Radical Acceptance is a distress tolerance skill in Dialectical Behavior Therapy (DBT). It teaches us to accept things as they are, completely and fully. It means not resisting, or not attempting to change. Rather it means seeing things as they are.
 
This can be a challenging skill in DBT! It can be hard to look at our problems and say “I accept it for exactly what it is.” We want to change things that are unfair, painful, or problematic. But radical acceptance forces us to look at something and say, “it is what it is.”
 
It’s important to clarify with this skill that it doesn’t necessarily mean that we are approving of something. Acceptance does not mean approval. It does not mean we have to like something. It simply means we recognize the facts of the situations.
 
Acceptance also doesn’t mean agreeing. I can accept that something is happening without agreeing with it. For example, let’s say you’ve asked your boss for a raise, and your boss says no. Despite the fact that you’ve worked late, taken on extra projects, and have definitely earned your raise. You might completely disagree with this decision, and you can still radically accept that this is the final decision.
 
Radical Acceptance does not mean that we tolerate abusive behavior. Radical Acceptance does allow us to recognize abusive behavior, however, and help us decide how to respond to it. Once I recognize that something is happening, once I radically accept it, I can then decide how to respond to it. Moreover, by accepting our pain, we reduce our suffering. As the famous saying goes, “Pain is inevitable. Suffering is optional.” Radical Acceptance helps us reduce suffering.
 
As with all of our DBT skills, Radical Acceptance takes a lot of practice. It is not easy to accept things as they are. To practice, start first by practicing small things. If it’s raining out and you were hoping to go on a hike, radically accept the weather. If you wanted to pick up a bottle of olive oil and the grocery store is already closed, radically accept that you’ll go to the store the next day. As you feel comfortable practicing these smaller instances, you’ll be able to start practicing radical acceptance with bigger issues that come up for you.

IMPROVE the moment is a distress tolerance skill in Dialectical Behavior Therapy (DBT). It is a skill to help us in the midst of challenging times. It doesn’t necessarily mean that we automatically feel better, but it can help us from feeling worse.
 
I: Imagery
Use imagery to help you cope. You can imagine yourself in a safe place. You can imagine yourself coping with the difficult situation you’re experiencing in an effective way. You can imagine a place that makes you feel happy. Any images that help you feel safe and calm.
 
M: Meaning
Make meaning out of your pain. This can be a challenging skill, because at times, we aren’t ready to make meaning. There are times, however, when we can look at a painful experience, and see what we can learn from that experience or how we can grow. We can also make meaning by finding moments of gratitude within our pain. For example, we can express gratitude for a friend or loved one who supports us in our pain.
 
P: Prayer
Prayer can mean many different things! It can be praying to God, or it can be praying to a higher power. Prayer can be connecting with Wise Mind, meditating, or setting intentions. It can be going on a hike and taking in nature. It can be volunteering and connecting with your larger community. Prayer can be anything that allows you to connect with a higher power.
 
R: Relax
Engage in relaxing activities. Take a gentle yoga class or practice deep belly breathing. Try a half-smile meditation. Take a hot bath or shower. Drink a cup of your favorite tea. Hug a friend or family member. Watch your favorite movie snuggled up in your favorite blanket.
 
O: One Thing in the Moment
Similar to the DBT mindfulness skill, One-Mindful, be mindful of what you are doing, and only do one thing at a time. So often, we multitask. Instead, put down your cell phone, stop scrolling through social media, turn off the television, and just do one thing in the moment.
 
V: Vacation
Give yourself a vacation! This can be a week-long European destination trip, or it can be a brief 10-minute vacation in your mind. It could be imagining yourself going on a dream vacation, or it can even be giving yourself a few hours, removed from work, and watching your favorite TV show.
 
E: Encouragement
Be your own cheerleader! Talk to yourself the way you would your best friend who might be struggling. While this can be challenging to do, tell yourself all of the ways you are coping well. Encouraging statements like, “you got this!”, or “you’re doing a great job,” can help us in challenging times.

When our emotions become overwhelming, it can be hard to respond to them. If we feel depressed, we might feel stuck or trapped, and all we want to do is sit on our couch and mindlessly scroll through Instagram. Other times, we can feel so angry that we want to punch a hole in the wall.
 
