DBT Therapy Skills - Distress Tolerance

Stressful events happen in life, it is inevitable. When intense emotions make their way to the surface, we may cope with the stressful event by accessing coping mechanisms like drinking alcohol, self-harm, etc. While these activities may cause emotional release for the moment, they have a negative impact. The wisest thing to do is to set up a sort of “insurance policy” for yourself, for when stressful events arise. 

These insurance policies are what we refer to as a Crisis and Safety Plan. The Crisis and Safety Plan is a prefabricated plan that gives you healthy coping mechanisms to utilize (that you have tried and noticed the skill help). 

Now, you may be saying, “But, I don’t feel like I have any healthy coping mechanisms…” I would beg to differ! In the distress tolerance series, you can identify healthy coping mechanisms you already have in your tool belt, and learn some new ones that will work for you to add to your toolbox. DBT therapy gives us some convenience in memorizing these new skills by presenting them as acronyms. We will explore one distress tolerance skill. If you are interested in learning more, view the DBT skills group listed towards the bottom!

Distract with ACCEPTS is a helpful acronym that can help you to identify what helps you to distract yourself when you cannot easily solve the issue at hand. 

So let’s explore this acronym together

A = Activities: Pleasant activities allow us to distract ourselves physically and mentally. You may notice a loss of interest in the normal pleasant activities you enjoy doing. It is important to continue those activities, regardless of the loss of interest. If we wait until we are excited to participate in those activities, we may be waiting a long time. 

C = Contributing: Contributing helps us to get outside of ourselves and our issues. Contributing can be as easy as holding the door open for someone, doing a favor, telling a loved one you are thinking of them, etc. 

C = Comparisons: You can compare your current situation to more difficult situations in your life, and be grateful for where you are now. 

E = Emotions: Creating the opportunity to experience the emotion that is desired. For example, listening to loud music when feeling uninspired, listening to lo-fi music when feeling anxious or irritated. 

P = Push Away: Pushing away the issue if it is not urgent. Try to think, is this an issue that I need to solve today? If not, lock the issue in a box and put it at the top of your closet, until you are ready to start tackling the problem. 

T = Thoughts: When something distressing is sticking in your mind, make a mindful decision to think about something else totally unrelated. It could be thinking through the process of baking a cake, doing a sudoku puzzle, counting to 100, etc. 

S = Sensations: Engaging the senses has a great way of impacting the way you feel. Whether that be through exercising, playing really loud music, smelling a candle, or taking a hot/cold shower. For self-harm behavior - engaging the senses by holding ice can be a great way to practice harm reduction.  

By Leeann Martinez, LMSW, DBT-C

Are you interested in how acronyms and skills like the ones above may be able to help you navigate life in the way you desire? DBT therapy may be the right next step for you, and our team is ready to help. There are many other skills to tolerate the distress that will be explored in an upcoming DBT Skills group. Whether you are an adult or teen, there is a group for you! Teen groups are Tuesday’s 5-6 pm Virtually, 6-7 pm In-Person. Adult groups are Thursday’s 5-6 pm Virtually, 6-7 pm In-Person.  In person groups are hosted in our Arlington, TX therapy office!

Resources:

Lane Pederson. Cortney Sidwell Pederson. The Expanded Dialectical Behavior Therapy: Skills Training Manual. Second Edition. 2017