Here’s to the crazy ones. The misfits. The rebels. The troublemakers. The round pegs in the square holes. The ones who see things differently. They’re not fond of rules. And they have no respect for the status quo. You can quote them, disagree with them, glorify or vilify them. About the only thing you can’t do is ignore them. Because they change things. They push the human race forward. And while some may see them as the crazy ones, we see genius. Because the people who are crazy enough to think they can change the world, are the ones who do.
The DBT distress tolerance acronym ACCEPTS is a group of skills to help you tolerate a negative emotion until you are able to address and eventually resolve the situation. In an early season of the 90’s sitcomFriends, Monica is dating Pete Becker. He calls her from out of town and says, “We need to talk.” Monica wonders if it is a good talk, or a bad talk? She is in psychological distress waiting for his return. The skill set she would use while waiting for Pete to come home is ACCEPTS.
This DBT skill stands for Activities, Contributing, Comparisons, Emotions, Push away, Thoughts, and Sensation. These techniques are designed to keep your emotions manageable until you can resolve the problem.
Engage in an activity, and this can be just about any healthy activity. Read a book, make strawberry jam, go for a walk, call your friend, wash the dishes. Anything that keeps you busy and keeps your mind off the negative emotion will help. If you finish, move on to a new activity. (You could potentially have a very productive day while awaiting that dreaded situation!)
Do something kind for another person. Giving service can help you relieve emotional distress in a couple ways. An act of service is also an activity that, as mentioned above, will help get your mind off of the problem at hand. Additionally, we feel good about ourselves when we help someone else, and that in itself can help you deal with stress. Help cook dinner, mow the neighbor’s lawn, or bake cookies for a friend or relative. Each of these contributing ideas will distract you from your current situation.
Put your life in perspective. Is there a time when you’ve faced more difficult challenges than you’re facing today? Maybe not—maybe this is the most intense situation and most intense emotion you’ve ever experienced. (If so, you may need to jump back up to the TIPP section.) If that’s the case, is there another person who has suffered more than you? Are you in your safe home, while in another part of the world someone else is searching for food and shelter after a natural disaster? The goal of this exercise is not to add more distress and emotional pain to your current situation. Instead, use this skill to add a different perspective to what you’re experiencing right now.
You have the power to invoke the opposite emotion of your current distressed feeling. If you are feeling anxious, practice meditation for 15 minutes. If you’re feeling depressed, go ahead and Google Image search “adorable puppies”. (If you’re in need of a real laugh, search “ugly puppies”.) Adding a dose of the opposite emotion helps reduce the intensity of the negative emotion.
When you can’t deal with something just yet, it’s okay to push the problem out of your mind temporarily. You can push away by distracting yourself with other activities, thoughts, or mindfulness. You can even set a time to come back to the issue. You know that it will be addressed, and you can relax in the interim.
Replace negative, anxious thoughts with activities that busy your mind, such as saying the alphabet backwards or doing a Sudoku puzzle. These distractions can help you avoid self-destructive behavior until you’re able to achieve emotion regulation.
Use your five senses to self-soothe during times of distress. A self-soothing behavior could be taking a warm bath with a lavender bath bomb and relaxing music, eating a comforting snack, or watching your favorite show. Anything that appeals to your senses can help you cope with the present situation.
The dialectical behavior therapy skills in ACCEPTS help you tolerate your distress until the appropriate time to resolve the situation. Once you’re ready and able to address the problem head on, other skills, such as DBTinterpersonal effectiveness, can help you get your needs met.
You’re at your emotional breaking point. Maybe the worst has happened, or maybe it was just the “last straw”. The DBT distress tolerance skill you need is TIPP. This skill is designed to bring you down from the metaphorical (hopefully not literal) ledge.
TIPP stands for Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation.
When we’re upset, our bodies often feel hot. To counter this, splash your face with cold water, hold an ice cube, or let the car’s AC blow on your face. Changing your body temperature will help you cool down—both physically and emotionally.
Do intense exercise to match your intense emotion. You’re not a marathon runner? That’s okay, you don’t need to be. Sprint down to the end of the street, jump in the pool for a few laps, or do jumping jacks until you’ve tired yourself out. Increasing oxygen flow helps decrease stress levels. Plus, it’s hard to stay dangerously upset when you’re exhausted.
Even something as simple as controlling your breath can have a profound impact on reducing emotional pain. There are many different types of breathing exercises. If you have a favorite, breathe it out. If you don’t, try a technique called “box breathing”. Each breath interval will be four seconds long. Take in air four seconds, hold it in four seconds, breathe out four, and hold four. And then start again. Continue to focus on this breathing pattern until you feel more calm. Steady breathing reduces your body’s fight or flight response.
PAIRED MUSCLE RELAXATION
The science of paired muscle relaxation is fascinating. When you tighten a voluntary muscle, relax it, and allow it to rest, the muscle will become more relaxed than it was before it was tightened. Relaxed muscles require less oxygen, so your breathing and heart rate will slow down.
Try this technique by focusing on a group of muscles, such as the muscles in your arms. Tighten the muscles as much as you can for five seconds. Then let go of the tension. Let the muscles relax, and you’ll begin to relax, as well.
Temperature Intense Exercise Paced Breathing Paired Muscle Relaxation
The distress tolerance skills in TIPP will bring you a step closer to wise mind, where you will be able to make a constructive choice and cope productively.