Making a Distress Tolerance Box

Anyone that’s been under a mental health team for a while, is likely to have heard of the term ‘distress tolerance’. The basic idea is that you build up your tolerance to distress, in a healthy way. Often it’s used if you’ve been using maladaptive coping mechanisms (in other words, not coping with things very well). You’re often encouraged to ‘sit with’ crappy feelings, whether it be feeling low, feeling anxious, stressing about food, needing to self harm, feeling at war with your family, or something else.

It can be super helpful to have a distress tolerence box to help with this ‘sitting’ business. I’ve been building mine up a while, so I thought I’d share it in case anyone else feels like setting up their own box.

Often you’re encouraged to try and work on the five senses: something to see, smell, taste, feel, and hear. In my case, when I’m struggling, I can’t deal with taste or strong smells, so I haven’t included those in my box. I also can struggle with noise, so I don’t have that in their either (though I’ll often leave the TV on quietly). Personally, the things that help me most are things to feel, and things to do, so those are the things my box mainly focuses on.

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To begin with, you’re going to need a box. Make sure it’s pretty enough that you’ll want to use it, sturdy enough to not fall apart when you fill it, and big enough to fit stuff in. I got mine from HomeSense and it definitely didn’t break the bank.

Then you can start to fill it and that’s when the fun begins!

Everybody’s box will be individual, because what works for one person won’t necessarily work for another, but here are some ideas of things you could include, and where I got them from.

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To start with, I have things from my friends. Things that remind me that I’m loved. Things that remind me that I’m not the worst person in the world, and that I’m lucky to have some wonderful people in my life. Some of these things are cards, some are letters, some are quotes that people have sent me. I have a seperate box of letters and cards, as well as the ones in my box (plus a few more on my wall – I pen pal with a fair few people!), but the ones that I’ve put in this box are ones that have particular meaning to me. Some include photos, too, which is always lovely. If you don’t have letters and cards from people, you can always ask your friends to send you things to include. It’s a really hard thing to ask, but from experience, people normally love to do it!

As well as letters, cards and things, I have some envelopes which are a little more specific which one of my friends sent me. They are envelopes with ‘open when…’ on the front – they’re a really lovely idea and if you don’t feel able to ask a friend to help you with it, you could always write your own, there are loads of ideas for topics online.

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Next, I have some important reminders. Personally, one of the things I struggle to deal with is scales, so I have a scale disclaimer in my box. I also have a box of ‘press pause’ cards which can be bought from Blurt, because often when I’m struggling everything can feel overwhelming and too fast, and that can help me to break out of that zone, and take a deep breath.

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I also have some other nice little things I can read. A little book of hope which Mum bought me, a little box of happiness, some worry dolls which a friend bought me, a bookmark and pen with some quotes on, and a little bag of happiness which is from the World Mental Health Day that I ran at uni a few times. You can buy them from not on the high street, or you could make one yourself!

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Moving on from the sentimental bits and bobs, I have a lot of different things to touch. I have a handwarmer, because I find temperature can be really grounding. I also have some stretchy toys which I got really cheaply from Hawkins Bazaar’s party bag section, and some balloons with different textures in and a bag of jelly balls which were sent to me by  friend (check her out on instagram at the.recovery.shoebox.project). I also have a couple of puzzles which I can fiddle with – a wooden one and a metal one.

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I find things to do really helpful, so I have quite a few things to do in my box, so that I can pick and choose depending on what mood I’m in. I have some little cross stitches, some colouring books and an origami book (with colouring pencils – the last thing you want to do, when feeling distressed, is to hunt around for some pencils). I also have some ‘make your own bunting’, a ‘paint your own suncatcher’, and some mazes and other paper puzzles, which were all from the.recovery.shoebox.project.

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Finally, I have some things to remind me of my inner child (because if you can’t look after you, sometimes it can be helpful to think about treating yourself the way you would treat your child). Bubbles, glow sticks, play doh, a little googly eyes monster, and a glitter jar (which was also from the.recovery.shoebox.project, but they’re pretty easy to make).

