Distress Tolerance Wrap-up

There’s a little more to the distress tolerance module, and I want to wait until I get into the emotional regulation and interpersonal relationship modules before I go into that material.

I was struck by a thought the minister had this past Sun during the sermon, and as a result, posted a new song – Good Won’t Get You There.

I also posted a new list –
12 “Christian” Beliefs that
Can Drive You Crazy.

ACCEPTS

Last post’s topic, IMPROVE, was about ways to improve our view of the situation.  Today, ACCEPTS, is about using resources to accept what can’t be changed.  This is one of my favorites because it’s about distraction!  These suggestions are also taken from DBT Skills Training Handouts and Worksheets, Second Edition by Marsha M. Linehan.

A – Activities

  • Clean a room of your house
  • Play a game, read a book, do a crossword/sudoku, listen to music
  • Spend time with your parents, spouse, children, or friends
  • Go out for a meal

C – Contributing

  • Find volunteer work to do
  • Help someone else, send a encouraging note to another,
    or surprise someone with something nice
  • Give away things you don’t need

C – Comparison

  • Compare how you’re feeling now
    to a time when you felt different
  • Think about people coping the
    same as you or less well than you
  • Compare yourself to those less fortunate

E – Emotions

  • Read emotional stories to change your emotions
  • Listen to emotional music to create new emotions
  • Listen to soothing music or read something scary

P – Pushing Away

  • Push the situation away by leaving it for awhile
  • Build an imaginary wall between yourself and the situation
  • Put the pain on a shelf; box it up and put it away for awhile
  • Deny the problem for just this moment; block thoughts and images from your mind

T – Thoughts

  • Count to 10; count anything
  • Repeat words to a song in your mind
  • Work puzzles or read a book

S – Sensations

  • Squeeze a rubber ball very hard
  • Listen to loud music
  • Hold ice in your hand or mouth
  • Take a hot or cold shower
  • Go outside if it’s very hot or cold

IMPROVE

The first set of skills for Distress Tolerance – STOP, TIP, Pros & cons, Self-soothe – are about internal regulation or thought processes.  This next one uses both internal and external resources.  The acronym IMPROVE is about boosting mental ability and emotional regulation when a situation can’t be solved or mitigated immediately.  It’s a way to gain tolerance for distress.  Below is the IMPROVE acronym and some examples for each option (taken from DBT Skills Training Handouts and Worksheets, Second Edition by Marsha M. Linehan).

I – Imagery

  • Imagine everything going well
  • Imagine a relaxing scene
  • Imagine hurtful emotions draining out of you
  • Remember a happy time and imagine yourself in it again

M – Meaning

  • Find purpose of meaning in a painful situation
  • Focus on any positive aspects of the situation you can think of; repeat these in your mine
  • Remember, listen to, or read about spiritual values

P – Prayer

  • Open your heart to God
  • Ask for strength to bear the pain
  • Turn things over to God

R – Relaxation

  • Take a hot bath or shower
  • Get a massage or do some stretching
  • Breathe deeply
  • Change your facial expression

O – One thing

  • Focus your entire attention on just what you are doing
  • Keep your mind in the present moment
  • Focus your entire attention on something physical, body sensations, exercise, etc.

V – Vacation

  • Take a one hour breather from work
  • Turn off your phone for a day
  • Get in bed and pull the covers over your head
  • Go to the beach, the woods, or the park
  • Get a magazine and read it with chocolates 😊

E – Encouragement

  • Pick an encouraging phrase and repeat it:
    → I will make it out of this
    → This too shall pass
    → I will be okay
    → I am doing the best I can