Learning Center - Dialectical Behavior Therapy - DBT Treatment

The goal with distraction is to get our mind off the issue. We can apply this to stressful things going on in our lives or apply it directly to an urge to “fall off the wagon”. DBT offers a series of tools to get our mind away from potentially damaging thoughts. Remember the acronym: A C C E P T S.

Activities – Find or schedule something to do to redirect the focus. Call a friend and go out for a drive. Watch a movie, go to the gym and exercise, or take a walk. something fun that's as far from whatever dysfunctional behaviors your trying to conquer as possible. Hopefully, you’ll be away long enough to let the drive pass.

Contributing – Do some volunteer work somewhere. If you don't have a regular charity, church, school or other group you support, there's a great site called VolunteerMatch, where I've searched to find volunteer opportunities. They have one time, ad hoc and regularly scheduled volunteer needs there. You can even just call a friend with kids, and offer yourself as a free babysitter for a night.

Comparisons – Compare your situation with someone else in much worse shape. The goal is to put your bad situation in perspective. So, watch a tragic soap opera, read some tragic news stories, call a friend who's in worse shape than you and allow yourself to accept that your own situation could be much worse. This isn't the most effective tool for me, but it does work for some.

Opposite Emotions – Identify the emotion that you’re feeling and find a way to experience the opposite emotion… negate it. So, if you're feeling sad, go do something silly… watch a funny movie or TV show… go to a comedy club. If you're feeling exceptionally upbeat (invincible) perhaps read a sad, tragic book, news story, or watch a tragic movie… maybe even a horror film to scare yourself.

Push away – Dig deep and imagine the thoughts you're having as a physical entity… a couch, table, dresser… then visualize using all your might to push it away, completely out of sight. In your mind, picture an imaginary box… grab the thought and put it in the box. Tape it up, tie it up, put it in another box then visualize putting it in a safe, tossing it out the window, or burning it. Get rid of that thought metaphorically. I recently watched a television show, where a man wrote down his troublesome thoughts, tossed it into plastic container and put it in his freezer. When his freezer was full, he took them all outside and smashed them up.

Thoughts – Put your mind to another task. The trick here is to do some ACTIVE thinking; something with a bit of a challenge. Recite the alphabet backwards and forwards. Do a crossword puzzle, jigsaw puzzle, play a game of chess, or a video game. Go outside and count all the stars in the sky.

Sensations – The idea here is to shock your system with one or more of your senses. When your body is shocked, your lower brain functions kick in and will dislodge your troubling thoughts. Dive into a cold swimming pool, or take a cold shower. Go into your car or a nightclub and BLAST some loud music. Put a rubber band around your wrist and snap it a few times. Hold a bag of ice or frozen veggies against your hand, face, neck or back.

Think these through now, while you're in a good frame of mind, and figure out which of these you think would be easiest to try. Then try them. Honestly, I tried every last one of them, and found a few that work for me at different times. After you've given them a shot, and understand what may work for you, jot them down on a note card and put it in your wallet or purse. Next time you're tempted to reach for one of those ever-present dysfunctional behaviors, reach for the card instead of the behavior. Pick one on the card and try it. Put every ounce of energy into it and see if you're able to make it through. If you're like me, you'll find that different situations call for different distraction techniques. The more you practice using these the more ingrained that response will be. Remember, you need to unlearn the dangerous behavior an learn something more productive that works. It will take time, but eventually it'll become an automatic response.

While learning these, I found it helpful to review and rethink them when the crisis passed. For example, I had a fight with close friend and really felt just awful. I grabbed the cheat sheet, where I'd marked those things I thought would work. I thought "Activities" would work, and I called a friend and asked if we could go out for coffee. I was still pretty upset, so I wound up talking to her about the issue. She wasn't in a great mood herself and wasn't being very supportive, nor was she in a mood to go for coffee. I gave up at that point. Later, though, I reread it and realized that I didn't need a friend, I could have gone for coffee myself. Next time, I though, I could call and put off discussing the situation. Perhaps just going out for coffee and talking about fun things would have worked better. Or, I could have called another friend, if the first one wasn't able. I have lots of examples of where my first, second, third, etc attempts didn't work out as planned. Each time, though, I learned a little more about how to approach it in a more effective way.

Exercise

Go through this list, when you're in a good state of mind.

• List two or three possible ways you can see yourself using each of these. For example, under "Activities" list two (positive and productive) activities that you can see yourself doing and enjoying.
• Then prioritize the list. Number each of the things you listed. Put a "1" next to the one thing that you think would be most practical, and you'd have the most success using. Put a "2" next to the next one, and so on until you've put a number next to everything you listed.
• Finally, take a note card or small piece of paper and write down the top three. Keep this in your wallet, purse, cell phone case, or somewhere that would be convenient to you, and handy when you hit a rough patch.

Practice Assignment

Over the next week or so, when you feel yourself getting upset, or tempted to indulge in some self-destructive behavior, grab the list first and try one of them. You may be able to get yourself out of that state of mind the first time, but chances are, you'll have to try different things until you find something that works.

Also, begin a journal. Each night, spend a few moments before bed and jot down how your mood was that day, and if you hit any crises. Were you able to try anything from your list? If so, what did you try and how effective was it? Is there something you can do next time to make it work better?

As a useful reference, you may wish to check out the Crisis Survival Cheat Sheet.

When you're ready to move on go to: Section 8 - Self-Soothing with Five Senses.

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