IMPROVE

• It does not make you inferior if a situation is more than you can handle; it makes you a person who knows your limits.
• Sometimes, it is absolutely appropriate and necessary to temporarily bury feelings, hide them, or push them away. When we do this we are getting through the moment, and taking on only as much as we have capacity for. 
• We use distress tolerance skills as short term tools to help us manage when the intensity of our emotions is at a 9 or 10 out of 10. At those times we are at risk of coping in a manner that eases our duress for the moment, but creates problems for us down the road.
• Think: substance use to numb ourselves, lashing out (verbally or physically) at others to release emotions, having an internal experience of our emotions that is so intense we can’t process what’s happening around us effectively, self-harm, or causing harm to others out of our own duress. 
• If you’ve ever looked back and thought, “I wasn’t in my right mind when I made that decision” chances are you could have used a distress tolerance skill to help you through.
• Distress tolerance skills are not for the weak or people who “can’t handle it”, they are for any and all of us when a situation pushes us to our edge.
• Remember, with distress tolerance skills we are not changing the moment, we are helping you get through the moment in a manner that will not create further problems for you once this moment has passed.
• Distress tolerance skills have the added bonus of helping you “reset” so you can cope and come back online with you faculties intact, enabling you to manage the stressors ahead of you.
• Using distress tolerance skills is often about getting out of black and white (all or nothing) thinking; “if I can’t make the problem go away, there is nothing I can do” is not constructive. You can improve your experience and increase your capacity to handle what is coming if you give yourself permission to use distress tolerance skills.
• There is no right amount of time needed for you to be in a mode where distress tolerance skills are necessary, but generally speaking if you’re in a distress tolerance mode for more than 24 hours you may be navigating into the territory of avoidance, which creates a whole host of other problems in your life. 
• In today’s post I cover the skill “IMPROVE” from Marsha Linehan’s Dialectical Behavior Therapy textbook. Not every part of this will work for every person, consider this skill (and others I offer) as a buffet for you to pick and choose from for you to cope with your specific situation or stressors.

I – Imagery. If you can’t leave the situation in real life, you can temporarily use fantasy to create a new environment to be in. This skill can help us escape internal or external duress (i.e. imagining a more pleasant scenario), or, if it feels accessible, you can use it as a way of boosting yourself up (i.e. imagining yourself coping well).

M – Meaning. Terrible things happen. One way in which we can survive them is by making meaning out of them. This is often too big a task to do in the present, but what you can do is have faith in your ability to find meaning eventually. This can look like, “I don’t know how this will ever make sense to me, but I believe that I will find a way to learn, grow, and be a better person because of this”.

P – Prayer. If you are religious than this probably already makes sense. If not, think of prayer less literally as “asking god”, and more figuratively as a surrendering yourself to forces outside of your control. Prayer usually includes accepting what is happening and our limited ability to change it all while asking for help from some yet to be determined place (like from others, a future version of ourselves, our community etc).

R – Relaxing.  Remember, our brains and bodies are connected in a giant feedback loop. If you are stressed, anxious, and upset your body is likely carrying that tension physically which signals to your brain the need to be on high alert (which can further heighten tension). You can interrupt the feedback loop by relaxing your body which will decrease your experience of the stress.

O – One thing in the moment.  This is reviewed extensively here. This skill centers us and can reduce our experience of chaos.

V – Vacation (temporarily) from responsibilities. Also known as, a break, denial, avoidance, or time to regroup. For this to work you really have to clear your mind of the problem and focus on something else.

E – Encouragement. Our internal world can be brutal. Try shifting your internal voice to approach yourself like you would a friend or a child (with encouragement, kindness, a focus on capacity and strength, and without all the harshness that may be present for you at a difficult time).

Comments:

1. I write a lot in this account about the benefits of being present with your whole self throughout your day, which includes your body, emotions, thoughts, feelings, values, priorities, and the environment around you. While I absolutely stand by that recommendation, like nearly everything I’ve written about, this is not an all or nothing recommendation and the helpfulness of being present in this manner exists on a spectrum; there are times in all of our lives when we need to recognize our limits and our inability to be truly present in the moment. This post will help you identify where your limits are and, hint, often they are not where you want them to be. This post explains the rationale for distress tolerance skills. In it I cover the importance of having “distress tolerance skills” (as Marsha Linehan of DBT calls them) in your coping tool belt. I also cover how our brains respond to intense negative emotions in the comments. 
2. Some of us may not identify with having our emotions at a 9 or 10 out of 10, but we do identify with repeatedly having those moments where we wish we hadn’t handled something in some way, or with feeling the opposite of intense emotions – nothing at all. The IMPROVE skills may be helpful for you too in those times, as well as grounding, another version of a “reset” for our brains that helps bring us back to the present and improve impulse control. Grounding skills are a version of vacation from responsibilities combined with one thing in the moment.
3. Another way to think about when to use distress tolerance skills is when you are outside of  your window of tolerance.
4. When we force ourselves through a moment that is more intense than we know how to handle, without taking care of our emotional needs we are not only not using distress tolerance skills, we are at risk for experiencing the situation as traumatic. Read here for more on what makes something “traumatic”.
5. Your ability to use these skills heightens with a mindfulness practice, which helps us increase our ability to control what we place our attention on. See my prior posts on the rationale for mindfulness skills, for an introduction to meditation and its purpose, for sensory based meditation and for free form meditation.
6. Struggling with feeling like you shouldn’t “need” to do this or use these skills? See my post on Acceptance for help with this.
7. Are the concepts in IMPROVE new to you? That’s ok. The best way to help them become habits is to have realistic expectations for how to incorporate them into your life. See my post on how to make long term sustainable change. 
8. A note on prayer. There are different types of prayer, why me prayers, asking for help prayers, acceptance prayers. In my experience “why me” prayers further our experience of helplessness where as acceptance and asking for help prayers are often more helpful in coping with an unfair or difficult moment.
9. Understanding how emotions work will help you better understand the “R” – Relax – skill. See post from November 1st, 2021 for more details on how our emotions work. As Marsha Linehan says of relaxing, “Often people tense their bodies as if by keeping them tense, they can actually make the situation change. They try to control the situation by controlling their bodies. The goal here is to accept reality with the body” by relaxing it. The quote is from page 99 of Linehan’s Skills Training Manual for Treating Borderline personality disorder, 1st edition. Full Citation: Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. Guilford Press. 
10. Further insight into the benefits of “one thing in the moment” “O” skill, from Marsha Linehan’s manual:  “Focusing on one thing in the moment can be very helpful in the middle of a crisis; it can provide time to settle down. The secret of this skill is to remember the the only pain one has to survive is ‘just this moment’. We all often suffer much more than is required by calling to mind past suffering and ruminating about future suffering we may have to endure” The quote is from page 100 of Linehan’s Skills Training Manual for Treating Borderline Personality Disorder, 1st edition. Full Citation: Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. Guilford Press.