Today's skill of the month comes from Dialectical Behavioral Therapy (DBT). It is part of the acronym ACCEPTS. Each of the skills in this acronym will, at some point, probably become a skill of the month but today we're just looking at the "T" which stands for "Thoughts".

ACCEPTS is part of the distress tolerance skill module and the Thoughts which are part of this are meant to distract one from the current stressful situation. This should really only be used AFTER one has assessed what, if anything, can be done to change the stressful situation and done whatever may help to minimize the stress. When the stress cannot be escaped, it must be "tolerated" until it ends and Thoughts help us to do that.

Thoughts is one of the more "fun" skills to use since, despite what you might think if you've read many of my entries, has nothing to do with changing your thoughts (like we would do in Cognitive Behavioral Therapy). As a distress tolerance skill, we are using other thoughts--thoughts that have absolutely nothing to do with the situation--to distract us from the unavoidable stressful situation.

I recommend to my clients to "prethink" this one because if you're in a stressful situation that you must tolerate, it will probably be quite difficult to think of Thoughts to distract yourself. So, make a list of Thoughts before you need them so that when you do, you're ready to go!

Okay, so what are these Thoughts? Basically, anything that requires you to really think! For most people, if I asked you to count backwards from 100 by 7's, it would require you to really think! That would be an example of Thoughts. The idea is that these are not stressful thoughts--they have nothing to do with the current stressful situation--they require you to think about something OTHER than your stressful situation and because of the nature of the Thoughts, hopefully you're challenged enough so that your brain is kept pretty busy at the task and finds it more difficult to return to thinking about the stressful situation--at least for a few minutes. Depending on how much you've practiced, you might have to use many Thoughts to get through one of these stressful situations, so make a list!

Here are a few more ideas for Thoughts: 

  • list the States in alphabetical order
  • list the Presidents in order of their presidency
  • recite phone numbers of childhood friends or family members
  • recite the preamble to the Constitution
  • recite the alphabet backwards
  • alternate reciting the alphabet and counting (A-1, B-2, C-3...)
  • come up with a list of common textisms and give them new meaning (LOL=Lions, Otters and Limabeans instead of Laugh Out Loud)

Remember, the really important part of this skill is not to distract yourself if there is something you can do to actually change the stressful situation. An example of when you might use Thoughts would be if you find yourself stuck in a traffic jam. You can't really change the situation (until you can get off the freeway perhaps) so you might as well distract yourself until such a time that you can change it. 

The other important part to remember is to do your prethinking! Make a list (like the one above) ahead of time so that when a stressful situation occurs, you don't have to actually think of what Thoughts you're going to think! Wow! That's a bit of a convoluted sentence that probably wouldn't make sense without having read through this entire post!

Enjoy this skill of the month the next time you need to distract yourself!