Tips, Ideas & Recommendations in CBT Treatment

Life is full of ups and downs. Sometimes, challenges throw us into emotional turmoil, leaving us feeling overwhelmed and unsure how to cope. Here's where coping strategies come in – mental and behavioral tools we use to manage difficult emotions and navigate stressful situations. But with so many strategies available, how do you choose the right one? Let's explore the two main approaches: emotion-focused coping and solution-focused coping.
Facing the Feels: Emotion-Focused Coping
Imagine you receive a critical email from your boss. Your heart races, anger bubbles up, and you feel like lashing out. Emotion-focused coping acknowledges these intense emotions and focuses on managing them rather than directly addressing the source of stress. Here are some key features:

• Riding the Wave: Emotion-focused strategies don't try to suppress emotions. Instead, they help you acknowledge and accept your feelings without judgment. Mindfulness exercises, deep breathing techniques, and journaling can be effective tools.
• Seeking Support: Talking to a trusted friend, therapist, or family member can provide emotional validation and help you process your feelings in a healthy way.
• Self-Soothing Activities: Engaging in activities you find calming, like taking a walk in nature, listening to music, or taking a hot bath, can help reduce emotional intensity and promote relaxation.

Problem-Solving Power: Solution-Focused Coping
Now, let's say that critical email from your boss keeps nagging at you. You want to address the situation and prevent it from happening again. This is where solution-focused coping comes into play.

• Identifying the Problem: The first step is to clearly define the problem causing you stress. In this case, the issue might be unclear communication with your boss.
• Brainstorming Solutions: Once the problem is identified, actively brainstorm potential solutions. Maybe you could schedule a meeting with your boss to clarify expectations, or perhaps you could implement a system for double-checking your work before sending it.
• Taking Action: Choose the most promising solution and take concrete steps to implement it. Following through demonstrates a proactive approach to problem-solving.

Choosing Your Weapon: When to Use Each Strategy
So, which strategy should you choose? The answer depends on the situation. Here's a general guideline:

• Emotion-focused coping is ideal for:
  • Managing overwhelming emotions like anxiety, anger, or sadness.
  • Situations where the stressor is out of your control.
  • Taking a step back and gaining perspective before tackling a problem.
• Solution-focused coping is ideal for:
  • Situations where the stressor is something you can potentially change.
  • Feeling empowered to take control and prevent future problems.
  • When a clear action plan can reduce ongoing stress.

These approaches aren't mutually exclusive. You can often combine them. When faced with a challenge, acknowledge your emotions (emotion-focused), then brainstorm and implement solutions (solution-focused). By having both tools in your coping toolbox, you can navigate life's curveballs with greater resilience and emotional agility.

Life throws its fair share of curveballs. Difficult emotions, stressful situations, and intrusive thoughts can leave us feeling overwhelmed and lost at sea. Acceptance and Commitment Therapy (ACT) offers a powerful technique called ACE (Acknowledge, Connect with your Body, Engage), also known as "dropping anchor," to help us navigate these stormy waters and find our inner calm.

Why We Struggle:
Our natural tendency is to avoid or fight unpleasant emotions. We might try to distract ourselves, numb out with unhealthy habits, or ruminate on negative thoughts. However, these strategies often backfire, leading to increased anxiety and a feeling of being stuck.

The Power of ACE:
ACE provides an alternative approach, helping us develop psychological flexibility. Here's how it works:

• Acknowledge (A): The first step is acknowledging your thoughts and feelings without judgment. Simply observe them – "I'm feeling anxious" or "That was a critical thought." This creates space for them to exist without fueling them further.
• Connect with your Body (C): When emotions run high, we often disconnect from our physical sensations. Focus on your breath, how your feet feel on the ground, or any physical tension. This grounding technique brings you back to the present moment.
• Engage (E): Instead of getting caught up in your thoughts and feelings, shift your focus to what truly matters. Engage in the present activity, be it a conversation, a task at hand, or simply observing your surroundings.
  
  

Benefits of Dropping Anchor:

• Reduced emotional intensity: By acknowledging emotions without judgment, we lessen their power over us.
• Increased mindfulness: Focusing on the body brings us back to the present, where we can make conscious choices.
• Greater clarity: Stepping away from unhelpful thoughts allows for more rational decision-making.
  
  

When to Drop Anchor:

• Anxiety or panic attacks: Use ACE to acknowledge your anxious thoughts and feelings, ground yourself in your body, and focus on your breath or calming techniques.
• Rumination: When caught in a cycle of negative thoughts, use ACE to acknowledge them, refocus on your body and surroundings, and engage in a different activity.
• Stressful situations: Practice ACE to manage overwhelming emotions, stay present, and navigate the situation effectively.
  
