Thursday, June 2, 2016

Distress Tolerance and Acceptance

Distress Tolerance and Acceptance

Karen Connell, LPC, COTA/L

When faced with hard situations or strong emotions in life we find ourselves looking for relief from experiences that seem overwhelming or all consuming. We often focus on changing circumstances or events to relieve ourselves of the distress caused by the circumstances. Reality is, however, that we will experience pain and distress as a part of life. Anxiety, worry, fear, shame, sadness, anger and more are all human experiences- believing they are uncommon or should be easily avoided can create more pain and distress for ourselves.

Our efforts are more effective when we understand that we have options of how to deal with strong emotions. Yes we can try to affect the situation or change circumstances and we can be successful in doing so. It is important to see yourself as effective in these areas.  However, the goal of tolerating or accepting distress and suffering in the moment is truly a skillful option of managing the emotionally overwhelming moments to find peace for ourselves. Learning to accept and find meaning for these strong and uncomfortable emotions is an opportunity for your growth in relation to yourself and your perception of these struggles.

The beauty of this lesson is that in tolerating distress we find we are capable of coping through a difficult situation- “making it through without making it worse” and in practicing acceptance of distressful moments we find freedom from the fear, anxiety, worry, pain or suffering that we long to escape. When we resist emotions the power within them seems to grow. When we stop resisting them and see them for what they are: a current situation or experience we are having that we may or may not be able to change or control- their power diminishes. Trying to avoid pain generally leads to more problems than it solves. Obsessively avoiding stressors that cause pain or grieving without resolve are two examples of ensuring the pain will only continue.

Acceptance of unwanted emotions is a difficult concept for us to understand and embrace. It is most important to distinguish between accepting or tolerating distress in the moment and approving of the distressful situation. Just because we aim to accept these circumstances does not equal our approval of them. Practicing acceptance involves seeing reality for what it actually is- without attachment to it or judgment of it. It is letting go of our biases and opinions of how something should be (trying to push it away or telling ourselves it should be different), and instead finding what actually is at this moment. When we mindfully look at the moment we are in- however overwhelming or infuriating it may be- we can see it as just the moment we are in, causing emotional responses, thoughts and feelings. It is freeing when you can get to that place in a moment of emotional chaos or overwhelm.

For example, we can accept the fact that our loved one is in an unhealthy relationship we cannot get them out of, but we do not approve of this relationship. We can tolerate that our parent does not endorse our choice in career, but we do not approve or agree with their opinion or judgment. We can tolerate painful feelings of being alone or uncertain about our future and not approve of them as a way of life for ourselves. Releasing the attachment we have to these emotions and situations is a very powerful and healthy thing we can do for ourselves in times of high distress and emotional chaos.

Acceptance of emotions in the moment can be done in a practice of observing the breath while distressed. We quietly turn our attention to our breathing and notice ourselves in this moment as we actually are- no judgment, no fighting against the emotions- just recognizing the strong experience we are having of sadness, fear, pain or overwhelming frustration. Observing the breath brings us into the moment and accepts what is. With time this practice quiets the emotions and we are loosened from their grip. Radical Acceptance is a concept of saying to oneself when in the moment “the past is in the past” “it is what it is” “I can’t change what has already happened” “this moment is an accumulation of so many previous moments in which people were doing the best that they could”. This is powerful when current or past situations are the source of our distress.

Since we are not always able to accept strong emotions in the moment we must at times just tolerate them and do the best that we can until they have passed for the time being. The idea is to deal with the strong sometimes almost intolerable feelings and get through without making it worse. As said earlier when faced with strong emotions we can be reactive when trying to avoid them and create more problems as a result. At other times we are not in a situation to be able to process these strong feelings, such as in the workplace, yet we still feel upset, alienated or the like and have to tolerate the emotions.

