How Is Avoidance Addressed in DBT?
By Jeanette Lorandini
Taking a break from an overwhelming situation can deeply benefit our health by taking us out of fight-or-flight mode.
However, to people struggling with addiction or self-harming behaviors, “distracting yourself” could end up turning into avoidance. It might mean grabbing a couple of beers or turning to physical pain instead. In the end, the issue isn’t resolved, just ignored.
In Dialectical Behavior Therapy (DBT), “distracting yourself” is just one aspect of the larger picture. We are not meant to stay in a state of distraction for an extended period, nor is it a final solution.
The principal goal is to accept the reality of the situation and develop healthy coping skills instead. Distracting yourself so you are pulled into a different mindset will allow you to revisit issues in a clearer headspace and resolve them.
Let’s further break down how DBT addresses avoidance and distraction—in all its meanings—during a crisis.
The Big Picture of DBT
DBT teaches us to use mind and body-stimulating behavior to distract from intense emotions so that we can better accept and work through problems. However, what happens when these behaviors look eerily similar to avoidance techniques we used before therapy? We avoid instead of accept, which is not the goal of DBT.
There is more to healing than noticing emotion. That’s just the first step—if you struggle with this, try stating out loud what you’re feeling: “I feel sad.”
Great! Now, stop and notice where you feel sadness in your body. Are your legs heavy? Did your shoulders drop? What urges do you feel to avoid this emotion?
Now—and especially if the emotion becomes too much to handle—take a moment to choose a Distress Tolerance skill to develop. Distress Tolerance (DT) is a person’s ability to navigate a highly emotional situation without getting overwhelmed.
Through DBT, you should practice sitting in the space between recognizing the emotion and soothing yourself. Time spent in this space should get longer and longer each time your emotions become too much. This will steadily increase your acceptance of the situation without hastily rushing to avoid it.
Choosing Distress Tolerance Skills
Another goal of DBT is for the person to manage a perceived or actual crisis as healthily as possible. (Accepting the reality of the situation even when it’s out of your control.)
Crisis situations are situations that cause us to enter fight-or-flight mode. Ideally, we want to stop fight-or-flight mode from happening and regulate our emotions to address the situation rationally.
Let’s look at some of the most frequently taught DT skills.
Self-Soothing: As children, this looks like sucking your thumb or hugging a soft toy. As an adult, we need something more socially appropriate. Try choosing something that uses your five senses—sight, sound, touch, taste, and smell. Pick up an object and list through the senses, or look around the room and do the same. This helps relax your brain and exit the fight-or-flight response.
Pros and Cons: Stopping to consider the pros and cons of a situation helps avoid impulsivity and potentially choosing the most harmful outcome as a result. This is a fantastic skill to develop if you struggle with lashing out.
Radical Acceptance: “It is what it is” thinking. When we try to control things, we invite the possibility of failure and cause ourselves even more stress when that happens. Accepting that some things in life are simply out of our control takes a lot of the pressure out of stressful situations.
Distraction: A.k.a., “healthy avoidance with purpose.” Physically leaving a location and starting a calmer activity like watching TV, reading, petting an animal, or cleaning can help reset the brain to be more productive.
Humans aren’t perfect. We aren’t equipped with everything we need to solve life’s toughest problems, but we can become more mindful when problems arise.
DBT shows us that there are healthy ways to “avoid” stressful situations for a short period so that we can tackle them later with a clear head. Interested in how DBT can turn your life around? Schedule an appointment today.
Suffolk DBT proudly provides quality dialectical behavior therapy, a form of cognitive behavioral therapy, at their offices in Manhattan and Long Island, New York and online. Their experienced NYC therapists specialize in serving teens, children, adults, and college students struggling with depression, borderline personality disorder, eating disorders, and self-harm. Dialectical behavior therapy (DBT) skills and treatment can help you or your kids to manage emotions and work through life’s challenges.