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Dialectical Behavior Therapy (DBT), developed by Dr. Marsha Linehan, has gained significant recognition for its effectiveness, particularly in treating Borderline Personality Disorder and chronic suicidality. Central to DBT’s success is its focus on acceptance and change. Within this framework, the “ACCEPTS” skill set, part of the Distress Tolerance module, plays a pivotal role. This article delves into the essence of the “ACCEPTS” skills, their importance in DBT, and how they can be applied to manage distress and enhance emotional regulation.
Understanding the "ACCEPTS" Skills in DBT
The “ACCEPTS” acronym in DBT stands for Activities, Contributing, Comparisons, Emotions, Pushing away, Thoughts, and Sensations. Each component represents a strategy to tolerate distress and cope with difficult emotions in a healthier way. These skills are designed to help individuals endure and survive crisis situations without resorting to self-destructive behaviors.
The Components of "ACCEPTS" Explained
1. Activities
Engaging in positive activities to distract from distressing emotions. This might include hobbies, exercise, or socializing.
2. Contributing
Focusing on helping others or contributing to the community to shift attention away from oneself and reduce distress.
3. Comparisons
Comparing oneself to people in worse situations can help bring perspective to one’s own problems, though this should be approached with caution to avoid invalidating one’s feelings.
4. Emotions
Invoking opposite emotions by engaging in activities that elicit different feelings than the current distressing emotion.
5. Pushing Away
Intentionally pushing away distressing thoughts or situations by mentally ‘blocking’ them or setting them aside to deal with later.
6. Thoughts
Distracting the mind with different thoughts, such as counting, planning, or focusing on a challenging task.
7. Sensations
Using intense physical sensations to distract from emotional pain, like holding ice, taking a hot shower, or eating something with a strong flavor.
"Mindfulness is the first skill taught in DBT, and every skill thereafter builds upon it."
"Distress tolerance skills are an integral part of coping effectively with one’s emotions and avoiding impulsive behavior."
The Importance of "ACCEPTS" in DBT
The “ACCEPTS” skills are essential for those who struggle with overwhelming emotions and impulsive reactions. These skills:
Provide Immediate Relief
They offer quick strategies for managing intense emotional distress, reducing the likelihood of harmful responses.
Promote Long-term Resilience
Regular practice of these skills strengthens one’s ability to handle emotional crises more effectively.
Encourage Mindful Awareness
By focusing on external activities, individuals can step back from their emotional experiences and gain perspective.
Applying the "ACCEPTS" Skills in Everyday Life
Incorporating “ACCEPTS” into daily life involves recognizing when you are experiencing distress and actively choosing a skill to mitigate the situation. Here’s how to apply these skills:
Choose an Activity
When feeling overwhelmed, engage in a positive activity that you enjoy or find fulfilling.
Find Ways to Contribute
Volunteer, help a friend, or perform random acts of kindness.
Use Comparison Wisely
Remind yourself of times when you were in a worse situation, or think of challenges others face.
Invoke Opposite Emotions
Watch a funny movie, listen to uplifting music, or read an inspiring story.
Push Away Distressing Thoughts
Visualize a ‘mental box’ where you can store distressing thoughts temporarily.
Distract Your Mind
Count to 100, do a puzzle, or plan an event.
Seek Physical Sensations
Hold an ice cube, take a hot bath, or engage in intense exercise.
The Role of "ACCEPTS" in Crisis Situations
In moments of acute distress, where self-harm or other impulsive actions might feel imminent, the “ACCEPTS” skills can be lifesavers. They help in navigating through the crisis by providing alternative coping mechanisms.
Challenges in Practicing "ACCEPTS"
Implementing these skills, especially in the midst of emotional turmoil, can be challenging. It requires practice, patience, and sometimes guidance from a DBT therapist to effectively use these skills.
Expert Insights on "ACCEPTS"
Dr. Linehan and other experts in DBT emphasize the importance of distress tolerance skills like “ACCEPTS.” As Dr. Linehan states, “Distress tolerance skills are an integral part of coping effectively with one’s emotions and avoiding impulsive behavior” (Linehan, 1993)1.
Conclusion
The “ACCEPTS” skills in DBT represent a practical approach to managing life’s inevitable emotional storms. By learning to tolerate distress through healthy distraction and self-soothing techniques, individuals can navigate through their emotional landscape with greater resilience and composure. These skills are not just about enduring hardship; they are about cultivating a life worth living, even in the face of adversity.
"Accept" Skills Book Recommendations
Here is a collection of the best books on the market related to “accept” skills:
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Your Thoughts about the "Accept" Skills
It’s highly recommended that you jot down any ideas or reflections that come to mind regarding “accept” skills, including related behaviours, emotions, situations, or other associations you may make. This way, you can refer back to them on your Dashboard or Reflect pop-ups, compare them with your current behaviours, and make any necessary adjustments to keep evolving. Learn more about this feature and how it can benefit you.
References
- Linehan, M. M. (1993). Skills Training Manual for Treating Borderline Personality Disorder. Guilford Press.
