Episode 34 – Distress Tolerance (Pt. 4)

We’re getting close to the end of these distress tolerance bits. This time we’ll go with the ACCEPTS and IMPROVE methods. Next will be self-soothing, body scan meditation, and sensory awareness, but I don’t feel like talking about those right now. I personally hate the meditation methods because I think they’re boring.

ACCEPTS is a skill set focused on distracting from the crisis situation. The actual phrase is “Wise Mind ACCEPTS”, which I think sounds stupid, but hey, I didn’t make this stuff up myself, and it’s been proven to work.

This acronym stands for:

• Activities
• Contributing
• Comparisons
• Emotions
• Pushing away
• Thoughts
• Sensations

Examples include but are not limited to:

• Activities – play computer games; find an event to go to; play sports; focus attention on a task you need to get done; call or go out with a friend; or listen to your iPod (can you tell this was developed in like 1993?) or download music.
• Contributing – find volunteer work to do; surprise someone with something nice; call or send an instant message encouraging someone or just saying hi; or make something nice for someone else.
• Comparisons – compare how you are feeling now to a time when you felt different; compare yourself to those less fortunate; or think about people coping the same as you or less well than you.
• Emotions – listen to emotional music; read emotional books or stories, old letters; or watch emotional TV shows or go to an emotional movies.
• Pushing away – push the situation away by leaving it for a while; block thoughts and images from your mind; or put the pain on a shelf, box it up and put it away for a while.
• Thoughts – repeat words to a song in your mind; work puzzles; or watch TV or read.
• Sensations – listen to very loud music; hold ice in your hand or mouth; or take a hot or cold shower.

I’ve used some of these methods instead of being self-destructive, and they are a good replacement for self-destructive behaviors. I personally like hanging out with friends as a distraction.

IMPROVE is about improving the moment. This acronym stands for:

• Imagery
• Meaning
• Prayer
• Relaxing actions
• One thing in the moment
• Vacation (brief)
• Encouragement and rethinking the situation

Examples for these include but are not limited to:

• Imagery – make up a calming fantasy world; imagine everything going well (also another skill called “coping ahead”); or imagine hurtful emotions draining out of you like water out of a pipe.
• Meaning – focus on whatever positive aspects of a painful situation you can find; remember, listen to, or read about spiritual values; or repeat these positive aspects in your mind.
• Prayer – turn things over to God or a higher being; ask for strength to bear the pain; or open your heart to a supreme being, God, or your own Wise Mind.
• Relaxing actions – take a hot bath or sit in a hot tub; practice yoga or other stretching; change your facial expression; or drink hot milk (tried that once, never again).
• One thing in the moment – focus your entire attention on just what you are doing; put your mind in the present; or focus your entire attention on the physical.
• Vacation (brief) – give yourself a brief vacation; get in bed, pull the covers up over your head; go to the beach or the woods for the day; take a blanket to the park and sit on it for a whole afternoon; or take a 1-hour breather from hard work.
• self-Encouragement and rethinking the situation – by thinking: “I’m doing the best I can”; “I can stand it” (repeatedly); “It won’t last forever”; or “This too shall pass”.

List, and then practice, rethoughts that are important in your crisis situation. This will help reshape your thoughts on the issue and make future related issues easier to deal with.

IMPROVE can be more difficult to practice, as some of it requires you to believe your own thoughts. If you practice it in lesser situations, it will probably be easier to apply it to bigger situations later on.