Distress Tolerance & ACCEPTS skill

Trigger Warning: Self-Harm 

Recently I’ve graduated from the Mindfulness module now today, onto Distress Tolerance. You need to understand mindfulness for these to make sense.

Distress Tolerance: 

Coping with painful feelings and urges. Coping with pain is important for 3 reasons.

  1. Pain is part of life and can’t always be avoided.
  2. If you can’t deal with your pain, you may act impulsively. (My problem)
  3. When you act impulsively, you may end up hurting yourself or not getting what you want.

You can either accept the moment OR live with the pain. This really spoke to me because I used to (before knowing I had a diagnosis of BPD) act very impulsively whenever I would experience pain. Emotional, physical, mental you name it. I knew what I was doing in the moment but it’s like I didn’t seem to care, at all. It’s not until I come down from that emotion or until I’ve decided to accept the pain, that I realize I done something I shouldn’t, or then I start to feel guilt, shame, disgust, etc. These impulses are different for everyone, mine used to be promiscuous sex (from years of shaping my mind, this is how you feel something other than pain) self-harm by burning my skin or stealing. Stealing was huge for me, and I’ve came pretty close to dealing with authorities, and completely having my Mom lose trust in me, which took about 2-3 years to get back.  Give yourself time to calm down before acting in distress, something I am learning.  This is the skill called “ACCEPTS” I learned today.

(A)ctivities.  Try something either a physical or mental activity. Hobbies, reading, cook, go shopping. I like to go for a walk. Don’t let it get to the point of avoidance. 

(C)ontributing: Contribute! Focus on someone else for a change, or help a friend with an issue. Do something good for society. Lately I have been picking up a lot of volunteer work, and trying to convert myself to Buddhism. 

(C)omparisons: Compare yourself to people coping the same as or less well than you. Think about a time where you weren’t in a good place vs. now and make that comparison. I was taught to compare yourself to someone you idolize and think “What would they do?”. My go to is to think of someone who was very special in my life, my ex. I idolize about in the situation what he would do, or how he would think. I idolize him because I admire how he views the world, his knowledge, how far he has come through his journey and his willingness to create positive thoughts in his life. How wise and calm he always can be. How logical his thinking is, while mine is totally emotional. He uses his wise mind. He used to tell me it was easy and I always admired that about him, how he can turn a negative situation into a positive one, and that’s how I think about comparisons.

(E)motions: For this to work, you need to read or watch or listen to things that have an emotion opposite to what you are feeling. If I’m angry, I watch my favorite comedy series. If I am sad, I usually listen to music that makes me raging angry. 

(P)ushing Away: Distract by pushing away a distressing situation by leaving it mentally for awhile. Build an imaginary wall between yourself and the situation. Block your situation in your mind. Each time it comes up, tell it to go away. This skill I have a hard time with, because I obsess over certain situations, or over-think to the point where I start to believe myself. Change your environment! I use a stress ball to ground myself, and focus on that instead of the situation. Give yourself an “emotional deadline”, and take a break. Think of a “Black box” in space, someone told me about this in DBT today. Imagine you are putting all your shit in this black box, close it, and push it into space. Interesting.

(T)houghts: Counting to 10, or counting all the tiles on the floor in order, back to front, anything to keep your focus on counting.  Reading, writing, etc. I like to write blog posts to get my thoughts out, or finish homework I need to do. 

(S)ensations: To gain a sense of awareness. I struggle with self-harm. Try holding ice in your hand, just feel the cold. I also like to get ice and trace it along the parts of my body I want to harm, and just think about the sensation on my skin, apposed to burning. Listen to loud music, take a cold shower with ALL your clothes on, it’s amazing. Try going outside with no jacket, touch something soft or just feel how the weather is, feel the cold and the wind. 

I’ve linked some practice sheets and other things on distress tolerance, as I only learned so much about it today. But I am happy to say, using the sensation and comparison skills, I haven’t self-harmed in about two weeks, even if an emotional distressing conversation.  Much love to you all xo

https://www.therapistaid.com/therapy-worksheet/dbt-distress-tolerance-skills

https://www.getselfhelp.co.uk/docs/DealingwithDistress.pdf

https://www.sunrisertc.com/distress-tolerance-skills/

https://www.mindfulnessmuse.com/dialectical-behavior-therapy/tolerate-distress-with-a-c-c-e-p-t-s

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