DBT Distress Tolerance Skill: PROS AND CONS
Feeling stressed or overwhelmed can sometimes make it difficult to make helpful choices. When humans are under stress or in an emotional crisis, we often make emotionally-driven decisions and leave out our brilliant reasonable mind. This can lead to feelings of guilt and shame. One way to engage in more helpful decision-making is to step back and consider the reasonable/rational and emotional sides within us. Pausing to evaluate a situation can prevent us from making impulsive and potentially regrettable decisions.
When you feel a strong urge to engage in unhelpful behaviors, consider trying PROS and CONS, a Dialectical Behavior Therapy (DBT) Distress Tolerance skill.
Mostly, this strategy is exactly what you think it is. The PROS and CONS skill is meant to help you be more effective in deciding whether a set of behaviors is useful or not.
When you have an urge to engage in unhelpful behavior, you have two options: (1.) You can impulsively engage in the behavior without putting much thought behind the decision, or (2.) You can use the PROS and CONS skill to take a step back and decide if you would like to proceed with the behavior. If you’re just starting out and it’s too difficult to do this now, consider sitting down with your therapist and practicing this skills ahead of time with support.
Simple Guide for PROS & CONS Skill:
Find something to write with (can be a phone, tablet, post-it, etc.)
Write down one behavior you are going to evaluate (for example, self-harm)
What is your goal in this situation?
Make a list of the PROS of engaging in the behavior (think short term and long term)
Make a list of the CONS of engaging in the behavior (think short term and long term)
*Consider the impact of the behavior on different areas of your life: Relationships, school, work, feelings about yourself, personal goals (short-term and long-term)
Remember earlier when I mentioned tapping into your emotional and rational/reasonable sides? Both sides have valid points that deserve to be heard. In DBT, tuning into your reasonable and emotional minds will help guide you toward a decision that matches your values and how you want to live your life.
As DBT and ACT therapists, we acknowledge and recognize that the behavior you’re considering may be the best way you can think of to improve your mood or manage a difficult moment. This behavior may have worked in the past to bring you relief. And this makes a lot of sense. However, if your behaviors and feelings aren’t helping you live the life you want to life or are interfering with meaningful relationships, it might be time to consider something new.
For more guidance on working through distress with the PROS & CONS skill and using other DBT skills, reach out to us at hello@mindchicago.com.
Authored by Mind Chicago therapist Fatima Sakrani, LSW
