What is Emergency Tolerance? A therapist explains why it’s your easy tool to survive the pandemic era

Welcome to the new age of fear. Come on in, make yourself comfortable and let’s learn how to deal together.

That’s the pandemic-era message we’ve learned through a practice called stress tolerance. It’s part of a therapy school known as Dialectical Behavior Therapy (DBT) that offers practical solutions to lingering discomforts whether you’re struggling with mild irritability or major depression. Originally developed in the 1970s by a formerly suicidal young woman who later became a… award-winning psychology professorToday, DBT is being used by a wide variety of adolescents and adults trying to cope with ongoing trauma… such as a global health crisis that seems to have no end date in sight.

We asked Dr. Karol Darsa, psychologist and author of: The Trauma Map: Five Steps to Reconnecting with Yourself, for tips on using distress tolerance and DBT in our daily lives.

PureWow: Let’s start with a speed lap. Let’s say I’m in a crowded subway with masked riders and I’m worried about a breakthrough Covid infection. What can I do?

Karol Darsa: There are two DBT skills you can use.

  1. Practice mindfulness. This is a simple way to focus on the present without any judgment or feeling. It helps you to pay attention in a non-judgmental way to what is happening inside you (your thoughts, feelings and bodily sensations).

  2. Practice radical acceptance. In short, this means fully accepting what you cannot change. We can’t change the fact that we are still in the middle of a pandemic and being angry at the facts of the virus only increases our stress.

PW: Do you think the current open ended, no promises, lingering uncertainty and the risk of the pandemic may be more damaging to some people (such as trauma survivors)?

KD: For survivors of past trauma, emotions such as depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms increase because any current stressor can evoke memories and feelings of past trauma. For example, someone who comes from a troubled family may struggle with community restraining orders during the pandemic, as being forced to stay home as an adult can bring back childhood memories of not being able to escape dysfunction, or emotional or physical abuse. Individuals who become ill may have additional difficulties because they are reminded that they were powerless as children while bedridden with serious illnesses or because they cared for an alcoholic parent who was often ill. Concerns about finances can bring back memories of witnessing domestic violence when a parent lost their job.

PW: Can you give us an easy-to-remember technique that we can use when we’re feeling upset? With an example?

KD: There is a fear tolerance tool in DBT known by the acronym STOP. It was helpful to a client of mine who, as the numbers of COVID hospitalizations increased, felt paralyzed with fear of getting sick as he was reminded that he was in the hospital for four weeks after a gunshot wound. We worked through the following:

  1. Stop! Stop and don’t respond to whatever stimuli you come across. Keep control of your emotions and your physical body. (I taught my client to slow down and not react while he was reading the news.)

  2. Take a step back. Remove yourself from the situation. Take a short break or take a deep breath. (My client wanted to constantly read the news and obsessively test himself for the virus. Instead, he agreed to stop reading the news for a while and focus his attention elsewhere.)

  3. to observe. Take a moment to look around and your surroundings and surroundings, both indoors and out. How do you feel? What do others do and say? (My client learned to challenge his fears and to pay attention to other feelings and to his suffering.)

  4. Work mindfully. Think about your goals in the situation and act with full awareness, including what will make the situation better and what will make it worse. (Finally, through increased mindfulness, my client realized that the obsessive fear of the virus was rooted in his unresolved trauma. Through continued therapy, we helped him resolve those issues.)

PW: Any other general tips?

KD: Here is an example of mindfulness. Suppose you had an argument with your partner. Just notice your feelings, don’t label them as bad or good. Don’t try to get rid of them, just observe that you have the feelings without judging them. If you’re overwhelmed, take a walk and notice everything you see, hear, and smell. Pay attention to your bodily sensations. At the same time, notice your thoughts, but don’t try to change them or fight them. Be an observer. This exercise ultimately helps calm your nervous system.

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