What Distress Tolerance Means in Dialectical Behavior Therapy

DBT

Our everyday lives can throw curveballs our way. Whether it’s going through a breakup, losing a job, or just feeling an overwhelming amount of stress, this distress is part of being human.

How we choose to respond to this distress can make all the difference in our outcomes. This is where dialectical behavior therapy (DBT) and distress tolerance can come into play.

So, what exactly is distress tolerance?

Under DBT, distress tolerance refers to our ability to endure emotional pain in the short term without making anything worse. It’s a survival tactic used to get through the present moment, especially when things feel unbearable. You’re not focusing on solving a problem or pretending everything is fine.

Why Distress Tolerance Matters

therapy session

Here’s a real-world example. Imagine you’re on your way to an important work meeting when you suddenly hit a traffic jam. You’re watching the minutes pass while you haven’t moved more than a few feet. By now, you realize you’re going to be late, and your anxiety is through the roof. You can’t magically fix your situation, but you can choose how you respond. Do you spiral or do you stay grounded?

Distress tolerance skills are specifically designed for these types of crisis situations. Ones where your emotions are intense and there is no quick fix. By using these skills, you can avoid impulsive actions like lashing out or self-harm. Instead, these tools provide you with the tools to ride out the emotional wave.

Key Distress Tolerance Skills

DBT can offer a range of strategies you can use in times of crisis. While not every skill will work for every person, you should explore them to see what fits your needs. Here are some strategies that can be helpful.

TIPP Skills

These are quick, body-based techniques to shift your emotional state and regulate your nervous system. TIPP stands for temperature, intense exercise, paced breathing, and paired/progressive muscle relaxation. Examples include:

  • Holding ice cubes

  • Splashing your face with cold water

  • Running to the end of the street

  • Jumping jacks

  • Deep breathing

  • Box breathing

  • Tensing and relaxing muscles while focusing on breathing

Distraction

Sometimes, the best way to reduce your anxiety is to divert your attention to something else. Examples include:

  • Watching a movie

  • Scrolling through social media

  • Talking with a friend

  • Cleaning an area of your home

  • Organizing a closet

Self-Soothing

Self-soothing involves engaging your senses in a comforting way to reduce your distress and resume a state of calm. This includes:

  • Lighting a candle

  • Listening to calming music

  • Curling up with a cozy blanket

  • Enjoying a favorite meal

Radical Acceptance

This one can be especially helpful when able to be used effectively. Radical acceptance means accepting your reality just as it is, whether or not you like it. You’re making an educated choice to let go of the things that you cannot change or have any control over.

This Goes Beyond Avoidance

A misconception about distress tolerance is that it’s a fancy term for avoidance. In DBT, it’s more complex than that.

These skills are meant to survive a moment in time, but not escape the emotions you’re feeling forever. Once the crisis has passed and you’re able to think more clearly, you can return to problem-solving through your situation.

Practice Makes Perfect

Like any other skill, distress tolerance is something that will require practice. Don’t expect to master it overnight. With time, however, you should notice that challenging situations become more manageable. As these coping strategies work, you'll start to build more confidence, which in turn can be very empowering.

Working with a Therapist

If you’re struggling with managing intense emotions or feel like you’re stuck in patterns that are no longer serving you, DBT therapy could be a great tool to effect change. Book your first session with us to learn more.

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