Distress Tolerance – Distract

Distraction is Distress Tolerance skill that is one of my top “go to” items and possibly the easiest. Of course, I also have ADD and distraction is kind of a built-in skill to start with. The basic idea of our Pink Elephant and Blue Donkey is an example of distraction – what can you do to pull your focus off the crisis situation enough so that it becomes tolerable?


In Dialectical Behavioral Therapy (DBT), there are a large number of acronyms to help remember different skills and tools.  When we talk about Distracting, the acronym ACCEPTS helps to offer ideas:

(A)ctivities – Do something. Do you have a hobby? Is there something you would like to try out? Go for a walk or out for a meal. Go see a friend. The key here is to physically do something.

(C)ontributing – Do service. Volunteer or provide another service to another. Help someone or make something for someone. Turn your focus away from yourself and toward another.

(C)omparisons – Think of the starving children in Africa. Ok, that was probably too much, and yet sometimes when we are in distress we get pulled into a vacuum of our own emotions. Take a moment to observe those around you who may not be as lucky. Count your blessings.

(E)motions – Shoot for opposite emotions. Feeling sad? What can you do that makes you happy, even if you don’t feel like it? Watch a comedy, or if you are feeling worked up, what calm down? Research shows music can be a powerful tool for our emotions, have various playlists.

(P)ushing Away – Put the issue “on the back burner.” If possible, walk away from the situation for a time. Now, this does not mean avoid it forever, yet cut yourself off from it. Stop ruminating (thinking about it over and over), talking about it, and letting it affect you. Visualize putting it in a box, locking that box, and putting it on a high shelf.

(T)houghts – Refocus. Change what you are thinking about. Use your observing skill. Count items or even colors in a picture. I used to do jigsaw puzzles to refocus my mind. Not only was this great mindfulness practice, it was a great cognitive exercise.

(S)ensations – This one was taught as using intense sensations such as holding ice in hour hand, squeezing a rubber ball in your hand, listening to loud music, etc. I always avoided this category as I understood my limits and therefore offer my wisdom to you – if you struggle with self-destructive behaviors, avoid this category, at least for a while. I have written in my notes, “no punching things.”


This week, write down 1 – 3 things each day that you did in each of the ACCEPTS areas to help with distress. You might want to assign a number to each item to indicate how helpful it was in distracting you from the situation – for example:

  • 5-was able to use the skill and tolerated the situation
  • 3-was able to cope a bit and it helped somewhat
  • 1-I used the skill and still couldn’t cope with the situation

At the end of the week, review your list and non-judgmentally think about how you did. What things worked better than others? Was there a reason why? Are there other skills you would like to try this week?

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