By Carissa Weber
Welcome back to the third episode of distress tolerance! I really love talking about distress tolerance skills! They help us increase frustration tolerance, build new connections between our prefrontal cortex and that darn amygdala, and release feel good neurotransmitters to calm down our triple F response. Because of all of those benefits, distress tolerance skills get 3 whole posts!
Just to recap our last three posts to refresh your memories:
DBT is a form of psychotherapy to help us remain present in the moment andengage in reactions that are healthy and helpful.
The core pillars of DBT include distress tolerance, mindfulness, emotional regulation, interpersonal effectiveness.
Some distress tolerance skills are: TIPP, self-soothing, IMPROVE, and ACCEPTS.
Today, we are going to move on to the skill of wise mind. Wise mind is a staple of DBT and distress tolerance skills. The great thing about wise mind is that it is a skill that allows us to acknowledge what that darn amygdala is trying to tell us to do, while at the same time allowing the prefrontal cortex to kindly bitch slap it.
We have done a lot of talking about the role of that darn amygdala and the prefrontal cortex in my post Mental Health and the Brain: A Breakdown (Literally and Figuratively). In this post, I am going to refer to that darn amygdala as the emotional brain (because it is) and the prefrontal cortex at the reasonable brain (as that is what it is). Wisemind uses these terms to not only explain what is going on in your brain, but to take away negative labels associated with what our brain does (wait what? Can we say trying to remove the stigma? Way to go Marsha Linehan!!).
As we know, that darn amygdala, I mean, the emotional brain, is used to help us stay alive and react based on what we are feeling. This tends to mean the emotional brain is a bit more impulsive when we are stressed because it wants us to not be stressed. The emotional brain strives to make decisions without really considering the long-term outcomes of its actions as it wants us, the body, to feel comfortable again as quickly as possible. In the moment, you can start to identify emotional brain decisions by the physical cues your body is giving you (you know, all that fun stuff that happens like increased heart rate and respirations, feeling tense, stomach aches, and perhaps avoidance all together?), the type of language you are using (for example, “you’re making me mad”, “I’m too discombobulated,” and my personal favorite “why am I always the one making dinner?”), and striving for instant gratification (like eating that candy bar secretly on the way home so you don’t have to share only to feel guilty later when your darling significant other made you dessert). These tell-tales (along with the whole thought tracking we talked about in Cognitive Behavioral Therapy: Why it Works) help you identify what your emotional brain is striving for.
Now we have the prefrontal cortex (grrrr), the reasonable brain. No different than the prefrontal cortex thriving on facts, so does the reasonable brain. It takes a moment to slow down and explore the facts that are driving our emotions. It also takes time to slow down to identify if the outcomes of our actions are really what we desire to have happen. The reasonable brain works by looking at the objective facts of a situation and applying those facts to create stress relief. You know you are using your reasonable brain when you say things like “let me get this straight” or “is there another way to look at this?”. Another way to tell if you are using your reasonable brain is when you observe what options you have at your disposal for solving the stressor at hand. You may be using some of those thought challenges we talked about in Cognitive Behavioral Therapy: Part Deux when you are activating your reasonable brain.
Now comes in wise mind. Wise mind is acknowledging both your emotional and reasonable brains and making them work together to create the best solution to the stress you are feeling. By combining both emotional and reasonable brains together helps us create the following:
- A balanced thought process
- A respectful place to identify our emotions
- A rational responses to our emotions
- A way to validate your experiences
As we use wise mind and reap the above benefits, you will start to notice something happen in your brain. First, the adrenaline, norepinephrine, and cortisol will slowly start to dissipate. What comes next? You guessed it! The neurotransmitter acetylcholine will start to decrease, meaning you will feel a bit less muscle tension and your heart rate will go down. This will trigger your brain to start releasing some GABA, thus calming your body. As this is happening, the reasonable brain (a.k.a. – the prefrontal cortex), will release the neurotransmitter glutamate. If you recall from the post Neurotransmitters: the Language of the Brain, glutamate is released when our hippocampus and hypothalamus are forming memories. Glutamate is being released to help your brain remember what to do when you face this stressor again, meaning (in theory) that you will not be as stressed the next time it happens because you will remember what to do.
