DISTRESS TOLERANCE: The Complex PTSD Workbook

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If the first goal of emotion regulation is to learn to sense the ebb and flow of your inner world, the second goal would be to increase the range of your window of tolerance.


Having a trauma history tends to result in a reduced capacity for sensation and emotion. It is important learn how to exist with difficult feelings. You can do this by slowly developing your ability to stay present with increasingly greater amounts of sensation.

 

You can broaden your capacity to handle distress by slowly stepping out of your comfort zone. In somatic psychotherapy, you can learn to increase your window of tolerance through an activity called pendulation.

 

Pendulation involves alternating your attention between feelings of safety and feelings of distress as they are experienced in your body.

 

The practice goes as follows:


• Within a safe environment, choose a recent distressing event to think about. Depending upon your comfort level, you can choose a relatively minor recent event or perhaps one where you found yourself triggered outside your window of tolerance. Mindfully observe any emotions, thoughts, and body sensations that you experience as you recall the event.


Bring your attention to the areas of your body where you feel tension or discomfort. Stay with the sensations for a few breaths.

• Choose a descriptive word for your distress. Your word can correspond to a sensation, an emotion, a color, or an image. Some examples are “jumpy,” “angry,” “hot,” “locked,” “fear,” or “dark.”


• Now, bring your attention to any area of your body where you feel calm and at peace. Maybe this resides around your heart, or perhaps in your hands or your legs. If you are unable to find any positive sensation, look for an area of your body that feels neutral.


Again, allow your awareness to reside here for a few breaths.


• Choose a descriptive word for your calm or neutral sensation. Again, your word can correspond to a sensation, an emotion, a color, or an image. Some examples are “relaxed,” “peace,” “free,” “clear,” “empty,” or “light.” • Now begin to alternate your attention back and forth between the distressing and calm sensations.

 


Think about your distressing event, feel your sensations, and connect to your descriptive word. See if you can stay with the uncomfortable experience just a little longer. Then, return your attention to your calm or neutral sensation, any related image, and descriptive word. Perform several rounds, alternating your attention between your calm place and the distressing event.

 

• Notice any new sensations in your body, including the desire to breathe deeply, let go with a sigh, or move your body in response to your felt experience. Perhaps you feel the impulse to shake or push your arms or legs. These impulses are part of sequencing—a normal and healthy resolution of the fight-or-flight reaction. Follow any urges to move until you feel complete.

 

Once you feel familiar with your pendulation practice, you can choose to try it with a distressing trauma memory from your past. However, if this is new for you, it is wise to instead unwind traumatic material with a somatic psychotherapist who is familiar with Peter Levine’s Somatic Experiencing ® therapy.

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