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Chasing adventure & living mindfully while parenting through mental illness


DBT Skills for Parents: ACCEPTS for Distress Tolerance

DBT Skills for Parents: ACCEPTS for Distress Tolerance

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When you're with kids all day, there are inevitably moments of chaos and distress. There's nothing like multiple screaming kids clinging to you to send you into a panic! When you live with mental illness, It isn't just regular moments of distress that spike your cortisol spiking. Depending on your individual triggers, simple things like kids birthday parties, school pick up, doctors appointments can make you feel paralyzed with fear and anxiety. If you have depression, sometimes it's as simple as having a week of sickness run through your family and throw off your routine.Regardless of the reason, DBT Distress Tolerance skills can be very helpful. One of the main skills is ACCEPTS skills.DBT uses a lot of acronyms to help you remember everything. ACCEPTS stands for:

  • A = Activities
  • C = Contributing
  • C = Comparisons
  • E = Emotions (opposite)
  • P = Pushing Away
  • T = Thoughts
  • S = Sensations

Not every one of these skills works well for everyone. The beauty of DBT is that there are lots of different solutions to your different distresses, so you can pick a few to hone. Some will work for one type of distress but fail for another. Sometimes, if something that has been working for awhile stops working, you can pull another trick out of the bag. Here's a little about each skill:Using activities is pretty straight forward, and it is one I use a lot when I have a depression resurgence. It was my main strategy for avoiding postpartum depression. It works well if you are having obsessive thoughts about something. If you are watching your kids, you can't always do the ideal activities, but there is definitely always something to do! And kids and their chaos can actually sometimes be a good distraction if they aren't the main thing sending you into distress! Take a trip to the library; ride public transit; color pictures; make up a silly song; bake or cook a new recipe.When it comes to contributing, don't over think it! I spent a lot of hours searching for things to volunteer for where I could also still herd my toddlers. Unfortunately, there aren't too many things. There is always visiting nursing homes, or you can go through clothes and toys to donate to charity. I personally bring things in and look within my network for who I can help. Maybe I can make a meal for friends having a hard time or welcoming a new baby. Check in with a friend and practice active listening. Send a funny email or text to someone to brighten their day. Watching a friend's kid so they can run errands or have a break. The point is to look beyond your own needs and crises and focus outside yourself.Comparison is a bit of a tricky one. This requires being able to control which thoughts you hold on to. Having some experience with mindfulness is key. Compare yourself to people who have it (seemingly) easier, or to people who are doing as well as you. It is important to not let shame creep in here. If you're comparing yourself to someone who successfully deals with similar problems, someone who is maybe a mentor or a model, ask youself what advice they would give. If this causes you to fall into a shame spiral, though, abandon it!Using Opposite Emotions can be as simple as listening to happy music when you are feeling angry, or watching a scary movie when you are sad. Do something that puts you into a different mental space, and see if your mental space changes to adapt to the new circumstances.Pushing Away thoughts is another form of distraction. While using this as your only form of distress tolerance, it can sometimes come in handy. You are not always in a situation where you can process your distress in a healthy manner. Pushing away those stressful thoughts (ideally to unpack them at a later date) can be very useful. When stressful moments come up while you are with your kids, this is doubly useful!Distracting with other thoughts is usually about trying to act with the logic part of your brain. Count as high as you can. Do a crossword puzzle or a sudoku. One of my go-tos's for Distress tolerance is the old school game Minesweeper. You can't play it unless you think completely logically, and that helps me shut off the overactive emotional side of my brain. I keep it on my phone so I always have access. Breccan is such a chatterbox, I can usually get him going on telling me a story or talking about planes or excavators. This can help pull me out of my mind.The last skill is distracting with sensations. This is different than just self-soothing with nice smells. This involves creating a strong sensation that literally shocks your brain. It is important that the sensation not be harmful, especially if you have a history of self-harm. An ice cube on the wrist or back of the neck is a great example. Stepping outside into a strong wind. My favorite example, though not always the most convenient, is to activate the mammalian dive reflex (not recommended for those with heart conditions or eating disorders though).


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