Distress Tolerance 2

Welcome back! Let’s continue exploring other skills within the Distress Tolerance module. Last time we talked about using the TIPP skills and self soothing through our 5 senses as ways to self-regulate intense and difficult emotions. Let’s continue with two skills that are helpful to temporarily distract our minds from a current stressful situation that is causing dysregulation. Remember, these skills are meant for short-term relief, not as a long-term solution to solving our problems. We’re not meant to push away our emotions entirely, as they can (and will!) resurface later.

Let’s begin with ACCEPTS. The ACCEPTS skill is an acronym that stands for activity, contributing, comparisons, emotions, pushing away, thoughts, and sensations. This skill is helpful when we need a “break” from whatever is stressing us out, and some space to re-calibrate and approach the problem with a clearer mind.

Activities: Engage in an activity. Do something to take your mind off of whatever is bothering you. Read a book, go for a walk, talk to some friends, do some chores around the house, etc. The point is to do something that keeps you busy, but is also low stress so your mind gets a bit of a mental vacation.

Contributing: Do something nice for someone else. Get out of your own head for a while and give back to someone in a meaningful way. This doesn’t have to be huge. Check in with a friend, pay someone a compliment, help someone else out with a task. We feel good about ourselves when we help others.

Comparisons: Think about a time where you’ve overcome something difficult or challenging in the past. Remember what you were thinking and feeling back then and how you were able to survive it. Another way to use this skill is to consider other people who might be going through something harder than you. This can be tricky, because it can easily slide into invalidating yourself and that’s not the goal here. This is meant to add a different perspective to your experience and get you unstuck from catastrophizing. This skill can be difficult to implement for some people, so if it doesn’t resonate with you, feel free to leave it!

Emotions: Distract from your current emotion by creating another one opposite. If you’re angry, watch something hilarious to make you laugh. If you’re anxious, engage in something soothing and calming (deep breathing, gentle stretching or exercise). Give yourself other experiences that to help return to an emotional equilibrium.

Pushing Away: This skill is great for when you have a problem you can’t immediately solve. When we get stressed, we tend to hyperfixate on what’s stressing us out and that in turn increases our stress and anxiety. Practice allowing your thoughts to pass without holding on to them. If you need something more activating, write all your thoughts down and then rip up the paper to symbolize those thoughts going away. Distract yourself with other activities and let the intensity settle back down before reengaging.

Thoughts: Our thinking mind tends to shut off when our emotions grow in intensity. This skill involves practicing turning back on our thinking mind to find more balance. Try thinking of a positive quote or do something mentally stimulating (Sudoku, puzzle, chores) to reengage with your thinking brain.

Sensations: Stimulating our senses can be an effective way to manage emotions. This can be especially helpful for people who self-injure when they feel overwhelmed and in distress. Try holding an ice cube, taking a cold or hot shower, listen to loud music and scream along, etc. Once you use this skill, it’s helpful to look to some of the other skills we’ve discussed to use in conjunction.

Next, we’ll talk about the IMPROVE skill. This skill is meant to help you replace the thoughts, emotions, and sensations with more pleasant experiences to reduce distress. IMPROVE stands for imagery, meaning, prayer, relaxation, one mindfully, vacation, and encouragement.

  • Imagery: You can use imagery to create a safe, calm place for you to relax. Really put yourself there and take in all the sights of the pictures you create in your mind. This can be a place that you know or somewhere imagined. 
  • Meaning: Life isn’t always fair, and it can be easy to get caught dwelling on difficult situations. It can be helpful to shift perspectives and try to find the meaning in whatever situation you find yourself in. What can you potentially learn from this? How can you hold on to what’s important to you, even in hard times? 
  • Prayer: This can have several meanings to different people. It can mean turning to a higher power in a religious sense or not. It can mean tapping into the idea of “strength” or turning to Wise Mind. Prayer is a way to connect to something bigger than us, whatever that means for you. 
  • Relaxation: Find a bit of comfort! Take a hot bath, snuggle under a blanket practice deep breathing, go for a leisurely walk. Do something really soothing to help alleviate intense feelings. 
  • One Mindfully: When difficult things happen, it can cause a wave of memories from other difficult things to flood us. Remind yourself that all you need to do is get through the moment that’s in front of you. Stay present and grounded, and take things one step at a time. When you start getting caught up in stories from the past, gently bring yourself back to the present moment. 
  • Vacation: Give yourself some space from the problem. This skill is meant to be brief, and with the intention of returning to the difficult situation once you’re more calm. Take a nap, zone out in front of the TV for an hour, turn your phone off for a little while, etc. Just give a brief, easy break from what is currently stressing you out. 
  • Encouragement: We all talk to ourselves, why not make what we say a little bit kinder? Give yourself some self encouragement! Say positive affirmations to yourself, remind yourself that this will pass and that you’re doing the best you can. Things are already hard, why not show yourself a bit of ease?

Next time we’ll wrap things up with exploring Radical Acceptance. This one is a bit challenging so it deserves its own separate post. Keep practicing these skills and stay tuned!

The article is by Alissa Hager, LPC, LCMHC
Palmetto Counseling and Consulting, LLC