Distress Tolerance Techniques to Prevent Self-Harm

Distress can be a major trigger for people with mental illness. And for those who struggle with self-harm, distress can be dangerous.

In my experience with a bipolar II/borderline personality disorder diagnosis and a history of self-harm, distress has the tendency to generate a cycle of negative emotions. When the intensity reaches a point of overwhelming severity, I feel triggered to engage in self-harmful behaviors—as if physical pain will dull the intense emotional pain I’m feeling.

Obviously, self-harm is self-defeating and only leads to more distress, so how can we stop this cycle? Since we cannot completely avoid distress, we must learn to adjust ourselves to handle the demands life places upon us. Through work with my therapist, I have learned to use the following distress tolerance techniques when I feel overwhelming negative emotions.

Mindfulness

Mindfulness is helpful to practice even when you aren’t feeling distressed, so you can employ it more reflexively when distressing situations arise. Focus on an activity—such as breathing or doing the dishes—observing all aspects of what you’re doing and allowing your attention to be entirely captivated. How does the activity look, feel, taste, smell, sound?

Then, when a distressing emotion bubbles up, apply the same technique to simply observe the emotion and resist the urge to act on it. Instead, continue to observe until the emotion’s intensity fades. This is a simple awareness of your emotions—but it takes practice to use it effectively.

Contrary Action

What would you normally do in a very distressing situation? You can use mindfulness to stop and think about this, and then mindfully choose a healthier alternative. Allow yourself enough space to observe and reflect on how you feel before you impulsively react.

Choosing a contrary action is not necessarily easy when every fiber of your being is screaming for destructive, reactive behavior. But when you have developed the mindfulness skills to look ahead and realize that destructive behavior will only bring you more distress, you can look at the situation more rationally.

Once a healthy choice is made—to go for a walk, perhaps, instead of resorting to self-harm—you can observe how the healthy choice looks, feels, tastes, smells, sounds. You can use your sensory perceptions to focus on the calming, restorative sensations your healthy choice elicits. 

Compassion

People who engage in self-harm often experience self-loathing, which can get emphasized during the negative cycle of distress. Compassion towards yourself is necessary to begin healing from the damage of self-harm and self-loathing.

You can do this by restructuring self-talk and reframing your thought patterns. Instead of “I’m such a failure,” try using more gentle and constructive language: “I’m doing my best, and I’m making progress even if I’m not entirely where I want to be yet.”

Even making the choice to talk to yourself with compassion instead of cruelty is an example of a contrary action. One compassion technique that has helped me immensely is asking myself: “What would someone who loves herself say or do right now?” and then doing my best to choose that language or behavior.

Learning distress tolerance techniques to prevent—or even reduce—self-harm is not a perfect solution. The point is to learn to love ourselves enough to face challenging circumstances and respond to them in ways that are inclusive of our own self-care. Overcoming self-harm is a process that requires attentiveness and a strong personal commitment. Simply making the choice to try and curb self-harmful impulses is a triumph on its own. The willingness to practice loving yourself is the first step—and you deserve it.

Ashley Miers is a Los Angeles-based singer/songwriter, actress, and mental health activist dedicated to inspiring hope and healing through her work. Ashley has struggled with symptoms of Bipolar II and Borderline Personality Disorder traits throughout her adult life, surviving several suicide attempts and struggling with cutting and substance abuse. Ashley now speaks, performs, and advocates for therapeutic approaches. Ashley’s goal is to inform and inspire in an effort to assist others with mental health challenges as they progress on their own healing journeys. Find out more information about Ashley at www.AshleyMiers.com.