Sensory Body Awareness Skills to Reduce Distress Through DBT

Dialectical behavior therapy – or DBT – is a form of therapy created specifically for individuals with borderline personality disorder. Through DBT, highly sensitive people learn distress tolerance skills that allow them to navigate uncomfortable or painful situations and manage urges to engage in harmful behaviors. DBT creator Marsha Linehan, divides distress tolerance skills into three categories:

1. crisis survival techniques
2. sensory body awareness
3. reality acceptance

The intensively trained DBT treatment team at Skyland Trail helps clients in our DBT residential treatment program learn and practice these skills as they work toward ending the painful cycle of feeling stuck and out of control. In this blog post, we’ll explore sensory body awareness.

What Is Sensory Body Awareness?

At the anatomical level, sensory body awareness is possible thanks to sensory neurons called proprioceptors. These proprioceptors, which are found in our muscles, ligaments, and joints, create a constant dialogue between our central nervous system and our brains that inform us of where our body is in space at any given moment. We can feel the stretch of a muscle as we extend our limbs, the tension in our hands as we grasp an object, and the weight or load of an object that we’ve picked up. Often, we don’t pay attention to these types of sensations until they reach a threshold. Sensory body awareness is about being extra mindful of these tiny communications within ourselves, even if we are stationary.

By practicing mindfulness of our body, we are able to connect our brains to present experiences more easily, which can lead to our brains being more accepting of reality. There are several sensory body awareness exercises that we can perform to do exactly that.

DBT Skill: Paired Muscle Relaxation

If you’ve never tried paired muscle relaxation, find a quiet, distraction-free setting and set aside ample time to fully explore its benefits. As you practice paired muscle relaxation more often, gradually venture to new places with more outside stimuli to truly understand how you can use this skill in stressful environments. Once you’ve found a good space, get your body into a comfortable position. Have a seat or lie down and keep all of your body parts uncrossed and free from supporting one another. It might even be helpful to loosen any tight fitting or restrictive clothing as well. Now you’re ready to get started.

• For each muscle group and body part shown below, concentrate on tightening your muscles—focusing both on the sensation of tightening those muscles and how it affects surrounding areas.
• Hold that tension as you inhale for about five seconds then release and breathe out.
• As you release tension, slowly say “relax” in your mind.
• Take note of the different sensations you encounter as you relax for about 10 to 15 seconds then move to the next body part or muscle group.
• Once you’ve practiced on each of the smaller, individual muscles or body parts, move on to tensing multiple medium-sized muscle groups together then larger groups. Next, try tensing your entire body all at once. When you tense your entire body, think of yourself as a stiff robot or piece of wood or steel. To release that tension, think about becoming a rag doll and let your body droop.
• After you’re practiced at full-body relaxation, practice it three to four times a day. You want to be able to quickly relax your body at a moment’s notice.
• With enough practice using the word “relax” in tandem with your muscle relaxation, you can eventually train yourself to relax your entire body by just saying the word “relax.” Practice helps the skill come more naturally to you when you need it.

DBT Skill: Effective Rethinking and Paired Relaxation

Stressful events prompt our thoughts which can produce strong emotional responses. Understanding and being mindful of those thoughts while also using paired muscle relaxation can help individuals who are seeking relief.

1. Write down the prompting event that produces distressing emotions that you’re aiming to reduce.
2. Ask yourself “What must I be telling myself about the event that causes such distress and emotional arousal?” Examine your interpretations and thoughts and write them down. It might be something like “They hate me” or “There’s no hope” or “It’ll never work.”
3. Rethink the situation and its meaning in a way that counteracts the thoughts and interpretations that are producing stress and difficult emotions. Write down as many effective thoughts to replace the stressful thoughts.
4. When you’re not experiencing a stressful prompting event, practice imagining one. At the same time, while you inhale slowly, say to yourself an effective self-statement such as “I can do this” or “I am in control.” When you exhale say “relax” and release any tension you may have in your body.
5. Keep practicing until this process of rethinking and paired relaxation becomes second nature.

DBT Skill: Half-Smiling and Willing Hands

Another great sensory body awareness skill, half-smiling and willing hands, allows us to physically take control of our facial expression and hand positioning in a positive way. Remember that your body connects to your mind, so by using your face and hands as communication tools between your body and your brain, you’re able to more effectively stay in control.

To half-smile, first relax your face from the top of your head down to your chin and jaw. Release the tension in your forehead, eyes and eyebrows followed by your cheeks, mouth, and tongue with your teeth slightly apart. If this seems difficult to accomplish, try tensing your facial muscles then releasing the tension. Keep your half-smile relaxed and natural rather than forced or tense. Allow the corners of your lips to turn slightly upwards. Try to adopt a serene facial expression.

To create willing hands, you essentially want to relax your arms while turning your palms up. If you’re standing, drop your arms to your side. With hands unclenched, rotate your hands with your thumbs out to the side, your palms up, and with relaxed fingers. If you’re sitting down, place your hands on your lap or thighs with the same palms up and relaxed fingers. You can also do this while laying down with your hands out to the side and palms facing up.

Once again, practicing half-smiling with a willing-hands posture will make the exercise more effective. Try starting your day, before you even get out of bed, with this exercise. If you have a spare moment or two throughout the day, find an object that’s still or calming like a leaf or piece of art and practice. You can do this exercise while listening to music. Remain present with the music’s rhythm, harmonies, and words rather than drifting to another thought.

You can also put half-smiling and willing-hands into practice when you’re irritated or frustrated with a situation or specific person to take control of your emotions. If you’re contemplating someone you dislike or are angry with, think about what makes them happy or may cause them suffering. Imagine their own perceptions and examine what their motivations and hopes might be. Think about their consciousness and identify if they are coming from a place of openness and joy or anger and prejudice. Once you feel compassion return to your heart, your anger and resentment for this person or group will dissipate.

DBT Skills like Sensory Body Awareness Help Regulate Mood

These sensory body awareness exercises, as well as many other mindfulness exercises, all work together to help us regulate and understand how our bodies and minds are interconnected. Remember to relax and breathe deeply to enjoy their full benefits.

At Skyland Trail, we use dialectical behavior therapy to help individuals regulate their emotions and responses to stimuli. DBT is one of the most researched treatments for borderline personality disorder and is significantly effective in reducing harmful thinking, behaviors, and impulsivity. Clients admitting to our residential psychiatric treatment programs aren’t given a one-size-fits all treatment plan. Our integrated treatment teams utilize a combination of individual and group psychotherapy, expressive therapies, pastoral counseling, and physical activity to help clients find recovery from mental illness and get back to a life worth living.

These DBT Distress Tolerance skills can be found in DBT Skills Training Handouts and Worksheets, Second Edition, by Marsha Linehan.