DBT - Distress Tolerance - Part 1

In my last post, I wrote about how using DBT, specifically mindfulness skills, helped me through a rough patch of bipolar symptoms. The skill sets of DBT include mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. In my last post, I wrote about how I used mindfulness  skills to cope with symptoms from bipolar and how those skills can help keep one mentally healthy in general.

Distress tolerance skills were also helpful in getting me through my last rough patch of bipolar symptoms. Distress tolerance skills are similar to mindfulness skills in that many of the skills help one focus in the present rather than fretting about the future or feeling depressed about the past. I’ll spend a couple posts on distress tolerance as there are a lot of skills and several were helpful to me in getting through my last rough patch.

The main distress tolerance skills my therapist had me work on was radical acceptance. Radical acceptance means accepting the world and the moment exactly how it is in that moment. In my post on mindfulness, I wrote about using the observe and describe skills to recognize memories and emotions that may be painful. Using radical acceptance, I work on experiencing the moment, no matter how uncomfortable, and accepting that moment for how it is, without denial and without judgment.

By accepting the situation or emotion without denying it, I’m more able to effectively deal with it. Denial of a situation or an emotion does not get rid of it. By pretending a situation or emotion is not there, it merely prolongs the situation or emotion because one has no opportunity to deal with them.

Radical acceptance was helpful to me as I went through my last bout of bipolar symptoms. When I get into a cycle of symptoms, I can start to feel out of control and begin to worry that I’ll continue spiraling and end up in really bad shape, possibly landing in the hospital. By using radical acceptance, I can stay in the current moment and focus on that moment alone rather than worrying about what may happen in the future.

Using radical acceptance does not mean you have to shrug, say, “it is what it is,” and leave the situation at that. Instead, one can still radically accept something and still work to improve or learn from the situation.

In my next post I'll write more about how to get through difficult moments—both by exploring radical acceptance in more depth and by using other skills and strategies.