DBT Video Text: ACCEPTS

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These are scripts from videos by Dialectical Behavioral Therapy creator Marsha Linehan describing DBT skills. You can purchase the videos from Behavioral Tech LLC.

Distracting is a skill that a lot of people already know about because distracting is when you throw your mind off of the problem. In other words, you think about or do something else. You know people when they say, ‘I threw myself into my work’. That’s when people are distracting.

I’ve got seven distract skills I’m going to teach you. The way to remember them is the first letter spells out the word ‘Accepts‘. Let’s start with A.

Activities

A means activities. Now the idea here is to just throw yourself into activities.  You can’t do activities that you can do mindlessly. You know how sometimes you do things and while you’re doing them all you’re doing is thinking about your problem? This is not a good idea. That’s not an activity for distracting. You need a distracting activity; one that will just fill up your whole mind. What are some examples? 

Reading is a really good activity. It’s one of my favorites but you can’t do reading if you can’t concentrate. So you could try reading if you can get yourself involved or you’ve got some great book and you’re dying to see how it goes. That’s a really good one if you can get involved. It’s always a good thing to keep a few books around that are really involving. That’s why I like junk novels. Really serious novels, serious reading – I like to do that sometimes. Well, actually, I mostly do that at work. But at home I keep spy stories and novels. I keep the kind of stuff you can just really get your mind into.

DBT ACCEPTS: A young person reads a book on a couch with bookshelves behind it.

Or, if you can’t concentrate and just reading’s out, how about exercise? Now with exercise, you’ve got to do an exercise that will really get your mind involved. So the best kind are the kind that are really hard exercises. Involving exercises. Ones that focus the mind. 

Maybe you’re a person who has hobbies. That’s what lots of people do. They throw themselves into their hobbies to distract from their problems. That’s always a good idea.  You have any hobbies?

I have friends who throw themselves into cleaning their house. I really do. I’ve got a friend she says, ‘Well, whenever I’ve got troubles I clean my house’. Now, I do that too.  Sometimes if I just can’t solve a problem, especially at work, I start cleaning my desk. You can always tell when I’ve got lots of problems – my desk is very neat. 

You could go to an event. You could go to a movie or concert. Open the paper; try to find something to go to. Movies are good. 

Lots of people distract from their problems by getting together with their friends. Now, the trick here is if you get together with friends to distract, what would you not want to do?  You guessed it. Don’t spend the whole time talking about your problems.

So that’s the list. Now you should add to it. Think of all the activities that have ever done you some good and add them to the list. You’ll probably be able to think up lots of them. The trick is, think up the activities when you’re not in a crisis. It’s really hard to think them up in a crisis. If the crisis is really bad, you want to be able to just open your list, go down it, do the first thing on the list, that doesn’t work, go to the second. If that doesn’t work, go to the third, just keep right on going.

What do you do if you don’t have any activities to fill up your mind? You need…can’t think of anything to do or everything seems boring or every time you try to do something all you do is think about your problems anyway. Move to the next skill.

Contributing

The next one starts with C. C, contributing. So what’s contributing? It’s where you distract from pain and suffering by focusing your mind on someone else or something else that you can contribute to, somehow make better. 

The idea here is to distract, that’s the good part. And the second good part is you try to distract in a way that will actually make you feel better about yourself. To make it even better, you try to distract in a way that will actually make the world a little bit better. So even if you’re suffering at least you’re doing some good in the world. 

You could do volunteer work. Lots of people do volunteer work as a way to kind of get your mind off themselves – get their minds off their troubles. 

Could do something nice for someone. If you’re in the middle of a crisis you could think, ‘Well, what would someone else like? What could I do for them?’ Maybe you could give them a call. You could call people you haven’t talked to in a long time who might be missing you. 

You could do something surprising for someone else. There are lots of things you can do that are contributing. You just have to think of something. Think back in your own life, what’s something that you do that contributes to other people, makes someone happier that you could do in a crisis. 

If you can think them up, write them down. Now’s the time. Write them down now.

It’s really important to remember that contributions don’t have to be big. The facts of the matter are, in the middle of crisis when you are just trying to survive, you’re probably not going to do something really big. That’s probably not the time. So, what you want to do is try to think up small things you can do.

