DBT and Distress Tolerance - the power of distraction
A while back we talked about Dialectical Behavior Therapy (DBT), a treatment offered here at Empowered Life Counseling. A unique component of DBT is weekly skills training class, which covers specific modules intended to improve one’s ability to cope while changing life-threatening behaviors. Distress tolerance has several great skills within it and today we will discuss the ACCEPTS skills, which has several great ideas for distraction activities.
What negative feelings do you struggle to deal with? Guilt, shame, sadness, fear and anger are common responses.
This skills module teaches the ability to cope with uncomfortable emotions. These skills are used when it is difficult or impossible to change a situation. The skills help to cope and survive during a crisis and to tolerate short/long term pain (physical or emotional). The goal of distress tolerance is to distract the mind just long enough to intervene in an emotional response to a stressful situation. Sometimes I tell clients, “The goal is to just not make it worse.”
What are some characteristics of distress intolerance?
Distress intolerance is the inability to cope with uncomfortable emotions. Common beliefs that people with distress intolerance have when experiencing negative emotions include (note which ones may ring true to you):
I can’t stand this.
It’s unbearable.
I hate this feeling.
I must get rid of it.
I can’t cope with this.
I’m going to lose control.
This feeling will keep going on forever.
It’s wrong to feel this way.
It’s weak.
Which thoughts did you relate to? So what does it mean if you start to feel uncomfortable emotions (what are those thoughts telling you)? What will happen if I let myself feel distressed?
Unhealthy distress escapes and these things only work short-term and make problem worse:
Avoidance - of situation, or excessively seeking reassurance from others, distraction and suppression
Numbing and withdrawing – alcohol, drugs, binge eating
Harmful release – scratching, picking, cutting
Learning to tolerate and accept distress
It is a powerful tool to learn to see the negative emotion for what it is, and change how you pay attention to the emotions, looking at them mindfully. Negative emotions important to our survival, rather than something to be feared/avoided at all costs. They help us in survival (fight or flight); remembering people/situations (e.g. good feelings following family picnic); coping with daily life; communicating with others; avoiding pain; and seeking pleasure.
It’s also important to remember that emotions are temporary, not permanent. One way to envision them is as waves that come and go, sometimes increasing, more intense; other times subsiding and family passing.
DBT loves acronyms, and ACCEPTS is one such acronym that helps us remember some ways to distract ourselves and learn to deal with difficult emotions. Learn more with this handy chart I made below!
Want to learn more about ACCEPTS skills? Check out this fun video! And stay tuned for more DBT skills in future posts!
Ready to learn more about DBT or see if you would be a good candidate? Contact Kara to schedule an appointment! DBT-informed counseling can help you build a life worth living! Don’t hesitate to call or email now!
Sources:
Linehan, M. M. (2015). DBT® skills training manual (2nd ed.). Guilford Press.
Linehan, Marsha M. 1993. Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York, NY: Guilford Publications.
McKay, M, J.C. Wood, and J. Brantley. The Dialectical Behavior Therapy Skills Workbook: Practical Dbt Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation & Distress Tolerance. , 2007. Print.
Dialectical Behavior Therapy (nih.gov)
Psychotherapy | NAMI: National Alliance on Mental Illness
How Dialectical Behavior Therapy (DBT) Works (verywellmind.com)
What is Dialectical Behavior Therapy (DBT)? – Behavioral Tech
