Beauty and the Borderline

A Journey towards Integration

Distress Tolerance: Wise Mind A.C.C.E.P.T.S.

young woman jogging with her dog in a parkOne thing you learn in DBT — Marsha Linehan sure seems to like acronyms!

The first acronym we encounter in Distress Tolerance is “A.C.C.E.P.T.S.” which stands for a whole bunch of ways you can distract yourself from your distress until it abates some.  It is, by far, the Distress Tolerance skill I use the most.

Wise Mind A.C.C.E.P.T.S.
With Activities:  Engage in exercise or hobbies; do cleaning; go to events; call or visit a friend; play computer games; go walking; work; play sports; go out to a meal, have decaf coffee or tea; go fishing; chop wood; do gardening; play pinball.
With Contributing:  Contribute to someone; do volunteer work; give something to someone else; make something nice for someone else; do a surprising, thoughtful thing.
With Comparisons:  Compare yourself to people coping the same as you or less well than you. Compare yourself to those less fortunate than you. Watch soap operas; read about disasters, others’ suffering.
With opposite Emotions:  Read emotional books or stories, old letters; go to emotional movies; listen to emotional music.  Be sure the event creates different emotions.  Ideas:  scary movies, joke books, comedies, funny records, religious music, marching songs, “I Am Woman” (Helen Reddy); going to a store and reading funny greeting cards.
With Pushing away:  Push the situation away by leaving it for awhile.  Leave the situation mentally.  Build an imaginary wall between yourself and the situation.  Or push the situation away by blocking it from your mind. Censor ruminating.  Refuse to think about the painful aspects of the situation.  Put the pain on a shelf.  Box it up and put it away for awhile.MP900385328
With Thoughts:  Count to 10; count colours in a painting or tree, windows, anything; work puzzles; watch TV; read.
With intense other Sensations:  Hold ice in hand; squeeze a rubber ball very hard; stand under a very hard and hot shower; listen to very loud music; sex; put rubber band on wrist, pull out, and let go.
Skills Training Manual for Treating Borderline Personality Disorder by Marsha Linehan, p. 166.

I try to use this skill whenever I notice I am starting to feel intense, or when I start to behave, or want to behave, in an emotional way.  It took awhile, but I set up a little tripwire in my mind — whenever I start yelling, or want to start yelling, it’s time to take a break and cool down.  I usually leave the situation by going to the bathroom where I can be alone, then — and this is very important — I validate my feelings.

“I feel angry/sad/ashamed/fearful,” I say to myself, depending on how I am feeling.  I try to describe the emotion — how it feels physically, emotionally, what I want to do.  Then I say, “It is perfectly understandable and natural to feel ____ when __________ has happened.”

And THEN, I use A.C.C.E.P.T.S.  I take the laptop into the bathroom and watch an episode of whatever TV show has caught my interest.  Or I work on this blog.  Or I read.  Or, if I have a lot of emotional energy, I listen to my mp3 player and do housework (usually starting with cleaning the bathroom, since I’m already in there).  Anything at all that I can throw myself into, occupy my mind completely so I don’t think about what has got me feeling so upset.

Playing Video Games

I’m sure many of you reading this are saying to yourselves, “But Beauty, I use that skill already, before I ever read that some hotshot psychologist created an acronym for it, sold it, and became a millionaire.”  Ah, but now that you know, you can circle that skill on your Diary Card for the day (#15. Distract) and pat yourself on the back for practicing DBT skills.  Good for you!

You’re not just practicing Distraction skills either, so keep that pen handy to circle a few more skills while you’re at it.  You’ve practiced #1 (Wise Mind) by trying a DBT skill instead of doing some unhealthy (to yourself, another person, an item, or a relationship).  If you validated how you were feeling, congratulations! — circle #2 (Observe) by noticing your feeling, and #3 (Describe) by describing the emotion.  If you tried to do it non-judgmentally, then circle #5 as well.  I used A.C.C.E.P.T.S. mindfully, meaning skills #4 (Participate), #6 (One-mindfully), and #7 (Effectively).

After all that hard work (and learning healthier new habits is very challenging for anyone) it’s time to reward yourself.  Eight skills in one blow!  Really, that’s how DBT skills work best — when they are used in concert with one another.  If you keep practicing, the skills become habitual, and you’ll begin to use them without even trying.

Next up: how to pamper your jangled nerves with Self-soothe!

Other resources:

Distress Tolerance — Part 1 (Distracting — A.C.C.E.P.T.S.)@Living with BPD

Transcript of From Chaos to Freedom:  Crisis Survival Skills, Part 1: Distracting and Self-soothing, a video lesson by Marsha Linehan, Ph.D.

DBT Skills Handbook, p. 61



One comment on “Distress Tolerance: Wise Mind A.C.C.E.P.T.S.

  1. Pingback: Distress Tolerance: Self-soothe | Beauty and the Borderline

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