By Dr. Mehri Moore
At THIRA Health, much of the work we do is built around dialectical behavior therapy (DBT), a modified form of cognitive behavioral therapy (CBT) that was developed in the 1980s by University of Washington researcher and professor of psychology and psychiatry and behavioral sciences Dr. Marsha Linehan.
DBT is grounded in the idea that certain individuals have a lower tolerance for distress than others, and thus are more prone to having intense emotional responses to seemingly ordinary circumstances. These individuals are quick to respond to stressful stimuli, have a more pronounced than average response to such stimuli, and tend to be very slow in their return to a baseline mental/emotional state. By building patient’s’ skill-sets in four areas – mindfulness, interpersonal effectiveness, distress tolerance, and emotion regulation – DBT help patients adjust detrimental patterns of behavior and regain control of their lives.
At THIRA, we treat DBT like a class, teaching skills, assigning homework, and assessing how effectively our patients incorporate these new practices into their daily routines. As a peek into one aspect of our DBT program, we’ve outlined some of the ways our patients – and, really, anyone who deals with excessive stress – can use their senses and basic faculties to self-soothe in overwhelming moments. Dr. Linehan is a big believer in this approach to stress management, indeed some of these tips are lifted directly from conversations she and I have had.
In a modern world defined by hustle and bustle, it’s easy to become visually overstimulated simply by going about your everyday life. When this happens, make an effort to look at calming images, whether art or something as mundane as stock photos of nature. Alternatively, close your eyes and recall to mind a favorite – and ideally relaxing – memory.
Proper tactile stimulation is one of the best ways you can go about establishing a sense of comfort and security. Taking a long bath or shower, putting a cold cloth on your head, brushing your hair, or wrapping a warm blanket around yourself may seem like unremarkable actions, but they can help reset your body’s sense of safety and calm. If you live with or near a loved one, solicit a hug or a massage, as even basic physical contact can help alleviate stress.
Stimulating your sense of taste can also help elicit feelings of comfort and familiarity, but only if it’s done mindfully. Eating your favorite food or drinking your favorite beverage can evoke good memories, but you should be careful to do so in moderation. Savor your favorite flavors, taking ample time to eat and making an effort to avoid over-indulgent “stress eating.” Further, avoid food and drink containing alcohol, caffeine, excessive sugar, and other stimulants or depressants.
Like taste, smell is an incredibly evocative sense. Everyone has a set of smells that are intertwined with a sense of “home,” and seeking out these smells in moments of stress is a great way to reestablish calm. Actions as simple as applying a favorite lotion (which can also be a soothing experience from a tactile perspective), lighting a scented candle, using a favorite body wash, smelling fresh-cut flowers, or making cookies or popcorn help create a milieu – a “smellscape,” if you will – that is conducive to internal peace.
Much like with visual stimuli, the modern world is not exactly optimized for a stress-fee auditory experience. As such, you have to make a significant effort to avoid auditory overstimulation, but with technologies like noise-cancelling headphones, it can certainly be done. Listening to your favorite music contributes to a sense of familiarity, but sometimes it’s also helpful to simply put on “nature sounds” like rain falling or birds singing, especially if you live and work in an urban area.
If you are physically capable, engaging in movement – whether not strenuous at all or highly strenuous – is an effective stress-reliever. Individuals who are prone to crippling stress and anxiety often feel that they lack control over their environments and the goings-on therein. Getting up and moving helps you remember that, at minimum, you have control over your own body and the actions it takes. Something as modest as stretching or gently rocking yourself back and forth is a good start, but if you’re capable, going for a run, practicing yoga [link to the yoga piece if it is published prior to this one], or dancing really gets the blood – and endorphins – flowing and takes your mind off whatever was troubling you.
Finally – and also in the vein of using your body as a de-stressing mechanism – exercising your vocal capacities can have a purifying and calming influence on your overall emotional state. In addition to the physical component of vocalization, using your voice – in whatever capacity – reaffirms your existence as an individual in the world, an affirmation which counteracts the feelings of smallness and helplessness that often accompany high stress and anxiety. Everything from singing to meditating with audible sounds (often, “Om”) to simply conversing with someone at length can go a long way toward anchoring you in your body and, by extension, in the world.