Wise mind has the added benefit of assisting in the growth of a stronger connection between the prefrontal cortex and that darn amygdala. That alone helps reduce the stress we have as there is a direct way for the prefrontal cortex to tell that darn amygdala to just stop. Another way that the brain benefits is the hippocampus healing and growing in size. This means we will have the ability to store more memories and be better prepared for future stressors. Isn’t neuroscience amazing!?
As I’ve preached in the past, I will preach it again here:
Practicing wise mind, daily, for 66 days will help not only make it a habit, but ensure your brain is starting to heal. Essentially: practicing will help reduce your self-doubt, anxiety, and depression. Don’t believe me? Check out my post Why Your Brain Needs a Routine for more information of the science behind brain growth.
Coping Skills Alert!
How do I practice wise mind? Great question! To start practicing wise mind, I tell my own clients to start first by finding something to write this stuff down on. Why? Seeing it, writing it, and reading it makes it stick better in the brain (plus, it gives you a practice sheet to look back on). The next step is identifying what the emotional brain is saying to us. Not only does it help get those emotions and impulsive quick fixes out of the way, it allows the reasonable brain time to think about what the facts of the situation are. Once that is done, write down what the reasonable brain is telling you. That way, you will have those concrete facts right in front of you to help challenge that darn amygdala, I mean, the emotional brain. Here comes the fun part, writing down what the wise mind is saying. This may take a few minutes because you really have to think about how you are going to show yourself some kindness and come up with a response that will help your emotions (but not get you into trouble).
One more skill I would like to talk about is radical acceptance. As stated by the great Marsha Linehan herself, “Radical Acceptance rests on letting go of the illusion of control and a willingness to notice and accept things as they are right now, without judging.” What does that mean exactly?
When we face truly painful events or emotions (like being embarrassed or ashamed of something), we tend to allow that darn amygdala to do what it needs to do to get us out of that situation (enter the triple F response). With radical acceptance, we actually allow ourselves to feel those not-so-nice emotions and accept their purpose. Through this acceptance, we start to learn how to navigate those difficult situations in a way that honors our experience, not deny it. As we learn to do this, we improve our overall distress tolerance level, but we also repair the trust with ourselves by stopping denying those emotions we don’t want to experience.
“The truth is, you’re not supposed to feel good all the time. Emotions all serve a purpose.”– Carissa Weber
It is also important to acknowledge that radical acceptance isn’t a big rubber stamp that says “approved.” Radical acceptance is not ignoring the painful emotions and pretending they don’t exist. If anything, that sort of attitude to emotions can land us in a downward amygdala fueled spiral. Radical acceptance then, is working through the pain to prevent more and future painful emotions from developing and lingering. Some of those emotions, like resentment, bitterness, and shame, tend to antagonize our mental health, leading to more issues with anxiety and depression and radical acceptance helps us process and let go of them.
Another Coping Skills Alert!
How do you use radical acceptance? When should you know when to use radical acceptance? These are great questions to ask. Lets start off with looking at an everyday example to practice radical acceptance so that you can get a feel for what you are looking for. What better example is there than the frustration of procrastinated tasks!
For me, I put dishes off until the last possible moment. Every time I see that sink full of dishes, I get irritated. I tell myself I’ll do them tomorrow, but then when tomorrow comes, something big happens and I excuse myself from doing them. About day 3 is when my household runs out of bowls and spoons. Isn’t it funny how the most crucial thing runs out the fastest? Anyways, I sit there, stew about having to do dishes. Then I get frustrated because I feel like the only person in the world that notices the dishes. I have been known to unleash fury on those in my household if they do the dishes, but they aren’t done my way. Then I am on my way of feeling guilty and ashamed for yelling at my kids for trying to help (where the heck was wise mind?!).