For example, there’s a grocery store two blocks from my house. I go there, I don’t know, a couple of times a week. So, I always think to myself whenever things really get me down, I’m really in trouble, having a bad day. I say, ‘Alright Marsha. All you have to do to make this day worthwhile is walk down to the grocery store. Get in line. And smile at the checkout lady.’ I figure they have really difficult days. Have you ever noticed how rude people can be to check out people in grocery stores? So, you can just make the whole world better by going down and smiling. That’s what I do. 

DBT ACCEPTS: A grocery store produce aisle.

Now, you may be one of those persons who, when you get in a crisis and then you think of contributing, you start thinking, ‘Oh, it isn’t going to make a difference. It’s really not worthwhile. It’s not my time.’ In a crisis sometimes we start putting ourselves down thinking we’re worthless, thinking that whatever we have to do doesn’t contribute. So, this is my advice. Stop that. That’s not effective. Go ahead and do it. Even if you don’t think it’s going to help, try it anyway. 

Well, what if you’ve already tried it. You either tried it and it didn’t work or you decided ‘I’m not doing it. I’m the one in trouble. I’m not giving something to someone else. I need someone to give something to me.’ Ok. Give it up. You’re not going to contribute. Let’s go to the next one.  

Comparisons

The next letter in ‘Accepts’ is C again, but this time it’s C for comparisons. When you’re trying to distract by using comparisons, what you’re trying to do is trying to compare your current situation or the current crisis to a situation that’s worse than the one you’re in now. 

So for example you could compare yourself to people who have less than you have. Or you could compare yourself to people who maybe have the same thing you have but they have a lot harder time coping with it. Or, you could look at your own life and you could think about times in your life when things have been a lot harder or you didn’t have the same resources you have now.

The whole idea is to try to feel better by comparing yourself to a time when you could feel worse. In other words you’re trying to get yourself to sort of say in your mind, ‘Could be worse’.

So how does this work? Well when it does work it’s probably generating a sense of gratitude or a sense of feeling lucky or even a sense of relief. So, that’s when it works. It works. You feel relieved. You feel better about yourself. Feel a little more competent.  Maybe you’re not quite as incompetent as you thought.

Emotions

E is for emotions. The idea is to distract from one emotion by figuring out a way to create another emotion. So how in the world would you do that?

Well, one really effective way, that you are probably already using anyway, is music. The secret to using music as distraction or crisis survival is to pick your music so that it changes your emotion. You’d be surprised at the people I know who when they’re sad, what do they do? They put sad music on. How do you think they feel? Do you think the get less sad?

No. So the idea is if you feel sad, what kind of emotion would you like to have? Well you probably want to feel energetic or even happy if you could. So you’ve got to put some energetic happy music on. 

Now what’s happy for one person may not be happy for another. That’s really important. I was once running a group of people who all had drug problems. And in the groups before that we’d always used music at the end of group to sort of rev everybody up; make them feel better. So in this group, I said ‘Alright, let’s put the music on’. They said, ‘No. No. No’. I said, ‘Why not?’ and they said. ‘Well every song we like makes us think of using drugs.’  I said, ‘Fine. Good. We’re not doing that. Don’t put that on.’

Now if you’re feeling really anxious and tense you could try putting music on that’s soothing and calming. Sort of soft music. Maybe background music; maybe classical music. That might help.

DBT ACCEPTS: a close-up on the stand up base section of an orchestra.

So think about what kinds of music change your mood. That’s what you want to do. You want to get that kind of list going and then when you are in a crisis, first what do you do?  Check out how you feel. Second, pick your music. Third, put it on. Fourth, make sure it’s loud enough that you can hear it, even low background music. 

What else could you do? Well, you could try reading. The most important thing though about reading is that you’ve got to find a book that’s emotionally involving. No newspapers, no magazines. Nothing scholarly. Nothing informational. You can’t read the encyclopedia. You’ve got to find a story that’s emotionally involving.

So it all depends on what’s emotionally involving. For me it’s spy stories. So I…if I really find myself worrying, kind of in a crisis, and I’m just making things worse by all the stuff I’m thinking, I’ll often just get up and try to read a book. But I try to pick a book I can become engaged in. I get all involved in the story and when I close the book, I try to keep my mind in the story. So I try to keep that emotion somewhat excitement.