But, instead of getting stuck on our couch, we call a friend and go for a walk. Instead of punching a hole in the wall, we pause and take some deep breaths. This is the Dialectical Behavior Therapy (DBT) skill, Opposite Action to Emotion.
 
Opposite Action to Emotion is a skill that helps us actively and behaviorally do the opposite of what we are feeling. Our emotions can often attempt to dictate our behaviors. And, our behaviors can directly impact our moods. Thus, if we do the opposite of what we are feeling, we will change our mood, and start to feel better.

How Does it Work?

Our thoughts, feelings and behaviors are all connected. For example, if I think, “I’m a loser, I have no friends, and everyone hates me,” I will start to feel sad or depressed. As a result of feeling sad or depressed, I might pull away from those who love me. I might binge eat, or misuse substances. But, if we were to change my thought to, “Right now, I feel lonely,” we might reach out to people we trust.  

How to Practice Opposite Action to Emotion
First, identify what you are feeling. Name your emotion: sad, angry, depressed, anxious, worried, irritable. Once we can label our emotion, we know what we need to do to change it.
 
Next, do the opposite of what you are feeling. For example: 
If you're feeling sad, do something that makes you happy: go for a walk, pet your dog, call your best friend, or watch a funny movie.  
If you're feeling angry, do something soothing: wrap up in a soft blanket, light a candle, drink a cup of hot tea, or meditate.
If you're feeling anxious, do the thing that makes you anxious (but be safe. If you are anxious about walking home alone at 3am, don’t walk home alone at 3am)! If you are scared to speak to someone, speak to them. If you are nervous to go out, go out. If you are scared to ask for a raise at work, write out what you want to say and then ask for that raise!

The idea is that we stop engaging in behaviors that amplify our unwanted feelings, and start engaging in behaviors that help us feel better. As with all DBT skills, this takes time and practice in order to see results.
 
Create your own list of actions you can take when you are experiencing difficult feelings. What are the things you do that are opposite from how you are feeling?

Self-soothing is a distress tolerance skill uses our senses to calm ourselves. We use our senses to soothe ourselves when we are feeling on edge, nervous, distracted, dissociative, or any other unpleasant feeling we might be experiencing. Our senses can ground us in the present, and help us regulate our emotions. When using this skill, try different methods to soothe using your senses. You might find some techniques are more effective than others.
 
Self-Soothing with Sight
Look at images that soothe you. Find phots of a beach, a mountain, someone you love, or an animal. If you are able to, go out into nature and look at your surroundings. Watch videos of waves rolling or fish swimming. Look at photos from a vacation you took.
 
Self-Soothing with Sound
Listen to soft music, or classical piano. Listen to nature sounds, such as rainfall or ocean waves. Open your window and notice all of the sounds you hear. Play an instrument you enjoy listening to.
 
Self-Soothing with Touch
Put on your favorite sweater, or your softest pajamas. Rub lotion on your skin. Take a bath or shower and notice how the water feels. Get cozy with clean bedsheets. Pet your dog or cat. Hug someone you love.
 
Self-Soothing with Taste
Cook something you enjoy eating, and then eat it (this also can use your sense of smell!). Eat your favorite piece of candy. Drink a cup of hot tea, coffee, or hot chocolate. Eat your favorite comfort foods.
 
Self-Soothing with Smell
Light a scented candle. Bake your favorite desserts and notice the smells. Use lavender oil in an oil diffuser, or use lavender scented lotion. Smell your fresh laundry as it comes out of the dryer. Smell flowers in your yard.
 
For more information on how to use Self-Soothing, listen to our latest episode, “”DBT Skill: Self-Soothing” on our podcast, Taproot Therapy: A Mindful Moment.

​We all like to feel accomplished. We like to feel that we are good at something. Knowing that we are skilled in certain areas helps us feel grounded and regulated. It can also increase our feelings of happiness.
 
Building Mastery is an emotion regulation skill in Dialectical Behavior Therapy (DBT), that helps us build awareness of, and practice, things we do well. Emotion regulation skills support us in both becoming aware of our emotions, and mindfully responding to our emotions. Thus, when we build mastery in something, we are able to respond to emotions in a supportive and mindful manner.
 
