Week two of psych coping skills training in From the Inside Out course

1. The Psychological Toolbox™
WEEK TWO:
Basic and Advanced
Distress Tolerance

2. Lesson Sources
• (1993) Linehan, Marsha. Skills Training
Manual for Treating Borderline Personality
Disorder.
• (2007) McCay, Wood and Brantley. The
Dialectical Behavior Therapy Workbook.
• (2011) McCorkle, Katharine. A Balanced Heart:
10 Weeks to Breakthrough.

3. Advanced Distress Tolerance
DISTRACT
RELAX
COPE

4. Monday - Crisis Survival Skills
• SELF-SOOTHE the FIVE SENSES
(workbook, page 23)
– Hearing
– Smell
– Taste
– Touch
– Vision

5. HEARING
(adapted from Linehan, 1993)
• Listen to beautiful or soothing music, or to
invigorating and exciting music. Pay attention
to sounds of nature (waves, birds, rainfall,
leaves rustling). Sing to your favorite songs.
Hum a soothing tune. Learn to play an
instrument.
• Dr. Marsha says: Be mindful of any sounds
that come your way, letting them go in one
ear and out the other.

6. SMELL
(adapted from Linehan, 1993)
• Use your favorite perfume or lotions, or try
them on in a store; spray fragrance in the air;
light a scented candle; put lemon oil on your
furniture; put potpourri in a bowl in your
room; boil cinnamon; bake cookies, cake or
bread; smell some flowers; mindfully breathe
in the fresh smells of nature.

7. TASTE
(adapted from Linehan, 1993)
• Have a good meal; have a favorite soothing drink
such as herbal tea or hot chocolate (no alcohol);
treat yourself to a dessert. Put whipped cream
on your coffee. Sample flavors in an ice cream
store. Suck on a piece of peppermint candy.
Chew your favorite gum. Get a little bit of special
food you don’t usually spend the money on.
• Dr. Marsha says: Really taste the food you eat;
eat one thing mindfully.

8. TOUCH
(adapted from Linehan, 1993)
• Take a bubble bath; put clean sheets on the bed;
pet your dog or cat; have a massage; soak your
feet; put creamy lotion on your whole body; put a
cold compress on your forehead; sink into a really
comfortable chair in your home; or find one in a
luxurious hotel lobby; put on a silky blouse, dress,
or scarf. Try on fur-lined gloves or fur coats in a
department store.
• Dr. Marsha says: Experience whatever you are
touching; notice touch that is soothing.

9. VISION
(adapted from Linehan, 1993)
• Buy one beautiful flower, light a candle and watch
the flame, go to an art museum, go sit in a lobby
of an old, beautiful hotel, sit and look at nature
around you, go watch the stars in the middle of
the night, walk in a pretty part of town or in a
park, look at beautiful pictures in a book or
magazine, watch TV
• Dr. Marsha says: Be mindful of each sight that
passes in front of you, not lingering on any.

10. HOMEWORK FOR NEXT CLASS
DBT Book, pp. 63-83
Read and complete exercises

11. VISION Exercise
In class: 15 minute activity
• Go through magazines and cut out pictures
that you like.
• Make a collage of them to hang on your wall
or keep some of them with you in your
handbag or wallet to look at when you’re
away from home.

12. MONDAY – HOMEWORK (W2)
• DBT Workbook: Read and complete pages 23
– 30 for group discussion
• Balanced Heart: Read and complete pages
assigned by Dr. Katie

13. WEDNESDAY - Crisis Survival Skills
• IMPROVE the Moment (Linehan, 1993)
– Imagery - calming and beautiful
– Meaning – purpose, meaning or value in pain
– Prayer – open to a Supreme Being
– Relaxation – music, exercise, bath, massage
– One thing at a time – right now, physical sensations
– Vacation – mental or actual, brief moment or a while
– Encouragement – cheerlead yourself with a mantra
“I can stand it. I am doing the best I can do.”

14. WEDNESDAY – HOMEWORK (W2)
• Read Mindful Breathing handout
• DBT Workbook: Read and complete pages 45–
59 for group discussion
• Balanced Heart: Read and complete pages
assigned by Dr. Katie, Week 2, Principle 2