BH DBT Skills Distress Tolerance pt2

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DBT Skills Training: Distress Tolerance pt. 2

Radical Acceptance and Willingness
PRESENTED BY: SUSAN SHADLEY, LMSW
PREPARED BY: SUSAN SHADLEY, LMSW & JESSICA WORTINGER, MS LLP CAADC
CONTENT TAKEN FROM SKILLS TRAINING MANUAL FOR TREATING BORDERLINE PERSONALITY DISORDER, LINEHAN, 1993 AND COGNITIVE BEHAVIORAL TREATMENT OF BPD, LINEHAN, 1993
 Masters of Social Work from University
of Michigan
 Mental Health Interpersonal Practice
 5 years experience in Department of Presenter
Corrections
information
 1 year with Department of Veterans
Affairs and
 BetterHelp Credentials
 5 years co-running a DBT Program
facilitating groups and using DBT in
individual sessions
What are Distress Tolerance
Skills & Why do we need them?
 Skills to tolerate and survive a crisis
 Skills to accept life as it is in the moment
 Everyone must tolerate some distress in life
because life is not pain-free
 Attempts to avoid pain often lead to more
problems than they resolve.
 Avoiding pain can lead to problems like PTSD or
pathological grieving.
 Trying to avoid painful thoughts, often makes
them more painful.
 ACCEPT what is from deep within
 Pain creates suffering only when
you refuse to accept the pain
 Deciding to tolerate the moment is
Radical 
acceptance
Acceptance is acknowledging what
Acceptance 
is
ACCEPTANCE is the only way out of
hell
 To ACCEPT something is not the
same as judging it good.
Radical Acceptance – How?
Turning the Mind
 Make an inner commitment to accept
 Commitment is not acceptance – it just
turns you toward the path.
 You must turn your mind and commit
over and over.
 Life Can Be Tough
 Some Things Cannot Be Changed Sayings to Help
 It Is What It Is with Radical
 You May Not Always Agree Or Like It, Acceptance
and that is okay
 Think of a hard situation from
your past that you have
accepted
Radical  Remember right before you found
Acceptance- out about this problem
 Think about how you first felt
Self-reflection when you had the problem
 Think about how you felt when you
acknowledged and accepted the
problem
Principles for Accepting Reality
Willingness Willfulness
 Doing just what is needed in each  Refusing to make changes that are
situation needed
 Focusing on effectiveness  Giving up
 Listening to your Wise Mind, acting  Doing the opposite of what works
from your inner self  Trying to FIX the situation
 Allowing into awareness your  Refusing to Tolerate the Moment
connection to the universe
Examples: Willingness vs. Willfulness
 A game of cards
 It makes no difference to a good player which hand of cards he gets.
 The object is to play the hand you get as well as possible;
 As soon as one hand is played another is dealt.
 Play as skillfully as possible then let go and focus on the next hand of cards
 Batting cages
 the balls just keep coming – if you are willing you may get a hit, and you are more
likely to effectively play – If you are willful you are not even going to try to swing
balls – so you are won’t get a hit – and you won’t learn how to be more effective.
Willing Hands to Accept
Reality
 Hands unclenched, palms up, fingers
relaxed
 Open to receiving
 Indicative an openness and
acceptance
 Opposite action to anger’s body
posture
 Anger is the opposite of accepting, it
says “this should not be”
Mindfulness for Distress Tolerance:
Half-Smile to Accept Reality
 Your brain and your body are connected – so if you
change your expression, you can change your
mood.
 A half-smile is slightly up-turned lips with a
relaxed face. To do this,
 Relax – by letting go or tensing and then letting
go
 If your smile is too tense, it can tell the brain
that you are hiding or masking something.
 By adopting a half-smile, a serene accepting face,
we control our emotions and can become more
accepting.
Questions & Discussion

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DBT Skills Training: Distress Tolerance pt. 2

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