Week review: DBT in practice- ACCEPTS

Last week was pretty rubbish emotion-wise.  I’ve been struggling a lot with feeling overwhelmed and vertigo-y, and it’s been getting worse over the last few weeks.  I’m also coming to the end of my current job and am about to start a new one, which is making me feel really anxious too so quite a lot going on at the moment.

After the losing a close friend, I had a pretty intense emotion crash which resulted in a lot of bingeing/purging and compulsive exercise which I’ve been trying really hard to manage over the last few months (after moving into a shared house and obviously don’t want my new housemate to know about that sort of thing) and I made a conscious decision to use DBT skills at every possible opportunity, not just when I’m feeling desperate or paranoid.  I’ve also decided to focus on one DBT skill a week in a blog post every weekend so this can be my ‘skill of the week’ for last week…

One of the distress tolerance skills I’ve found really useful this week is ACCEPTS.  DBT is full of acronyms which I kind of like because it makes it easier to remember the skills, and this one’s been particularly useful because it’s mainly about managing intense feelings/thoughts even if you can’t totally identify them which has definitely been true for me this week.  A stands for Activities, or doing something you enjoy.  I’ve been posting way more blog posts than people are probably interested in this week but it really has helped as a distraction technique and to try to express or regulate how I’m feeling.  I’ve also started drawing again which I’ve been really lazy about recently and am in the process of rereading the entire Sweet Valley High series which has actually become my go-to distress tolerance technique because it’s accessible via Kindle, easy to read and I ‘know’ the characters so well thanks for obsessive reading and fanfiction as a teenager, and it kind of feels like going home which is an amazing feeling.  I’ve kind of missed some of the characters (Olivia Davidson in particular- I’m avoiding the earthquake books!!) and it’s nice to read about other characters who feel ‘weird’ or like they’re getting things wrong as well as constantly aspiring to be more like Elizabeth Wakefield.  I learned a lot of social skills from SVH and I’m relearning some now, which I might end up blogging about at some point…

C is for Contribute- helping out other people.  I volunteer at Mind which I love, and recently started helping out again.  I love it for so many reasons; partly because I learn a lot from the groups too and from listening to service users, partly because the people who run the groups are awesome and I get a lot from listening to them too, and partly because I like feeling ‘useful’ or that I’m actually doing something constructive.  I’ve been doing voluntary work for nearly 17 years and it’s part of my life that I can’t imagine not doing, and I’ve got more from that than nearly anything else.  It’s amazing for everything from learning skills, acceptance, self esteem to basically anything positive you can think of!

The second C is Comparisons, or comparing where you are now to where you have been in the past.  This is a really useful one because it makes you realise that you have actually achieved stuff even if it feels like you’re constantly messing up.  A few years ago, I couldn’t keep a job and was ‘fully’ bingeing every day whereas now, I’ve had a job for over four months, I’m not living at home any more and the bingeing has reduced massively to low-level a few times a week.  I’ve also managed to be more assertive with relationships that aren’t healthy and am managing paranoid or obsessive thoughts so much better than a few years ago where they would literally take over my brain to the point where I couldn’t think about anything else.  Yes, I’m still feeling rubbish and get paranoid or obsessive on a regular basis but it’s nowhere near as intense and I’m hoping it’ll keep getting gradually less until it’s actually manageable…

E is the big one- Emotions, or more accurately OTHER emotions.  The point of this is to try to ‘displace’ the intense negative emotions with something positive that can distract from the intensity and make it more manageable.  My go-to way to do this is to watch The Big Bang Theory which is one of the only TV shows that is guaranteed to make me laugh and it really does work!  By some amazing coincidence, this week was the finale of season nine and had me in absolute hysterics which was AMAZING for temporarily getting rid of the vertigo and heart-clogging feeling I’ve had a lot over the last couple of weeks.  Won’t give it away for TBBT fans who haven’t seen it but it really is very, very funny!  Sometimes I wish I could watch TBBT several times a day to get the serotonin hit and to help to manage intense negative emotions, but playing scenes in my head does sometimes help (particularly if I pretend that I’m acting as one of the characters) and that’s something that might help other people with similar experiences?

P stand for Push away, or distracting your mind from whatever it is that you’re obsessing about or from negative emotions.  This is where I’ve been using my emotion card (see Opposite Action in action for more about that), and my rule is that I have to try at least two things from there before I can do anything potentially not-helpful.  Sometimes it works and it distracts for long enough for the urges to binge or cut to reduce to a more manageable level, sometimes it doesn’t.  But definitely worth a try!

T is for Thoughts- trying to manage the thoughts or make yourself think about something else.  This is the one I still haven’t managed to do properly so don’t really have much to add about it except that the theory is that by ‘making’ yourself think about something else, it sort of displaces the negative thoughts already there but my problem is that when I’m having obsessive or paranoid thoughts, I genuinely can’t get rid of them or think about anything else so I’m trying to find an alternative strategy…  For me, a couple of things that have helped are to ‘talk back’ to the thoughts like another person- I have a ‘bitch in my head’ who shouts at me a lot and a lot of the thoughts come from her, and I find it really useful to try to respond to her in a more compassionate or rational way, not to criticise her but to accept what she says and listen to her without actually believing her.  It sometimes helps, and the paranoid thoughts in particular are starting to reduce in intensity…

Last one is S: Sensations.  The idea of this is to use sensory stimulation to distract from the emotions, and it’s something I find especially useful because I tend to experience emotions ‘physically’ through vertigo, feeling like I’ve been punched in the stomach or chest, stinging feelings, dissociation, dizziness, feeling vacuum-y etc.  I have a few techniques I use a lot but smell is a big one- I carry smelling salts in my pocket and use them whenever I start to feel zoned out or dizzy and it really does help to ‘bring you back’ quickly and help you feel more ‘real’.  I also burn scented candles a lot to try to calm down, and play music to alter moods (I have a ‘mood stabilisers’ playlist as well as ‘happy/positive’ and ‘feeling rubbish’).  Taking a cold shower also helps if I’m feeling angry or overly hyped, or a hot bath if I’m feeling low or zoned out (careful with having a bath is you’re feeling dissociated, can make you feel worse and be dangerous- only if you’re just a bit ‘zoned’ or ‘unreal’ and not actually out of your body!).  I also use ‘soft’ things a lot and that’s really useful if I’m feeling low, vertigo-y or shaky; somethings wrapping up in a soft blanket and hugging a soft toy really helps to neutralise the vacuum or vertigo feeling.  There are obviously a lot of not-as-helpful sensation strategies which I won’t go into here, and it’s definitely best to use more constructive ones first if you can and see if that helps.  I tend to avoid taste-type ones because of ED issues but a lot of people find drinking hot chocolate good for feeling low or anxious, or eating something strong-tasting if you’re feeling zoned out.

Hopefully that makes sense and some of it is useful!  Will try to do a post like this about a different DBT skill every week…

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