindful walking (paying attention to the sensations in your body as you move), or even just taking a few mindful breaths throughout the day.
Use distress tolerance skills in real-life situations
Once you’ve got your toolbox built and you’re practicing mindfulness regularly, start noticing your triggers. When you feel that familiar sense of overwhelm creeping in, proactively use your skills. And don’t be afraid to ask for support from friends, family, or a therapist when you need it.
Frequently Asked Questions
How to make DBT interactive?
Making DBT interactive involves moving beyond lectures. Use role-playing to practice skills like assertiveness, mindfulness exercises with group discussion, and games that simulate real-life scenarios. Encourage group participation through brainstorming sessions and peer feedback to create a dynamic learning environment.
What activities help children with distress tolerance?
For children, try activities like blowing bubbles slowly to practice mindful breathing, creating glitter jars to observe swirling glitter settle (a metaphor for calming thoughts), or engaging in sensory activities like playing with playdough or kinetic sand. These exercises help children learn to focus on the present moment and tolerate uncomfortable sensations.
What is the game to practice distress tolerance?
A simple game is the “Ice Game.” Have participants hold an ice cube in their hand for as long as they can tolerate, focusing on their breath and using coping skills (like self-soothing statements) to manage the discomfort. This activity teaches them to endure physical distress and practice techniques for managing difficult emotions.
How to run a DBT skills group?
Running a DBT skills group requires structure and a supportive environment. Start with a brief mindfulness exercise, review homework from the previous session, introduce a new skill (like distress tolerance), facilitate interactive activities to practice the skill, assign homework for the week, and end with a brief check-in. Maintain a non-judgmental and encouraging atmosphere to foster learning and growth.
Summary
Distress tolerance skills can help you manage overwhelming emotions and urges. And a group environment can give you a safe space to learn and practice those skills.
These skills aren’t something you can learn once and then forget about. You need to keep practicing them and incorporating them into your daily life. The more you practice, the more resilient you’ll become and the better you’ll feel.