In DBT,
Distress Tolerance skills are used when we are unable, unwilling, or it would be
inappropriate to change a situation. It's important to use the right
skills at the right time. In order to change a situation or emotion, we
would use Emotion Regulation skills.
Distress Tolerance skills are used
to help us cope and survive during a crisis, and helps us tolerate short term or
long term pain (physical or emotional pain).
Acceptance means being
willing to experience a situation as it is, rather than how we want it to be.
Not to be willing (wilfulness) means trying to impose our will on a situation.
A willingness to accept things as they are, not as we think they should be.
Repeatedly 'turning the
mind'. To be in the actual situation you are in, rather than the situation
you think you're in, or think you should be in. Your mind is always going
to give you other ideas, interpretations, reminding you of old strategies.
Each time your mind wanders and you notice these other thoughts and images,
simply bring your attention back to this moment. Not judging the situation
to be good, or bad, or in any way. Simply bringing your attention back to
this moment, this situation, and being effective in this situation.
You may need to 'turn your
mind' many many times in a short space of time.
What Radical Acceptance is
NOT:
Not judging the situation to
be good
Not giving permission for
the situation to go on forever
Not giving up your options
It can help
to use memory aids to remind us of how we can help ourselves during distressing
times:
V
Vacation – take some time out of the situation, 'me' time, or imagining
yourself on an idyllic beautiful holiday
E
Encouragement – positive and calming self talk
Wise Mind ACCEPTS
A Activities
(see distraction ideas below)
C Contributing
– helping others
C Comparisons
– comparing self with (better) self
E Emotions –
generate different emotions by watching movie/tv, listening to music etc
P Pushing
away – thinking about or putting our attention onto something else
T Thoughts
- new thoughts. E.g. counting, playing 10 (10 colours in room,
10 musical instruments, 10 fruits, 10 Bond films etc)
S Sensations
– use seeing, hearing, smelling, tasting and touching senses
DISTRACTION IDEAS
Distraction
helps us feel better by diverting our attention away from the distressing
thoughts. It works even better if you choose something that will really grab
your attention and keep you absorbed in that activity. Different things work
for different people. It’s worth trying and practising many of those listed,
and more that you think of yourself, a few times each before giving up on it.
Home and
garden
Mow the lawn
Clean the car
Do some
gardening
De-clutter a
room or part of a room
Purge your
wardrobe (give to charity)
Clear out the
spare room (give to charity)
Sweep the
path
Cooking or
baking something pleasurable
DIY
Bath the dog
Brush the cat
Clean the
hutch/cage
Re-arrange
the furniture in one room
Leisure
Do a
crossword or sudoku
Try out
aromatherapy or reflexology
Visit the
hairdresser – try a new style or colour
Watch
television or a DVD
Play on the
computer
Surf the
internet
Watch the
clouds whilst lying outside
Read a novel
or new newspaper or magazine
Walk or sit
on the beach or park
Getting
out
Join a
leisure centre or health suite
Go for a walk
or jog
Get the old
cycle out!
Visit a new
church
Go to the
library
Visit a
museum
Check out
what movies are on
Go to a
concert
Browse an
antiques or charity shop
Find out what
free classes are on offer
Potter around
window shopping
Go out for
lunch
Go to the
beach – whatever the weather!
Learn to
drive, or take a trial lesson
Visit a
nursery, garden centre or park
Visit a
tourist attraction
Walk
alongside the sea, river, reservoir or lake
Take a bus
ride somewhere new
Visit an
aquarium or zoo
Visit a car
boot sale
Visit a
nature reserve
Visit a
historical or natural site
Visit an art
exhibition
Go for a
drive
Being creative
Take up a new
hobby
Learn
another language
Start an
evening class
Write a
letter or article for a magazine
Learn to
meditate, do yoga or tai chi
Start a diary
or journal
Write a short
story or poem
Take up a
musical instrument
Decorate a
room, or a piece of furniture
Paint, draw,
sculpt
Join a dance
class
Surf the
internet
Create a
weblog or site
Sew or knit
Bake
Make an
‘emergency’ box for distressing times – put in any small reminder of what
helps
Take
photographs
Make a
scrapbook
Sort out your
photos
Self
Soothing
Have an early
night
Eat something
you haven’t tried before
Listen to
some favourite (calming or uplifting) music
Try a
new newspaper or magazine
Have a bath
or shower
Use
aromatherapy oils
Massage your
hands or feet
Write a list
of things you have achieved, great and small
Soak your
feet
Make a list
of things that you can be thankful for
Paint your
nails
Meditate,
relax, yoga, tai chi, reiki
Cuddle a soft
toy
Write a
letter to yourself
Read a letter
you’ve written to yourself to read at these times
Making
contact with others
Telephone
someone you haven't spoken to for a while
Join a
self-help group
Join a civil
rights group
Do some
voluntary work
Write a
letter to someone you haven’t written to for a while
Talk to a
friend or family member
Phone the
Samaritans or another helpline
Join an
online support group or discussion forum
Email a
friend
Express
yourself physically
Bang a drum!
Scream, shout
or sing loudly!
Rip up a
phone book or newspaper
Dance
energetically to loud music
Write –
prose, poem, story, music, journal, diary, weblog, whatever comes into your
head
Write a
letter to someone, but don’t send it – shred or burn it outside
Run, walk,
cycle, swim, go to the gym
Paint
Vacuum
enthusiastically
Kick a ball
against a wall
Punch or kick
a cushion or pillow
Cry
Positive
Self-Talk
I can get through this, I’ve
managed before and I can now
I don’t need to do this, it’ll
only make it worse afterwards
I’ll regret it and feel awful
later
It helps for a few minutes, but
then it just makes it worse in the long run
I don’t want to end up at the
hospital again
I can cope for another hour – I
can take one hour at a time
IMPROVE
the moment
A Activities
(see distraction ideas below)
Making
contact with others