First things first, we have to be able to identify when we need to question the reality of the situation. That means, we have to look at and identify what our reaction is and if it fits with the situation we are facing. That can be really tough to do sometimes, especially if our emotions are running high.
Part of radical acceptance is using wise mind to identify what is in our control and draw attention to the reality of the situation. In the above example, the reality is that my kids really do try to help. My husband has other things he is trying to accomplish that are just as (if not more) important than the dishes. I am not alone in my procrastination.
The other part of radical acceptance is identifying the emotion we are having, and pay attention to it. Like I said above, there was frustration in the situation. There was also some resentment, exhaustion, and even loneliness in that example. As we label our emotions, we know what we are facing. As we identify those emotions, we are able to identify those emotions have a time limit. By saying that out loud, “My frustration will pass,” or ” I am not the only person struggling with the dishes,” or some other coping statement similar to those, we allow the prefrontal cortex to acknowledge the pain that darn amygdala is feeling is real. Once we have done this, it is important to move on to a healthy coping skill (such as those mentioned in the post Mindfulness: The Art of Becoming Calm, Cool, and Collected) we would like to use instead. This helps that darn amygdala see we are trying to help it, not keep it in pain.
If you are still feeling these strong emotions and cannot move past them, it is time to grab that pen and paper and literally write down how this feeling is serving you. Are these feelings helping you, or are they hurting you? This sort of pros and cons list can help your prefrontal cortex can help your darn amygdala to snap out of it.
While you are practicing radical acceptance, it is super important to be kind to yourself. Calling yourself names, telling yourself you’re overreacting, or even that your feelings don’t matter is not part of radical acceptance (feeling called out yet?). Doing these things invalidate what you are experiencing, which makes the distressful feelings even worse. Why pour lemon juice in a wound that already is hurting? That is what you are doing if you don’t show yourself some sort of kindness. That kindness may be eliminating negative self-talk for a few minutes, letting yourself experience the joy that comes from changing how you are reacting to the stress, or even (dare I say it) admitting you are not okay in that moment.
Practicing radical acceptance can be tricky. One way to tell you may need to be practicing it is when you start using those tricky cognitive distortions we talked about previously. Especially the cognitive distortion of “should.” Do you find yourself saying “I should do this” or “I shouldn’t have done that?” Those are great times to pull out radical acceptance. Another time you should practice radical acceptance is if you find yourself saying “why me?” or “It shouldn’t be like that!” a lot.
Whew! we got through a lot in this post, didn’t we? Thank you so much for taking time to learn about some of the harder (but rewarding) distress tolerance skills. I hope you are able to incorporate some of these in to your own journey to mental wealth and gain the confidence you deserve to have!
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- Gratz, K. L., Tull, M. T., & Wagner, A. W. (2005). Applying DBT mindfulness skills to the treatment of clients with anxiety disorders. In Acceptance and mindfulness-based approaches to anxiety (pp. 147-161). Springer, Boston, MA. Retrieved from The Wise Mind (Worksheet) | Therapist Aid
- McCarthy, Don (2020). WHAT IS RADICAL ACCEPTANCE? (AND WHAT IS NOT). Retrieved from What is Radical Acceptance? (And What is Not) | myTherapyNYC
- Miguel, Marie (2020). The Wise Mind: How logical reasoning can help manage emotions. Retrieved from The Wise Mind: How logical reasoning can help manage emotions | Center for Practical Wisdom | The University of Chicago (uchicago.edu)
- Olivio, Erin (2017). Wise Mind Living: Master Your Emotions, Transform Your Life. Sounds True Publishing
- Psychology Compass (date unknown). Training the Wise Mind for greater self-confidence. Retrieved from Training the Wise Mind for greater self-confidence – Psychology Compass