Distress Tolerance in EMDR Therapy and Somatic Psychology-Dr. Arielle Schwartz

Reclaim the Life You Want to Live

Distress Tolerance Dr. Arielle Schwartz

Art by Mark Lloyd

A common goal in therapy is to learn how to handle painful emotions skillfully. We refer to this as building distress tolerance. It is important to learn how to be with difficult feelings because no matter how hard we try, the challenges that accompany this human life cannot be entirely avoided. Practicing distress tolerance reminds us that feeling discomfort does not always necessitate reacting…sometimes simply slowing down can help us be aware of impulsive urges and we can then be mindful about responding in a skillful manner.

If you have a history of trauma, you might have developed a coping mechanism of compartmentalizing your feelings. But, remaining cut off or disconnected from your emotions has consequences. You lose the joy that comes from intimately connecting with yourself or others.

It takes effort to remain compartmentalized and you might begin to feel like you have to keep working, eating, drinking, or distracting yourself to avoid feeling. You might fear that you if you slow down you will be overwhelmed by your emotions. Unfortunately, this can lead to a vicious cycle in which you begin to push away or avoid situations that might bring up anything painful or uncomfortable. But inevitably, something triggers the feelings and they rush to the surface and to escape the discomfort you might be quick to react by yelling, withdrawing, blaming another, or blaming yourself.

“Healing requires patience. I encourage you to reconnect to your emotions and sensations gently and at a pace that isn’t overwhelming for you. You can broaden your capacity to be with discomfort…but it doesn’t stop there. This increased capacity for distress tolerance becomes the foundation for many positive changes such as increased self-compassion and improvements in your relationships with others.”
Dr. Arielle Schwartz

4 Practices for Distress Tolerance

Build your Resources

Distress Tolerance Dr. Arielle Schwartz

Often, when we feel stuck, numb, or disconnected it is because we do not yet have sufficient resources to process through life experiences. Resources for trauma recovery allow you to slow down processing of emotions to find a pace that you can tolerate. If you are feeling anxious it can be valuable to focus on grounding yourself with your senses in the here and now. Or, you can use imaginal resources to help you feel safe and peaceful. For example, imagine someone who you know could be there for your pain in a compassionate way. Imagine their face and how they’re eyes look at you. Notice how you feel in your body as you imagine this.

Most importantly, take the time to find a therapist with whom you feel understood. Someone who can help you develop work through traumatic memories in a safe manner. I deeply believe we are all meant to heal in the company of others.

Trauma Processing

Distress Tolerance Dr. Arielle Schwartz

Once your feel resourced, you can begin to turn your attention to the original cause or source of distress. In EMDR Therapy and Somatic Psychology we use a process called pendulation which is achieved by alternating your attention between feelings of safety and feelings of distress as they are experienced in your body. This invites you to focus on small amounts of the distress in tolerable amounts, allowing for manageable integration of a disturbing memory one piece at a time.

Ride the Wave

Equanimity Dr. Arielle Schwartz

Uncomfortable sensations that are accompanied with habitual thoughts such as “Make it go away” can lead to unhealthy avoidance strategies such as addictions, eating disorders, self- harming behaviors, or explosive emotional outbursts. Healing involves developing mindful awareness of your somatic (bodily) experience. Doing so will increase your capacity to tolerate the discomfort of big emotions and strong body sensations.

Remember, all emotions are meant to come and go and like waves in the ocean. They will rise up, crest, and subside. Notice your own relationship to this wave. Sometimes you might want to block an emotion before the wave even comes to the shore for fear that you will be overtaken by the experience. It is important to know that even the biggest waves of emotions will not destroy you.

Practice learning how to surf these waters. Become the witness of your experience by identifying your thoughts, sensations, and emotions. Remind yourself that all emotions are temporary, they are not permanent. Do not try to make the emotion go away. Rather, focus on slowing down and becoming curious about your experience. Notice how the emotion feels in your body. Bring awareness to your breath. Over time, you will notice your ability remain present with greater amounts of feelings and sensations. Sometimes, staying with an emotion just a little longer will provide clarity or point toward an action for resolution. However, if action is necessary slowing down will help you behave in a manner that is not impulsive but reflective and measured.

Breathing In and Out

Distress Tolerance Dr. Arielle Schwartz

Art by Mark Lloyd

This final practice is adapted from Buddhist teacher, Thich Nhat Hanh, who invites us to inhale as we name our experience and exhale as we recognize that this is one simply moment in time. For example, next time you are angry simply say to yourself, “Inhaling, I am angry. Exhaling, I am angry now.” Stay with the meditation for as many breaths as you need to until you feel grounded and clear.

Remember, when it comes to healing trauma, a slow and steady progression is the way to go. My hope is that as you practice mindful self-awareness to build distress tolerance that you have an opportunity to expand your experience of self-compassion. Growth and change aren’t easy…but the process is deeply supported when we rest in a foundation of self-acceptance. Set an intention to be nonjudgmental throughout all of the distress tolerance practices and set your sails for the journey of self-discovery.

Want to learn more about healing complex PTSD?

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About Dr. Arielle Schwartz

Dr. Arielle Schwartz

Dr. Arielle Schwartz is a licensed clinical psychologist, wife, and mother in Boulder, CO. She offers trainings for therapists, maintains a private practice, and has passions for the outdoors, yoga, and writing. Dr. Schwartz is the author of The Complex PTSD Workbook: A Mind-Body Approach to Regaining Emotional Control and Becoming Whole (Fall, 2016). She is the developer of Resilience-Informed Therapy which applies research on trauma recovery to form a strength-based, trauma treatment model that includes Eye Movement Desensitization and Reprocessing (EMDR), somatic (body-centered) psychology and time-tested relational psychotherapy. Like Dr. Arielle Schwartz on Facebook, follow her on Linkedin and sign up for email updates to stay up to date with all her posts.


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