DBT, or Dialectical Behavior Therapy, was developed by Dr. Marsha M. Linehan as a unique psychotherapy approach combining cognitive-behavioral techniques with concepts of acceptance and mindfulness. The core models of DBT are Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. While each of these comes with its own set of valuable skills, this blog post will teach you the three components of Distress Tolerance: Willingness, Half-Smile, and Willing Hands.
Understanding Distress Tolerance in DBT
Distress Tolerance in DBT comprises a set of skills aimed at helping individuals cope with and survive crises without making impulsive and potentially harmful decisions. It is particularly useful for those who struggle with overwhelming emotions, self-destructive behaviors, and difficulty managing stress. Distress tolerance skills help people prevent an emotional crisis from getting worse. DT also helps people acknowledge and assume control of real-life situations that they may feel cannot be changed.
Essentially, distress tolerance is all about weighing a situation, analyzing the pros and cons to avoid impulsiveness, and making a well-thought-out decision for a more fruitful outcome. Willingness, Half-Smile, and Willing hands are the best examples of distress tolerance skills aimed at crisis management.
The Power of Willingness
Willingness involves accepting one’s current situation despite it being uncomfortable or distressing. Instead of resisting or fighting against the reality of the moment, individuals are taught to cope with and tolerate it. The result is an eventual emotional de-escalation, giving way to effective management for better outcomes.
Willingness is a precursor of the other two concepts in distress tolerance, being willing hands and half smile. Without understanding willingness, one can never truly grasp the essence of the other two. Willingness is the opposite of willfulness, a trait displayed by several people (especially those with BPD) who usually begin DBT therapy. Willfulness is stubborn behavior where one refuses to tolerate distress, is unable to make changes, attempts to fix everything unsuccessfully, and gives up on the process of change without even trying. It is more of a resignation that eventually can lead to depression.
Willingness Expands Mental Perspective Through Mindfulness
It needs to be understood that trying to be in control and fixing things isn’t exactly a bad thing. Still, when you try to do so without fully acknowledging the gravity and reality of your situation, it most likely will be unsuccessful. Willingness in DBT teaches you to be ready to participate in the reality of life, come to terms with a situation, and listen to your wisdom, where logic, reason, and facts co-exist in balance with each other. Willingness is also awareness, where you learn to connect with your surroundings and the universe at large. A kind of mindfulness that helps you expand your perspectives to see things from different angles, beyond your immediate needs, and explore the bigger picture.
Essential Elements of Willingness
- Acceptance of Reality: Understanding that some situations cannot be changed and learning to co-exist with discomfort and pain without escalating the crisis.
- Letting Go of Control: Recognizing that not everything is within one’s control and embracing the idea that acceptance can lead to a more peaceful state of mind.
- Mindfulness Practices: Incorporating mindfulness techniques to stay present in the moment and Cultivate awareness of thoughts and emotions without judgment.
The Skill of Half-Smile
The Half Smile in DBT is a technique with its origins in Zen Buddhism and involves gently curving the corners of the mouth into a subtle half-smile, promoting a shift in emotional experience. Think of it as a Mona Lisa smile, but this is so much more than a smile. Your facial expressions are connected to your mind via communication with the brain. A tense smile relays the fact that you are faking your feelings because a threat hasn’t been eliminated. A half smile communicates acknowledgment of reality and contentment.
How To Half Smile
Relax yourself, and let go by tensing and relaxing your face, neck, and shoulder muscles. Relax each muscle like your eyes, brows, forehead, cheeks, mouth, and tongue. Unclench your teeth and keep them slightly apart. Turn the corners of your lips slightly up in a half smile so that you can feel it. Remember, this is not a smile that others need to see, but rather, what you should feel. Adopt a serene expression, and by half smiling, you will soon experience a relaxed facial state, which in turn relaxes your mental state. Learning to half-smile in challenging situations takes practice, but it develops gradually through repeated application.
The Benefits of Half Smile
- Changes emotional states: Half-smiling disrupts the intensity of negative emotions and encourages a shift from distress to a more balanced emotional state. It helps you accept the reality of a situation.
- Physiological impact: Activates the body’s relaxation response by altering the neurochemistry associated with stress, promoting a sense of calm. Releases feel-good neurotransmitters like dopamine, serotonin, and endorphins, acting as an anti-depressant to boost moods.
The Strength of Willing Hands
Willing Hands is another DBT skill that complements willingness and half-smiling. It involves adopting a posture of openness and receptivity, physically manifesting a mindset of acceptance. Willingness is another physical action that activates mind-body communication, where the simple act of uncrossing your arms or unclasping your hands can signal mental security. It is the opposite of a closed, defensive stance, such as crossing your arms. Willing Hands can help reduce negative emotions such as anger and frustration.
How to Perform Willing Hands
You can perform this technique in three ways:
- Standing: Keep your shoulders straight with your arms down and bend a bit at the elbows. Unclench your hands and turn them outward with thumbs out to the sides and palms facing upward. Keep your fingers relaxed.
- Sitting: You can adopt a meditative position with your hands resting on your knees or thighs, with palms turned outwards and fingers relaxed.
- Lying down: Much like the yoga pose of Savasana, lie on your back with arms at your side, hands unclenched, and palms facing upwards. This is good for relaxation and sleep.
The Benefits of Willing Hands
Willing handssignifies the willingness to accept a current reality and improves the mind-body connection. Acknowledgement then motivates and encourages one to adopt a non-defensive and open stance toward distress or a mental crisis. It helps the mind relax and de-stress to manage emotional problems and a crisis better.
Mastering distress tolerance skills like the three you learned here is a transformative journey that will empower you to navigate life’s challenges with resilience and mindfulness. By embracing concepts like willingness, half-smiling, and willing hands, you can develop several mental skills to help you survive distressing situations once thought unmanageable. DBT and its various skills aim to bring about a delicate balance of acceptance, mindfulness, and a commitment to self-growth and mental well-being.