In the Crisis Survival acronym, ACCEPTS, the letter ‘E’ stands for Emotions–and more particularly, for “different Emotions” from the ones we are feeling. The thought is that tuning in to another, perhaps equally intense emotion, can help us detach a bit from the strong feelings we’re experiencing in our crises. One of Marsha Lineman’s suggestions is listening to emotional music–and this is where Songza comes in. Songza is a FREE music app for your phone with a special feature: Playlists organized by mood. In Songza, you can listen to playlists organized around any of 20 different moods–among them angry, aggressive, confident, dark, happy, mellow, rowdy, and sad. So if you’re feeling angry, pick the “happy” playlist; or if that seems to incongruent, pick the “sad” or the “mellow” one–anything that isn’t your current mood.
Here’s a distraction that may interest some: Unscramble bits and pieces of Melville’s Moby Dick with a phone app called Omby. Though it’s best not to over-use distraction skills–relentless crisis probably means other skills are called for too–a bonus here is that one can eventually unscramble the whole novel. As a distraction skill, this could be filed under Activities or Thoughts in the ACCEPTS crisis distraction skills. And if it’s one of your values to read the classics, go ahead and double-dip: you’re distracting with something effective for Emotion Regulation! Read more about the Omby app here–or click the image below to access the iOS version.
Among the central crisis survival skills in DBT are those captured by the acronym IMPROVE. The suggestion is that we can render a crisis less intense, make it more bearable, by making use of the following:
Imagery (the subject of today’s entry)
Meaning, or finding a purpose to the suffering
Prayer, or a higher power (or your own Wise Mind) to help you bear the pain
Relaxing Actions such as a hot bath, neck or scalp massage, deep breathing, relaxing the facial muscles
doing One Thing in the Moment–or in other words, being fully present to whatever you are doing, focusing outside the mind
taking a brief Vacation, e.g., by turning off your phone for a day, reading a magazine, lying in bed for a bit, sitting in the park
and with self-Encouragement, or cheerleading statements.
Improving the moment with IMAGERY might mean: allowing yourself to imagine things going well; remembering a happy time from your past; making a visual image of your hurtful feelings leaving the body. Most of all, it means being able to call up a relaxing or peaceful place to which you can go in your mind when you are feeling distressed. As with many Distress Tolerance skills, it’s helpful to practice when you are not in a crisis. This is so that you can train your mind to think of the skills when you really need them–and also because it can help you get an inner sense of which skills are most effective for you.
Today’s suggestion is to try out this “Special Place” mediation from the Dartmouth University Student Wellness Center–or another of your choosing. This 6.5 minute guided mediation will invite you to do what the title suggests: Find your own special place. It also encourages you to give as much detail to that scene as you can so that the image is thick in your mind. The Dartmouth Student Wellness Center has a series of relaxation scripts–of which the Special Place mediation is just one. If you find the Special Place meditation effective, you might also be interested in some of their other free guided audio scripts.
I’m hoping to add to the blog a series of posts about specific Distress Tolerance skills so that readers can come here to find a menu of concrete distraction techniques. I welcome suggestions and favorite techniques from readers, so feel free to send me your favorites.
In the Distress Tolerance module of DBT, we learn the acronym, “ACCEPTS,” which encourages distractions in the presence of high stress by means of the following:
Activities, Contributions, Comparisons, opposite Emotions, Pushing away thoughts, Thoughts of other things (like math problems or song lyrics), and strong Sensations
One ACTIVITY you might try: Join the adult coloring trend. While there has been some dispute in the media about whether adult coloring does all that its proponents claim for it, most of these concerns don’t really matter for Distress Tolerance. Get yourself some markers or crayons (or use whatever pens and pencils you have ready to hand), print a free page, and give coloring a test run. Check in, if you can, with your emotions and your distress levels before you start–even if this is just a test run. Here’s where you can find some patterns:
Now, when you are ready to stop coloring, check in on what happened. What are your prevailing emotions now? How calm or stressed do you feel? Consider:
Is coloring effective in distracting you from whatever was on your mind when you started coloring?
Do you find yourself getting absorbed (i.e., in a Mindfulness sense, participating) in the activity?
Does it give your mind a break from obsessing, perseverating, catastrophizing, or otherwise feeling bad?
If coloring is effective for you, then print out some more pages or buy a book. You can add this skill to your Distress Tolerance repertoire-and congratulate yourself for finding something effective to do in those worst of emotional times.
Among the many available books, the following bring this Distress Tolerance Activity together with Mindfulness ideas:
Blue Star Adult Coloring Books
Link here to a personal narrative about depression and DBT by journalist Will Lippincott in the New York Times. Lippincott describes his early encounters with distress tolerance skills as well as the ways that DBT skills training has helped him in the long term to gain control over his troubling states of mind. A great introduction to DBT from a patient’s perspective. And an inspiring story.
The Lakeview Center is pleased to announce that Kelly Logan, PsyD, will be starting a new DBT Skills Training Group on Monday evenings from 7 to 8:30 pm beginning in November. Please visit our web page for more information about our DBT program and for contact and other information about the group.
Kelly Logan, holds a PsyD from the Adler School of Professional Psychology. She is a therapist at Linden Oaks at Edward Hospital where she is a DBT staff trainer and inpatient therapist. Kelly received her master’s degree from The Chicago School of Professional Psychology in 2008. She has over ten years’ experience working in outpatient, partial hospitalization, intensive outpatient, shelter, and inpatient settings with adults and adolescents. Kelly specializes in work with individuals with mood disorders, relationship issues, identity formation, anxiety, self-injury, binge eating, and other impulse control disorders. Kelly has completed trainings in both Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT). DBT seeks to empower individuals and enhance their quality of living by providing skills training in areas such as relationship effectiveness, emotion regulation, distress tolerance, and mindfulness.
Marsha Linehan, the founder of DBT, discusses crisis survival skills in this excerpt from her video series, From Chaos to Freedom.