Dr. Levy's CBT Blog
Insights on Well-Being, Contentment, and Cognitive Behavioral Therapy
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Distress tolerance is one of the four core skills taught in dialectical behavior therapy (DBT). DBT is a type of therapy that helps people learn to manage their emotions and behaviors in a healthy way. Distress tolerance skills are especially helpful for people who experience intense or frequent negative emotions.
One of the most well-known distress tolerance skills is ACCEPTS. ACCEPTS is an acronym for the following skills:
How to use ACCEPTS
To use ACCEPTS, simply go through the acronym and choose the skills that are most likely to be helpful for you in that moment. For example, if you are feeling overwhelmed by anxiety, you might try the following:
Tips for using ACCEPTS
Here are a few tips for using ACCEPTS effectively:
Emotions are an integral part of our lives, influencing our thoughts, behaviors, and overall well-being. However, for many of us, managing intense emotions can be a challenging task. Dialectical Behavior Therapy (DBT), developed originally by Dr. Marsha Linehan, offers a comprehensive set of skills to help individuals regulate their emotions effectively. One of these essential skills is TIPP, an acronym that stands for Temperature, Intense Exercise, Paced Breathing, and Paired Muscle Relaxation.
How do TIPP skills work?
TIPP skills work by changing your body's physical response to stress. When you are feeling stressed or overwhelmed, your body goes into "fight or flight" mode. This is a natural response that helps you to deal with danger, but it can also be uncomfortable and make it difficult to think clearly.
TIPP skills can help to calm your body down and bring it back to a more relaxed state. This can make it easier to manage your emotions and cope with the situation at hand.
How to use TIPP skills
One of the easiest ways to use TIPP skills is to change your body temperature. This can be done by splashing cold water on your face, holding an ice pack to your neck, or taking a cold shower. Changing your body temperature can help to activate the parasympathetic nervous system, which is responsible for the "rest and digest" response.
Another way to use TIPP skills is to do some form of intense exercise. This could be anything from running or biking to doing jumping jacks or push-ups. Intense exercise releases endorphins, which have mood-boosting effects. It can also help to burn off excess energy and tension.
Paced breathing is a simple but effective way to calm down your body and mind. To do paced breathing, simply sit or lie down in a comfortable position and focus on your breath. Breathe in slowly and deeply through your nose, and exhale slowly through your mouth. Try to keep your breathing even and regular.
Progressive muscle relaxation
Progressive muscle relaxation is a technique that involves tensing and relaxing different muscle groups in your body. This can help to release tension and promote relaxation. To do progressive muscle relaxation, start by tensing and relaxing the muscles in your toes. Then, move up your body, tensing and relaxing the muscles in your legs, stomach, chest, arms, neck, and face.
How to use TIPP skills in everyday life
TIPP skills can be used in a variety of situations, including:
Here are some tips for using TIPP skills in everyday life:
Let's say you have an important work deadline coming up, or an important meeting, or a job interview. You'll likely be a bit stressed about it, right? That's understandable - and useful! A reasonable amount of stress shows that we care about these critical tasks and can actually help us prepare better for them. However, every now and then, that stress gets out of hand...instead of encouraging us to be ready for the challenge, the stress mounts so high that it makes that challenge seem completely unattainable.
In the early 1900s, psychology researchers Robert Yerkes and John Dodson developed an empirical curve that illustrates our performance levels on a task relative to the stress levels present in that situation. It is easy to understand if you think about it in terms of a test at school. If there is no stress at all, we won't really prepare for the test, and might show up on the exam day without having done any studying. A good amount of worry and stress will encourage us to prepare for the test by reading the book chapters and doing the practice exercises, once...or maybe twice. An amount of stress beyond that might lead us to re-read all those chapters and re-do the practice exercises a few too many times, to the point where we may be too tired by the time the test comes along to get the best grades. And if we are really, really scared of the test, telling ourselves that it's way too difficult and we will never get a good grade on it, we may just throw our hands up in the air and not study for it at all. We may give up before we start, out of panic, exhaustion, and fear.
So, some stress is good. Too little or too much may lead to subpar performance. The question is how to modulate the stress to get it to the level that is good for you. There are many answers there, ranging from relaxation exercises to worry break and mindfulness moments to reappraising the importance and threat of the situations ahead. In TEAM-CBT, we have some great tools that can help with all of those!
Dr. Daniele Levy is a licensed psychologist offering CBT in-person and via Teletherapy in Menlo Park, CA. Her background uniquely combines leading edge training in behavioral sciences with deep expertise coaching and mentoring working professionals in dynamic organizations.
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Copyright © 2014 Daniele V. Levy, PhD
Bay Area Cognitive Behavioral Therapy (CBT)
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