What else could you do? You’re trying to get another emotion going. Well one way is to try to find some humor. I did that once. I was driving cross country and I was driving all the way from Washington DC to Seattle. So I had to drive across the middle of the country. So I was thinking as I drove across the middle of the country I figured I was going to be really bored because, you know, what do they have in the middle of the country? That’s how I was thinking at that time in my life. I figured, ‘Alright, they’re going to have cows and cows and cows’. And I thought that’s not going to be interesting. I’m going to get really bored so I’m going to take my comedy records, put them on tapes – you can tell it was records- this was quite a while ago. Put them on tapes then I was going to listen to them as I was going across the middle of the country when I had nothing to look at but cows.

So, as it turns out, going across the middle of the country turned out to be really interesting. And I actually didn’t listen to my records. But, after I got across the middle of the country, I came to mountains. You know how sometimes when you go up mountains and you can be on the side of the road that’s near the mountain or you could be at the side of the road that’s right near the ledge? Now if you’re on the side of the road near the mountain, you’re not going to be so scared. But if you have fear of heights – I have fear of heights – and you’re driving your car on the side that’s on the ledge, you’re going to get afraid. 

Well, take it from me, I not only got afraid, I got panicked. I kept seeing the edge so I started thinking that I was going to go over the ledge. I couldn’t even concentrate.  There was nothing I could do. What was I going to do? You just can’t stop your car and get out – I thought of doing this though. Stopping it and getting out and saying, ‘I’m too scared to drive! Would you drive my car?’ But I didn’t think that would work out too well.

So, I pulled my car over to the side, they’re turned out to be a little indentation where you could take your car. So I pulled my car over and I thought, ‘I’ve got to get through this.’ So what did I do? I put my comedy tapes on. And I started listening to comedy tapes. Now I had finally got myself back over onto the road, I’m listening to the comedy tapes – they took my mind off the edge of the highway where I could have fallen off. And I started, well I didn’t start laughing actually, but I did start smiling. And sure enough, I got through the drive.

Now that’s a really good example of crisis survival skills. You can do it with humor.

What else? Well, you could go to emotional movies. Movies are like reading though, if you’re going to go to an emotional movie, make sure you don’t go to a move that’s going to intensify the emotion you’ve got. So if you go to a movie, don’t go to a sad movie if you feel sad. Don’t go to a love story if someone just broke up with you. 

Pushing Away

What’s the next letter? P. P is for pushing away. It’s really a good set of skills to do when you just can’t cope. This is really hard. So I’m going to give you a couple of things to do that can make it a lot easier. 

The first step is get yourself a piece of paper. Get something to write with. The second step is to make a list: 1, 2, 3, 4, 5…You’re going to want to make a list of the main problems that are on your mind right now.  So for example you might say, ‘One: my mother. Two: my bills. Three: none likes me at work.’  And so on. Ok.  So that’s the first thing.  You make your list – put a number beside each one of them.  Alright. 

And the second thing is you go back over your list, one at a time, and for each item on your list, you ask yourself the following questions. Question 1: Can I do anything about that right now? And question 2: Is this a good time to work on it? Now if the answer to both those is yes, I can work on this problem now and this is a good time to work on it, ok, skip pushing away. Go to the first rule of crisis survival – solve that problem now.

However, lots of times you’ll say no, I can’t do anything now, it’s midnight, what can I do about my mother? Nothing. Is this a good time to work on it?  This is not a good time to work on my work problem because I need sleep. If I work on it now I’ll be exhausted tomorrow.  So if you say no to both then what you do is put a check mark next to it.

Say… let’s say you’ve got the first one, my mother, you’ve got that checked.  Now you go to the next problem.  And you ask the very same questions. You say, ‘Is there anything I can do about this problem now and is this a good time to work on it?’ And if you say no to either one of those, you put a check by it. And you just go one down your list. Now the idea is to use the first rule of crisis survival strategies on any problem on your list where the answer to both questions is yes. And where the answer to either one of those questions is no, then you can use the pushing away skill.

So what is the pushing away skill? What you do is you go through each one of the items on your list and in your mind you imagine picking the problem up, putting that in a box and putting it up on the shelf. You want to do this for each one separately. 

