Recently, I was driving somewhere, and the check-engine light went on in my car. That light has gone on before, and it didn’t mean anything. As a result, I didn’t get too alarmed. It seems to be more of a problem with the car’s notification system rather than the car itself, as the light went out a day later. At least that’s what I’m telling myself, because I don’t want to drive into town and take it to the shop and pay hundreds of dollars for it to be checked out!
This made me think about the DBT crisis survival skills. In DBT, there are four different types of skills: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. Within the distress tolerance skills, we have a whole set of strategies that are called the crisis survival skills. These skills are there to help you avoid making things worse when you’re already in a difficult or painful situation or crisis. The skills involve strategies like distraction, self-soothing, doing things to make the present moment a little bit easier and better, stopping yourself from acting on emotions, and managing extreme emotions when they come up. Although the skills can be incredibly helpful, people sometimes find them a little unsatisfying. I think this is probably because they don’t actually solve the problem that is contributing to your distress or crisis; they simply make it easier to bear and help you resist the urge to do anything that might make things worse.
Let’s say you’re on a road trip, and your car starts overheating. How could you make things worse? Well, you could keep driving and ignore the warning indicator, like I did the other week with my car! You could open up your dashboard and disconnect the wire going to the indicator. You could deny that this is happening or pretend that everything is OK. You could get angry and frustrated and rev the engine, drive faster, and so on. All of these things would probably make things worse, resulting serious and perhaps permanent damage to your car/engine, and none of them would fix the problem. Instead, slowing down, carefully pulling off onto the shoulder, and pouring water or antifreeze into the radiator so that you can get to the nearest service station safely might be the better way to go. Putting water or antifreeze into the radiator will not fix the problem; it will simply prevent the problem from getting worse and buy you some time until you can fix the problem.
The same goes for crisis survival skills. When your body and brain are red-lining, overheating, and so on, crisis survival skills can temporarily cool things down, prevent you from doing things that worsen the situation, and buy you some time so that you can identify and work on whatever problems are contributing to your distress. Maybe you’ve tried these strategies and thought, “Well, that didn’t work!” If so, give some thought to whether you did anything to make things worse while you were practicing your skills. If you didn’t, the skills worked. ~Alexander L. Chapman, Ph.D., R.Psych.