Ok, after the last post you’re probably thinking, when does this end?? Well, this is the last of it. The Distress Tolerance skills are in-depth for a reason – it’s hard to cope when you’re in crisis or feel completely and totally overwhelmed by something. This last bit is also part of distress tolerance, but it involves how to deal with reality – in other words, how accept what really is and not keep pushing for what we want it to be.

I want to stary by telling you a story about my ex-husband. He had a lot of good qualities, but accepting reality was not one of them. He had an idea that jeans should not cost more than $10, period. He would get very irate and make snide comments about “people charging more than they should” and about how the world wasn’t working the way it should either. Well…the problem is, you really can’t buy jeans for $10 anymore, unless they’re really crappy jeans or on some sort of once-in-a-lifetime clearance sale. So, we’d go to buy jeans, and he’d end up paying more than $10, and then would be in a rotten mood until something else distracted him. The problem here, is that he was making himself (and everyone around him) miserable by not accepting the reality that jeans simply cost more than $10 now. So…the point of this story is that by not accepting reality as it is, you end up hurting yourself (you feel pretty crummy) and your relationships (why hang around someone who is so negative all the time? There’s a reason he’s an EX, right?)

This is a common problem though – we all want the world to work the way WE want it to. I don’t know about you, but when I was a kid, I would say, “But it’s not FAIR!” and my mother would reply, “Well, life’s not fair.” Harsh…but also true. Life is not fair, it’s not the way we want it to be all the time. That’s reality. Kicking and screaming that it’s not right or not fair isn’t really going to change it. So, what do you do? As the serenity prayer says, accept the things you cannot change, change the things you can, and develop the wisdom to know the difference.

The important piece here is Accepting Reality.  There are things you can change, and things you can’t change. The reality is, in a crisis situation, there are things you wish you could change, but simply can’t. So, how do you cope? First, breathe. Breathy deeply, breathe consciously, count your breaths, observe how you breathe, follow your breath while listening to music, walking, talking, etc. You’re going to breathe deeply and consciously to calm your body and your mind. Be mindful here – your breathing will help you get to and/or stay in wise mind. Another technique Linehan recommends is “half-smiling” – this isn’t being all perky “little miss sunshine” – it’s accepting reality with your body. If you relax your face and mouth completely, you’ll notice that the natural expression for your mouth is a half-smile. It’s a serene, relaxed facial expression – and your body can tell things to your brain. Let your body/face relax and your mind will start to follow. Another technique: Be aware – be fully present in whatever you are doing. Be aware of your body posture, your muscle tenseness, your sense of being in the world and the universe, the taste of your morning coffee or tea – whatever. BE AWARE.

The last thing I’m going to discuss here is HOW to accept reality. I’ve already mentioned that there are things we can control and things we can’t. The hardest thing sometimes is accepting that we can’t control all situations, events or people. We can’t make people do what we want them to do, at least not without negative consequences. So, accepting reality means accepting the fact that we dont’ control or run the universe and everyone within it. Radical Acceptance is the term Linehan uses for this technique. It’s radical because it’s complete acceptance of what is. We might like things to be the way WE want them to be, but radical acceptances tells us that things are not that way. I sometimes tell people that they don’t have to LIKE the way things are, but they do have to accept it. Ironically enough, it’s only through accepting what is, that we can really work toward changing it. (Think about it – if we don’t accept reality, how CAN we begin to change it?) Here’s the thing: when you let go of fighting reality, you’re letting go of some of the thing that cause you pain. Sometimes, letting go means accepting that things hurt – like losing an important relationship, or accepting that you may have said or done things that won’t be forgiven. Acceptance is understanding and acknowledging what IS. Acceptance is NOT judging it as good. Remember – you don’t have like it, but it is what it is.

Accepting reality also means that we have a choice here. We can choose to not accept and keep fighting, even when it causes us pain or more distress, or we can choose to accept it and work on what we can change and how we react. Linehan calls this “turning the mind” and it means you commit to making the choice to accept. And you may have to do this many, many times – it’s a hard thing to learn, when your habit has been not accepting reality. You also want to be willing and not willful. What’s the difference? Willful is not doing what’s needed, not accepting, and refusing to tolerate the moment. Willfulness ends up hurting us – it’s the opposite of doing what works, is focused on being right above all else, and is trying to control, fix, or run every situation. Willing on the other hand is doing what works, listening to your wise mind, and accepting reality. Willingness is focused on being effective, not on being right. The bottom line is that being willing means opening up to changing the way you do things, the way you react to situations, and the way you work in the world. It’s being effective – and that’s what will help you get through crises.

Some good links:

DBT Self-Help (http://www.dbtselfhelp.com/index.html) is one person’s interpretations of the handouts used in DBT skills training. Although they are NOT the ones used in a skills training group, the author is someone who has been through skills training and has decided to share her notes and resources.

Marsha Linehan’s website (http://www.behavioraltech.org/index.cfm) has a tab with DBT resources on it that you might find helpful.

 Ok – that wraps it up for the introduction to DBT skills. If you’re interested in working on these in a group, Dr. Linehan’s website has a list of therapists who work in this area – they should be able to help you find a group. As always, if you have any comments or questions, please feel free to contact me: theothersideofthecouch@live.com

Please Note: The content on  this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral.

If you are in crisis or danger, please call 911 for immediate help. Please, again, realize that seeking out help really IS a sign of strength and not a sign of weakness. You don’t have to be alone in facing these things – there are people who care and who will help.

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