DBT ACCEPTS: A cardboard box on a shelf next to a stack of books

The trick is you’re trying to send a message to your brain that says, ‘Brain, cut it out. Stop dealing with this problem. Put this on the shelf.’ You’re really trying to send a message to yourself that says, ‘This is not effective. This is ineffective. This won’t work. I have nothing to gain by working on this problem now.’ And when that’s true, pushing away can be a really good skill.

So that’s the skill. It’s blocking, censoring, shutting off, putting away, getting rid of. But remember you can only do that, this only works when you can convince your mind that it’s not a good idea, that you can’t do anything if you work on it now. Because if your brain keeps thinking that somehow it’s going to get somewhere with this, you’re going to actually solve the problem if you keep thinking about it, you won’t get it on the shelf. It just won’t work. Alright. So that’s that skill. Shall we go onto the next?

Thoughts

The next letter in “Accepts’ is T. And T stands for thoughts. This one is the skill of distracting yourself from a crisis by focusing your mind on thoughts. 

Has anyone ever told you to count to ten when you’re angry? The idea is that if you count to ten you won’t yell or scream or do something you’ll regret. Most of us have been told that at least once. Well, that’s this skill. I know it sounds sort of silly and like not really an important skill but it can really work. It’s especially good in some situations. And the situations it’s really the very best in is when your emotions are really intense and you’re trying to keep yourself still. In other words you are just trying to keep yourself from doing anything until the crisis passes.

Or you could start naming things. Like if you’re with your boss and he’s being really really critical of you. You could be sitting there and in the back of your mind you could just be looking at him counting and naming the various things he has on. You could say, ‘Tie, shirt, jacket, hands.’ Just about anything that occupies your mind is good when you are in an overwhelming crisis and you’re trying to keep yourself from doing anything else. You’re trying to get your mind busy with something.

Thoughts, thoughts will work. Sometimes you could use just the same thought over and over. Because if your mind is empty, what do you think will happen? Crack! The crisis will go right into the middle of your mind. Take it from me, you’ll never make it. So, what do you do? You focus your mind on a word. That can be any word. All depends on what words work for you.

When we work with our clients we sometimes say breath in the word ‘wise’, breath out the word mind. ‘Wise mind‘. What’s good about that is you…you’re trying to get into a wise mind. When you’re in a crisis the whole idea is to act wisely not unwisely. So you might try that. Why don’t you try it right now while you’re listening? Breath in ‘wise’. Breath out ‘mind’.

You’re going to really want to make the mind go for a long time. Now the idea when you do this is try to become the words. So you want to just throw yourself into the words. You want to try to fill your whole mind, your entire self, up with the words. It’s often hard to do at the beginning. It’s hard to keep your mind focused on one thought. If your mind gets distracted, you start thinking about something else, don’t worry about it. The minute you notice it just come back to the thought, or the counting, what you’re doing. Just bring your mind back, start over again. 

If you practice this a lot it actually gets better. You’ll get really good at it.

Sensations

The last letter in the word ‘Accepts’ is S. And S stands for sensations that will distract the mind. This is a fabulous skill. It’s really helpful if you are in extreme emotional pain or you have physical pain or you’re overwhelmed with an urge to do something not in your best interest.

I sometimes tell people I work with, if they’re really feeling overwhelmed or they have an urge to do something destructive, try a hot bath. Or, a cold shower. Another thing people sometimes do especially if they have an intense desire to do something destructive and they don’t want to do it but they feel like they’re about to lose control, have you ever had that feeling? Like you really want to do something destructive, you really don’t want to do something destructive and you’re afraid you’re losing control, and you’re going to do it. Go to the refrigerator and open it up, get a piece of ice, hold it in your hand and keep it in your hand while it melts.

DBT ACCEPTS: A close-up of a steamy shower head.

Take it from me, this will distract the mind. And, it really works. I…I don’t exactly know why that works so well – I’ve been kind of amazed. I got people doing this and I figured, ‘Ok, it was a so-so skill’. But lots of people have told me it’s the most effective thing they do.

What’s important is that you distract your mind with the sensation that does not harm you. The idea here is to make things better not worse.

Those are the Distracting Crisis Survival Skills. You can remember them by just going through A-C-C-E-P-T-S.

 

This text is the unofficial transcript of Behavioral Tech, LLC.
Chaos to Freedom Skills Training Video. Posted with permission from Behavioral Tech.
Transcribed by Sylvia James, May 15, 2006