Tolerating distress in the moment can be done with skills that distract us from the current emotion, reduce contact with the source of the distress or change our emotional experience in the moment. The have a temporary effect and often have to be repeated when emotions are strong in order to get through without acting on our emotions. For example, finding an activity to get busy with like filing, coloring, a game on your phone, cleaning, going to the bathroom, cleaning out emails or any other activity that is accessible to you at the time can change our thoughts, images and physiological experiences in the moment. Finding someone you can assist or focus your attention on to contribute to them in some way shifts our attention to something else and increases our sense of meaning in that moment. Reflecting on other times when things may have been worse, when you have coped in difficult situations previously or comparing your situation to someone who is worse off can all change your perspective on your current situation. Self-soothing with sensations (drink hot tea, listen to calming music or sounds, wash cold water on face, stretch your body, massage your scalp, smelling essential oils) creates a different physiological experience than the negative emotion you were previously experiencing. Prayer, imagery or relaxation exercises are all powerful in the moment ways to tolerate distress and make it through.  These skills are all about making them your own- finding what works for you and trying new things when you feel nothing is working in the moment. And sometimes breathing and practicing acceptance of what it- just in this moment-is the quickest way to honoring our self and finding relief.

Linehan, M. (1993) Skills Training Manual for Treating Borderline Personality Disorder.  



Tuesday, September 3, 2013

Stuck in a Rut in Conflict City.

Managing conflict at work (or home) requires skill - correct that - skills.  Often we use one or two of these conflict resolution techniques and our limited approach offers varying degrees of success or, most likely, causes us problems.  Our conflict toolkit should have five tools in it that we are comfortable using and that are not overused. Before developing these tools we need to establish a positive view of conflict.

Merriam-Webster online defines conflict as a "fight" and this is the definition that can create problems for us.  When we hear the word conflict we often think "war" "battle" "dread", but conflict has a positive side.  The Webster definition preferred for defining conflict is a "mental struggle resulting from incompatible or opposing needs, drives, wishes, or external or internal demands".  This label for conflict allows us to see the opportunity with others when working with differences.  The example I like to use, for instance, follows:  If every time we see Sally we think, "Here she comes ready to pick a fight." we're armed and ready for battle when Sally might be coming to ask us if we want ice cream.

In case you would like to improve your use of the conflict management tools, below is a list of each mode as defined by the Thomas-Kilmann Conflict Mode Instrument (TKI):

Competing - advocating for our own needs and/or the wishes of your company.  This requires first KNOWING our needs and then ASKING for them.

Collaborating - working out a decision that is mutually beneficial to both your needs and that of the other person.  This skill is the most difficult and requires knowing what we want and WHY we want it (our end game) and what the other person wants and why they want it.

Compromising - a quick fix to end conflict requiring both parties to give up something.

Avoiding - walking away when the battle is not worth it.  This tool gives us the ability to prioritize our needs and wants and address the most important issues, letting the lessor items fall off the list.

Accommodating - knowing and meeting the needs of others.

To adequately use each skill (and to refrain from overuse) it is important to establish how much you currently use each skill.  CPP, Inc. sells this assessment to certain professional groups.  This assessment is provided to each client at Happy Brain Counseling, L.L.C. Go To The Website

Do you live to work or are you working to live?

Many working Americans place a great value on the reputation acquired with employers, our company and our colleagues.  We find satisfaction and confidence by being 'good at what we do' and in 'being busy.' Establishing a position as the bosses go-to for problem solving and being in the loop for everything that happens can feel rewarding and promising for longevity within the organization.  The industrious, professional work ethic left unchecked, however, can have a high price.

If you find yourself with a reduced ability to relax and unwind outside of work by enjoying time with family, friends and, most importantly, with yourself, you are not alone.  When you loose the personal side, struggles often begin outside of the office - problems with spouses, life partners, children, our health, and friends stop calling.  We can lose the ability to have fun; to laugh and look forward to new experiences.  Boundaries with employers, fellow employees and the company is important to avoid burnout and to maintain a successful employee reputation over time.    

One sign that you have lost the ability to unwind is a lack of hobbies and interests outside of work to rejuvenate the interesting human you used to be. Another clue may be a lost interest in physical exercise or an addiction to working out that is extreme. Relationship quality with children, spouse or significant other can also be telling.  If you rarely have time or make a occasion to connect with the people you care about - family, children, friends - perhaps too much energy is going to the job and not enough is invested in the mortals in your life.  Life is short and precious. Enjoy it!

At Happy Brain Counseling, L.L.C., working professionals learn to balance their working and home lives and keep the focus that life is meant to be enjoyed and work is only a portion of that experience.  Visit the website to find out more information or call 314/717-0190.