Weighing the Pros and Cons: A Helpful Distress Tolerance Skill

Author: Alyssa Pammer, Taproot Therapy Clinical Trainee

Pros and Cons can function as a beneficial distress tolerance skill in DBT. As with other distress
tolerance skills, Pros and Cons are often used in crisis situations. It can aid in helping us avoid
acting impulsively while weighing the pros and cons of the impulsive decision at hand. Instead
of acting impulsively, making the pros and cons list can help us act skillfully. It shows us that
better results pan out by making a skillful decision with our pain, rather than an impulsive
decision with our pain. It’s most common to use pros and cons when we have to participate in
something that we really don’t want to do.
The most common way to use the pros and cons skill is to make a pros and cons list. Most
people, at one point in their life, have made a pros and cons list about a decision. In DBT, we can
make a pros and cons list of our impulsive decisions and maladaptive behaviors.
In order to make this list, we can pick a maladaptive or impulsive behavior that we typically
engage in. First, we would make a pros and cons list of specifically engaging in the behavior. We
may ask ourselves, what good can come out of engaging in the behavior, and what negative
consequences can result as a part of engaging in the behavior? Then, we would make an
additional pros and cons list. This list will be for the same behavior, but we would evaluate the
pros and cons of not participating in the impulsive behavior.
While making the list, we can also consider both the short and long-term consequences of
engaging vs. not engaging in impulsive behavior. A way to do this on this list would be to signify
“ST” for short term, and “LT” for long term next to specific statements on the list. This shows us
that our behaviors can provide short-term relief, but may cause long-term conflict. By labeling
behaviors as short-term or long-term, we can also identify maladaptive patterns within our
behaviors, and learn to challenge them. Once we identify these patterns, we can skillfully find
ways to integrate new coping strategies in replacement of maladaptive and impulsive behaviors.
Pros and cons lists are often created before a behavior occurs, likely in therapy with a DBT
therapist. The list can then be used in a moment of distress, when there is an impulsive urge to
act upon a behavior. We can refer to the list that we made in a time of clear-minded thinking,
instead of using an emotional mind to make a decision.

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