DBT Distress Tolerance Skill: IMPROVE

Contrary to its name… IMPROVE is a skill that doesn’t necessarily “make things better.” It does, however, help you tolerate really difficult emotions and sometimes can shift your emotions in a more uplifting direction. 

When we are faced with a deeply difficult emotional experience, especially with circumstances outside of our control, sometimes the best we can do is to simply get through it and not make it worse. IMPROVE is another one of those Distress Tolerance acronyms (there are so many!) that help us “get through it” when we just don’t know what to do.

IMPROVE the Moment.

Imagery. Using your imagination, create a situation or scene different from the one you are in now. To create this pleasant space, bring your mind to someplace you would like to be. Imagine the sights, sounds, tastes, feelings, and smells in your mind.

Here is a fun and silly example for you… Imagine you are cozy in bed with a fluffy puppy curled on your right and a cute little kitten on your left. Your blankets are soft and cool. You smell the scent of hot cocoa being made in the kitchen. Outside of your window, there are a bunch of twinkling stars in the sky. You hear the soft purr of the kitten and there is a gentle breeze coming through your window. Ahhh.

When you’re in this imaginary place, you may notice that uncomfortable feelings and sensations may still exist. That’s okay. Remember, this isn’t going to “get rid” of your internal experiences. 

If creative thinking isn’t for you, you can also imagine things going well for you. Imagine the situation you’re in works out better than you expect. What would that look like? What would happen?

Meaning. Did you know that changing how we think about ourselves and our situation can impact our feelings? Sometimes when we look for it, the painful situation may have some meaningful lessons. Try focusing on what is important to you and how your actions, feelings, or sensations are helping you connect to this important stuff. For example, if your child is upset that their friend canceled plans with them, you can help them notice that the pain and sadness they feel is telling them that friendship is really important to them. You can discuss why they value friendship and how they can continue to be a friend even though the plans have changed.

Prayer/meditation: I know it’s hard to believe that we used the word “prayer” in connection with therapy. Yet, prayer and meditation are important parts of many people’s lives. Depending on your spiritual and cultural background, spending time in prayer or meditation can help you pause and focus on the moment and what is meaningful to you. Prayer and meditation can help us get unstuck from strong emotions, so we can more clearly shift our behavior and make more helpful decisions. In DBT, we believe there are many ways to engage in healing and distress tolerance - and prayer (or other spiritual practices) can be one of them.

Relaxing. We tend to become very tense when distressed. Using relaxation and stress reduction exercises is a wonderful way to help us shift our emotions in difficult moments. Some techniques to try: taking a bath, giving yourself a neck or scalp massage, drinking a soothing beverage like hot cocoa or a smoothie, listening to music, or anything you do that relaxes you. You can also try some soothing mindfulness exercises… but remember that mindfulness is not necessarily meant to be relaxing, yet some mindfulness practices can help us relax.

One thing in the moment. This skill is similar to the one-mindfully skill. It is focusing on one thing that you are doing right now, in the present moment. If you can stay in the moment rather than getting stuck in past pain or worrying about the future, you can avoid increasing your suffering.

Vacation. A break from a stressful situation can alleviate some of your distress. Although it would be wonderful if we could all literally go on a destination vacation, we’re actually referring to a mental or mini-vacation here. A mini-vacation can be as simple as closing the door to your office for some alone time, having lunch in the park, or going for a walk. It’s pretty much a break from your situation. Children can take mini-vacations by reading a book, watching their favorite movie with you, or setting up a fun bathtime play scenario. Can you pre-plan a mini-vacation with your child so they have a go-to activity in a moment of distress?

Encouragement. This skill is all about encouragingly talking to yourself. Our mood is greatly impacted by the way we speak to ourselves. When stressed, it can be easy to speak harshly to ourselves. The Mayo Clinic suggests various ways to shift your thinking in a more uplifting direction. For instance, they suggest giving yourself permission to smile or laugh, as well as saying kind statements to yourself. Self-talk Hack: Don’t say anything to yourself that you wouldn’t say to a friend.

For more guidance on managing emotional distress with the IMPROVE skill, reach out to us at hello@mindchicago.com. 

Authored by Mind Chicago therapist Fatima Sakrani, LSW