Coping with Acute Emotional Distress: Crisis Survival Strategies (Part 1)

Author: Kari Kagan, Psy.D.

​In this blog series, we will introduce a variety of skills that you can use to recover from intense emotional experiences.

The acronym ACCEPTS represents a skill from Dialectical Behavior Therapy (DBT) that is designed to help people manage intense emotions until they are able to productively address the situation that is causing the emotions. This skill is particularly useful for coping with situations that cause acute emotional suffering. These tools will help to tolerate intense uncomfortable emotions and once they start to subside, many people feel more equipped to deal with the original cause of distress.
 
ACCEPTS stands for Activities, Contributing, Comparisons, Emotions, Push Away, Thoughts, Sensations. Below I will review each coping strategy in more detail. Not all of these tools will work for everyone, but I encourage you to try as many as possible to figure out which work best for you.
 
Activities: Engage in any healthy activity that takes your mind off of the distressing situation. For example, reading a book, going for a walk, or talking to a friend could be alternative activities that give you a break for a short period of time. An ideal activity would be one that requires your full attention, such as cooking a new recipe.
 
Contributing: Try doing something nice for someone else. For example, spend part of your weekend volunteering at an animal shelter, cook for a friend, or send a thoughtful letter to someone in need. Doing something for others takes us away from our own suffering by shifting our focus to someone else.
 
Comparisons: The goal of making comparisons is to put your current situation in perspective. You could start by comparing yourself to you at a different time in your life. For example, if you can recall a time when when you weren’t doing as well or when you dealt with something more intense than what you are currently going through, this could serve as a reminder of how far you’ve come. You could also try comparing your situation to someone who might be experiencing more suffering than you are, such as someone who is in need of food or shelter. This is not to make you feel bad, but to help get perspective. This might not work for everyone, but it does work for some people and might be worth trying to see if it could work for you.
 
Emotions: Try doing something that generates the opposite emotion of the one you are currently experiencing. For example, if you are feeling sad, watch funny videos; if you are feeling anxious, try taking a few deep breaths.  Doing something that gives you the opposite emotion can help to reduce the intensity of the distressing emotion.
 
Pushing away: When you can’t address a distressing problem right away, it’s ok to temporarily put it aside in order to give yourself a break from it. For example, you can try invoking the image of putting it on a shelf in a closet where it is out of sight but you can go back to it when you want. It is important to remember that pushing away is a useful strategy for taking a break from acute distress, but if a problem is avoided for a prolonged period of time, it could make it worse. It is important to return to the problem once you feel you’ve had enough of a break and are better equipped to deal with it.
 
Thoughts: When your thoughts are consumed by a distressing situation, try distracting your mind with other thoughts, such as reciting the alphabet backwards or trying to name all the states. Temporarily occupying your mind with other thoughts can prevent someone from getting stuck in a negative thought spiral that could lead to destructive consequences.
 
Sensations: Try activating your five senses as a way of snapping out of a distressing emotion or of soothing yourself during a time of distress. For example, try holding ice cubes, taking a hot shower, lighting a scented candle, listening to pleasing music, or eating your favorite food.  Using the senses to distract from acute suffering can be very grounding and can help to stop the distress from continuing to spiral.
 
The ACCEPTS tool provides useful strategies for dealing with acute and overwhelming emotional suffering that could potentially lead to destructive consequences if not dealt with in the immediate moment.  Try using these tools to give yourself a break from the distress with the goal of returning to the situation once emotions are more manageable and you can be more effective in dealing with it.  If you would like more help in learning how to cope with intense emotions, feel free to contact us or another professional who can provide useful strategies for dealing with acute distress. Stay tuned for Parts 2 and 3 of the series for additional tips.