So, that concludes the little tour of my box. Pinterest has loads of ideas for other things you can include. If you don’t feel able to put your own box together, I highly recommed subscribing to Blurt’s Buddy Box – they send little self care packages every month and quite a few of the items in here are from those boxes, and I have other things from them on my noticeboard and walls. Other ideas for things you could include are: nail varnish, face mask, oils/sprays of your favourite scents, photos of loved ones, a list of songs you could listen to, or a USB stick with a playlist on, a teddy or other soft toy, tea bags, chocolate your favourite book… it contain literally anything that you feel could help you deal with feeling crap.

I hope this has been helpful to some people, of course once you’ve made your box, the hardest part is remembering to use it rather than resorting to doing not-so-helpful things! Please feel free to comment with other ideas for things you might include – I’m always up for adding more things to my box, and it might help others, too. If this kind of thing is helpful, please let me know and I’ll have a think about other posts I could do in a similar vein.

Sending warm hugs to everyone struggling at the moment Xxx

Even the darkest night will end and the sun will rise. -Victor Hugo

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7 thoughts on “Making a Distress Tolerance Box

  1. (because heck, last time I managed to cut my finger, entirely by accident, I *forgot I had a first aid box in the kitchen* and ended up trekking out to where I’d parked the car to get the travel pack from the glovebox, so what hope does this have against such garbled thinking?)

    1. Hi Tahrey,

      Thank you for your comments. I guess different things work for different people and while this may not be your cup of tea, it might be others!

      In all honesty, I don’t find that I use this box much myself. However, I have used it with friends who were in crisis and have found it to be really helpful in those circumstances.

      I hope that you are able to receive the help and support that you need.

      All the best,
      Naomi

  2. And yeah … the big problem like you say is remembering to use it, or being motivated enough to bother using it, rather than thinking it’s a stupid idea / forgetting about it completely (both significant risks with myself) and leaving it to gather dust under the bed or whatever. If someone could come up with a way to deal with those twin handicaps that come along with depression et al, it would probably spark quite the revolution in treatment and symptom mitigation.

    I mean, there’s all kinds of apps for remembering to take your pills, daft thought diary things, guided meditation programmes, etc, but it doesn’t seem anyone’s yet come up with one that can sense when you’re under a serious cloud and/or freaking out, and ping to remind you to give it a try. Maybe it can be a future development with integration of home CCTV webcams or activity tracker wristbands and devices like Alexa and such. Using the cams manually proved a great help when our family was rotating shifts keeping an eye on my grandmother in her last couple years of life, as proper care homes or a nurse who came in for more than a half hour once a day was far too expensive (and there’s absolutely no way she would have stood for it!)… whilst a Big Brother culture isn’t exactly appealing either, it seems it could be a handy additional application of something you may introduce to the home off your own back for security purposes, or to monitor your health in other ways, etc. Or even install for THIS reason.

    If anyone knows a good technique to get the right thought patterns entrenched so they activate at the right time (CBT has proven hopeless), and/or any phone apps and the like that actually CAN do the sort of thing I’m envisaging… please let me know, as it’s an issue I’ve had with a lot of otherwise perfectly good defusing techniques and resources over the last few years – ie, when you most need it, you’re not going to think of it, or if you do then it’ll only be in a disparaging, self-defeating way. I’m going to turn reply notifications on for just this one post…

  3. Funny… I thought one of the problems with my seemingly entrenched dysthymia and so on was the better part of two decades of having done just this… simply trying to sit it out. It almost ended badly on a couple of occasions, and I can only thank a certain couple of different people who saw me turning turtle on those occasions and decided to make nuisances of themselves and try to push me into positive, rather than negative action.

    I guess it depends what the problem is; I ended up here from a link on Blurt’s “Coping With Crisis” page (they’re more about the box than the technique, to be fair), or in other words ways to help whatever remaining shreds of rational consciousness you might have left prevent the rest of an afflicted mind self-terminating. Somehow I can’t see just sitting around being much use with that as it just provides opportunity to mope and spiral further down into a black mood, and by the point where you do get motivated to take some kind of action (particularly when the meds either kick in or wear off) it’s not going to be good, so it’s better to get up and get involved with something straight away.

    But on the other hand, if it’s dealing with anxieties, panic attacks, OCD and other things where a spot of meditation, reflection, and enforced calm and self-reassurance is necessary, then it’s absolutely the right thing.

    Hopefully the box can be turned to both uses 🙂

  4. Lovely post – thanks for sharing. I think my personal “box” is my whole house and so many of my treasured reminders are from or of you. Jxxx

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