Distress Tolerance Series #3 ACCEPTS Skills 

Distress Tolerance Series #3 ACCEPTS Skills 

If you haven’t already checked out the blog posts on 5 ways to handle a crisis, what the heck is distress tolerance, and the TIP skills, they are linked here in case you want more information.

 

The ACCEPTS skills are various ways in which you can distract yourself from your current stressful circumstances in the short term.

 

 

These skills are meant to be used when a problem cannot be solved immediately or when your distress threatens to overwhelm you and have potential negative consequences.

 

Different strategies may work for different people and it is important to experiment with multiple in order to determine what works best for you.

 

The goal of these activities is to trigger a different emotional response than your current state. Ideally a neutral or opposite emotion from your negative emotional state. For example, if you are feeling really sad you want to trigger an opposite emotional reaction, thus listening to a really sad song or watching a really sad movie is not ideal. Instead, doing something to trigger a neutral or happy state would be ideal, such as watching a comedy, looking at pictures of cute puppies, etc.

 

Each distraction strategy is described below with examples. At the end I will provide a prompt for an ACCEPTS practice session and invite you to try each of the strategies for yourself to see which you like best.

 

ACTIVITIES

 

Distracting with Activities involves participating in any activity that is REALLY engaging and distracting for you. This could literally be any activity that you want and can involve fun activities such as a game, sport, tv show, or mundane tasks like washing the dishes or folding the laundry. Examples:

 

  • Movies/ television
  • Clean a room in your house
  •  Computer/ video games
  •  Exercise/ play sports
  •  Surf the internet
  •  Eat a favorite food/snack
  •  Call a friend or loved one
  •  Listen to music/ watch music videos
  •  Build or make something/ do a craft or make artwork
  •  Read a book/newspaper/magazine
  •  Play cards/ play a game
  •  Do crossword, sudoku, or puzzles
  • Finish a project you put off

 

CONTRIBUTING

 

Contributing to someone else refocuses your attention from your own emotional pain and onto someone else for the short term. This can be something as small as sending a text message to check in on someone, waving at someone, or something as big as donating time and money to a cause you care about. Thinking of someone else helps you to momentarily forget about your own issues, and as a bonus may also boost a sense of meaning in life, which can also help improve mood. Examples:

 

  • Volunteer
  • Help a friend or loved one
  • Surprise someone with a favor
  • Donate unneeded items from your house
  • Donate time or money to a cause you care about
  •  Send a text saying hi or checking in
  •  Make something nice for someone (craft or food item)
  •  Do something thoughtful
  •  Say thank you or tell someone you care about them
  • Write someone you care about a card, letter, or email
  • Smile or wave at a stranger
  • Pick up litter, recycle, do something good for the environment

 

COMPARISONS

 

Comparisons involve either comparing yourself now to another point in your life (usually a point that was more difficult than now), or comparing yourself to someone else’s situation (typically to someone that is less privileged than yourself). For example, whenever I am struggling in the present I remind myself of the difficult experiences I have survived previously, such as my parent’s divorce, getting a college degree, completing my doctoral degree, etc. This helps to put my present pain in perspective and remind myself of how resilient I am. Another example is to compare your current situation to those of less fortunate people. For example, thinking of individuals who are homeless, who are refugees, who live in war-torn countries, etc. This also puts present pain in perspective in comparison to world issues.

 

Sometimes, people do not like the way the comparisons task is phrased and feel it is judgmental to compare oneself to others. If that is the case for you, I invite you instead to think of this as a gratitude task. You do not even have to compare to others in order to recognize that you are grateful to have a roof over your head, access to running water, supportive loved ones, access to food, etc. Examples:

 

  • Compare how you feel now to a time you felt differently
  • Think about people who might be coping less well than you
  • Compare yourself to others in less fortunate situations
  • Watch reality tv shows
  • Practice daily gratitude (think of three things each day that you are grateful for)
  • Remember how you were able to tolerate past difficult situations

 

EMOTIONS

 

The goal for distracting with emotions is to trigger a different emotion than the current crisis emotion. As you likely know, we can’t just turn up the dial on happiness or calmness, we have to engage in activity that will reliably activate a different emotion. If I just sit and wish for happiness, it will not come, but if I actively engage in activities that have made me happy before, I have a chance of shifting my current emotion. Examples:

 

  • Read emotional books or stories (joke books)
  • Look at old letters, cards, memories, or pictures
  • Watch emotional movies/ tv (scary movies, funny movies)
  • Listen to emotional music (soothing music, music that makes you happy or excited)
  • Have a dance party in your living room by yourself (or with willing housemates or pets)
  • Watch funny videos or videos of animals
  •  Read old journal entries of when you felt a different emotion
  •  Write a story about a different emotion
  •  Listen to an engaging podcast
  • Exercise

 

PUSHING AWAY

 

The majority of the time, we do not want to push away our thoughts and feelings, as this does not work and usually makes the situation worse in the long run. Generally, we want to have our thoughts and emotions as they are, without trying to change them, except in extreme circumstances in which having the emotion would lead to impulsive behavior. In that case, a last resort option is to push away thoughts and feelings in the short term so that we can survive the crisis without making it worse.