  

Dropping anchor is a skill that takes practice, but it can be a powerful tool for managing difficult emotions and living a more mindful life. The next time life throws you a curveball, remember to ACE your way through the storm and find your inner peace. Here is your map!

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.
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One of the most well-known distress tolerance skills is ACCEPTS. ACCEPTS is an acronym for the following skills:

• Activities: Engaging in activities that you enjoy and find distracting, such as going for a walk, listening to music, or spending time with loved ones.
• Contributing: Doing something nice for someone else, such as volunteering, running an errand for a friend, or simply offering a listening ear.
• Comparisons: Reminding yourself that everyone experiences difficult emotions and that your situation is not unique or hopeless.
• Emotions: Allowing yourself to feel your emotions, even if they are unpleasant. Trying to suppress or avoid your emotions will only make them worse in the long run.
• Pushing away: Putting the situation that is causing you distress on hold for a while, so that you can come back to it later with a clearer head.
• Thoughts: Distinguishing between helpful and unhelpful thoughts. Challenging unhelpful thoughts can help you to reduce your distress.
• Sensations: Focusing on your physical sensations, such as the feeling of the wind on your skin or the taste of food in your mouth. This can help to ground you in the present moment and take your mind off of your negative emotions.

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:

• Activities: Go for a walk, listen to calming music, or do some deep breathing exercises.
• Contributing: Call a friend or family member and offer to listen to them talk about their day.
• Comparisons: Remind yourself that everyone experiences anxiety from time to time and that your feelings are valid. You're doing better than many other people.
• Emotions: Allow yourself to feel your anxiety, even if it is uncomfortable. Trying to suppress or avoid your anxiety will only make it worse in the long run.
• Pushing away: If you are feeling particularly overwhelmed, you might try putting the situation that is causing you anxiety on hold for a while. You can come back to it later when you are feeling calmer.
• Thoughts: Challenge any unhelpful thoughts that you are having about yourself or the situation. For example, if you are thinking "I'm a failure," you could challenge that thought by asking yourself if there is any evidence to support it.
• Sensations: Focus on your physical sensations, such as the feeling of your feet on the ground or the sound of your breath. This can help to ground you in the present moment and take your mind off of your anxiety.

It is important to note that there is no one-size-fits-all approach to using ACCEPTS. What works for one person may not work for another. The best way to find out which skills are most helpful for you is to experiment and see what works best.
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Tips for using ACCEPTS
Here are a few tips for using ACCEPTS effectively:

• Be creative. There are many different ways to implement each of the ACCEPTS skills. For example, if you are not sure what activities to do to distract yourself, you can try making a list of things that you enjoy doing and then choosing something from the list.
• Be patient. It takes time and practice to learn how to use ACCEPTS effectively. Don't get discouraged if you don't see results immediately.
• Be kind to yourself. Everyone experiences difficult emotions from time to time. It's important to be patient and understanding with yourself when you are feeling distressed.

ACCEPTS is a powerful set of skills that can help you to manage distress in a healthy way. It is important to note that ACCEPTS is not a magic bullet. It will not eliminate all of your negative emotions. However, it can help you to cope with them in a more effective way. If you are struggling to manage your emotions, talk to a mental health professional about learning ACCEPTS and other distress tolerance skills.

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

Temperature
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.

Intense exercise
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
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:

• When you are feeling stressed or overwhelmed
• When you are having a panic attack
• When you are feeling angry or upset
• When you are trying to cope with a difficult situation
  
  

It is important to practice using TIPP skills when you are not feeling stressed so that you can use them effectively when you need them.

Here are some tips for using TIPP skills in everyday life:

• Identify your triggers. What are the things that typically make you feel stressed or overwhelmed? Once you know your triggers, you can start to practice using TIPP skills when you are exposed to them.
• Have a plan. Decide which TIPP skills you are going to use in different situations. For example, you might decide to splash cold water on your face if you start to feel anxious in a social situation.
• Be patient. It takes time and practice to learn how to use TIPP skills effectively. Don't get discouraged if you don't see results immediately. Just keep practicing and you will eventually get the hang of it.
  
  

If you are struggling to use TIPP skills on your own, consider working with a therapist who is trained in evidence-based therapies. They can help you to learn how to use TIPP skills effectively and develop a distress tolerance plan.

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!