There are two ways we can build mastery:
1.Recognize the things you are already doing well.
2.Learn something new and watch yourself grow.
 
The first way to is recognize those things we are already doing well. Maybe you are really good at leading team meetings at work. Or, you cook an amazing chicken stir fry. Some of us are skilled knitters and painters. Others of us have excellent driving records. Identify all of the things that you are already doing well, and notice how you feel when you do those things. 
 
The second way we can practice building mastery is by learning new things and witnessing ourselves gaining competence in new skills as we practice them. Think about when you first learned to drive as a teenager. At first, it was a new skill, and you had no idea how to drive. You might have felt frustrated, angry, and you might have even dreaded getting into the driver’s seat! Now, think about how you felt when you passed your drivers’ test and got your license. You probably felt a big sense of accomplishment! When we learn new things, and when we watch ourselves grow, we feel excited and proud.
 
What are some ways you build mastery?

​In the Netflix show, “Unbreakable Kimmy Schmidt,” the title character, Kimmy, has to turn a crank. It’s an endless and meaningless activity that she is forced to do. To get through the activity, she counts to 10. And when she gets to 10, she starts again. Kimmy states that she can do anything for 10 seconds.
 
There’s research that supports this! Researchers estimate that our feelings only last approximately 90 seconds. It’s a bit longer than 10 seconds, but 90 seconds is astonishingly short.

Practicing Riding the Wave
Riding the Wave of Emotion is a distress tolerance skill. Imagine your feeling as if it were a wave. It starts small, barely noticeable. It grows, until it reaches its peak. The peak of that wave lasts approximately 90 seconds. And then, our feeling naturally starts to decrease in intensity, until it subsides completely. While the entire wave of emotion might last longer than 90 seconds, the emotion at its most intense point will be short lived. In order to practice this skill, you simply have to be mindful of how you are feeling, and where you are on that emotional wave.
 
This skill allows you to track your emotion as it hits the peak and declines. This skill is helpful when you are feeling overwhelmed by emotion, but aren’t necessarily sure how to respond to it. By simply being present to the wave, you are responding to your emotion!  This is also a helpful skill for navigating urges. Our urges, just like our emotions, will subside. Urges can include self-harm, overeating, using substances when you don't want to, or any other habits you are hoping to break. 
 
Considerations
This skill is also helpful because there are times when we want to remain upset, anxious, angry, or whatever big feeling we are experiencing. And yet, as with all things in our lives, our emotions have a natural start and end point. They come and go. And when it is time for them to subside, this skill can help us do that. If you start to feel yourself trying to climb back up to the peak of the emotional wave, remind yourself that emotions are meant to crash on the shores, just like waves.

Taking care of our relationships is integral to our emotional wellbeing. But, we also want to care for ourselves in our relationships. By setting our boundaries and practicing self-respect, we improve our relationships and ourselves! FAST is an interpersonal effectiveness skill in Dialectical Behavior Therapy (DBT) that helps us do that.
 
 
F: Fair
 
Be fair to yourself by honoring your values and your boundaries. More importantly, don’t put others’ needs before your own. We have to be fair to ourselves and prioritize ourselves in order to be supportive of others.
 
A: Apologies
 
Apologize when necessary, but don’t apologize when one is unwarranted. We apologize so often when one is not needed. Don’t apologize for your presence, for your opinions, or your thoughts. Rather than apologize when you don’t need to, express gratitude to the other person. (For example, instead of saying “I’m sorry for being late,” say, “Thank you for waiting for me!”).
 
S: Stick to your values
 
First, identify your values. Once you have identified what your primary values are, you can stick to them. Don’t abandon your values when in relationship with others. Honor your values – these are the things you feel shape your life! Values are important, and by honoring our values, we stay true to ourselves while in relationships with others.
 
T: Truthful
 
Tell the truth! There is a saying therapists have: if a client is lying in session, they are lying to themselves. And the same might be true in our other relationships. Being honest in your relationships and with yourself helps honor others. It fosters relationships and builds safety in relationships.
 
How does the FAST skill work for you?