 

I find this is most useful when there is nothing you can do about the situation right now. For example if you are worried about a work meeting tomorrow, but there is nothing you can do to prepare for it at this moment. Pushing away from a negative situation can mean either leaving the situation physically or blocking it from one’s mind. Examples:

 

  • Leave the situation physically for a while
  • Leave the situation mentally, go on a mental vacation to your favorite place
  • Notice when you are thinking about painful situations and refocus your attention on something else
  • Imagine a wall between you and the issue
  • Put your emotions or thoughts in an imaginary box and put it up on an imaginary shelf in your mind
  • Remind yourself that there is nothing you can do about this right now and refocus your attention on to something else

 

THOUGHTS

 

It is not possible to have more than one thought at a time. Sure, you can have many thoughts moving very quickly, but they cannot exist at the exact same time. We can use this to our advantage when we are stuck in negative thoughts. We can instead start to think about something different, thus automatically the negative thoughts cannot be there during that time. You could repeat a favorite quote, song lyric, or just count from 1-100. Examples:

  • Count to 10, 50 100, whatever number you need, just keep counting
  • Count items you can see around you (floor or ceiling tiles, etc.)
  • Repeat a favorite quote or song lyric (ex: “It is what it is,” “This too shall pass,” etc.)
  • Do puzzles, crosswords, suduko
  • Read something of interest to you

 

SENSATIONS

 

Distracting with sensations involves using our strong senses to refocus our attention from our emotional experience onto something else. This involves using any one of our senses (smell, sight, taste, touch, and sound) to distract ourselves. It could be taking a hot or cold shower, tasting something strong like hot sauce, or snuggling with a soft blanket or pet. Examples:

 

  • Squeeze a stress ball
  • Play with a fidget item
  • Listen to loud music
  • Hold ice cubes in your hand
  • Take a hot or cold shower
  • Splash hot or cold water on your face
  • Run your hands under cold or hot water
  • Snuggle with a soft blanket, pet, or other comfort object
  • Drink a soothing cup of tea or other favorite non-alcoholic beverage
  • Put on a favorite scent or light a candle
  • Eat spicy food
  • Melt a piece of chocolate in your mouth before chewing it

 

PUTTING IT INTO PRACTICE 

 

Let’s put the skills to practice! Complete the following practice session to try each of the skills out and determine which skills you like best!

 

ACTIVITIES: Spend 10 minutes engaging in the activity of your choice from the following list:

  • Exercise
  • Cleaning
  • Craft
  • Cooking

 

CONTRIBUTING: Write a letter/ text/ or email to someone you love thanking them for their support and telling them what they mean to you.

 

COMPARISONS: Write down 10 scenarios that are worse than your current situation (ex: being in jail, being paralyzed, not having access to clean water or food, etc.)

 

EMOTIONS: Click HERE to Watch funny animal videos to trigger a different emotion.

 

PUSHING AWAY: Write out a script for your best mental vacation. Write down what you would see, hear, taste, smell, and feel in that location. For example if your mental vacation was in the mountains skiing it would look something like: “I wake up and look out the window to see fresh powder on the ground amidst the trees and mountains. I smell coffee brewing in the kitchen and fresh bacon being cooked. We get suited up in warm clothes to go out to the lift. I feel the cool air on my face as we ride the ski lift and smell the fresh pines. Etc.”

 

THOUGHTS: Play an online sudoku puzzle or word search to think about something different (links provided below):

Suduko

Word Search 

 

SENSATIONS: Spend several minutes engaging in one of the following:

  • Light a scented candle and enjoy the scent
  • Drink a soothing cup of tea
  • Run your hands under hot or cold water

 

Awesome job!  The next skill for practice will be Self-Soothing skills, tune in next week for more information!

 

Thank you so much for tuning in for the Distress Tolerance Series! I hope these skills are helpful to you right now and for a long time to come. Skills practice is not a replacement for professional help. If you are struggling with depression, anxiety, or other mental health concerns I encourage you to seek out professional help. ACTivation Psychology offers individual therapy for adolescents and adults struggling with anxiety, depression, transitions, Autism Spectrum Disorders, and other mental health concerns. Telehealth services are available during this time for individuals in the state of Colorado. Please remember that you do not have to struggle alone!

 

*The above is adapted from Linehan, M., M., (2014). DBT Training Manual. New York, NY: The Guilford Press. Please see the full text for more resources*

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