What's Distress Tolerance? Learn How to Manage Your Distress Through DBT

By Krista


Last Updated: October 23, 2022

American philosopher William James once said, “The greatest weapon against stress is our ability to choose one thought over another.”

This doesn’t mean avoiding distress or unpleasant emotions in life. In fact, experiencing negative emotions or events is something everyone goes through at one point in time or another.

“Distress tolerance” is all about learning to manage your response to a situation. In truth, we can’t control every situation that we meet. But we can control our reaction and how we process or cope. 

Distress tolerance skills are actually rooted in Dialectical Behavior Therapy (DBT), which is a type of Cognitive Behavior Therapy (CBT).

So, let’s dive in!

  • What should you know about distress tolerance?
  • How can you use it to manage any distress in your life?



What is the Meaning of Distress Tolerance?

Distress tolerance refers to the ability to manage your emotions without overwhelm and with the eventual goal of returning to equilibrium. In other words, it’s about overcoming life’s challenges, without making those challenges worse. And a lot of it revolves around acceptance.

In turn, these distress tolerance skills can help prevent us from that “out of control” feeling, which can, ultimately, lead down a slippery slope and really impact our mental health.

These skills also include a variety of techniques, which we will explore in a section below (and offer suggestions on how you can use them!).



Why Do Some People Have Low Distress Tolerance?

There are many reasons someone might have a low distress tolerance.

For example, your childhood or adolescence could shape whether you have a high or low distress tolerance. A child who was scolded for showing normal emotions, like crying, might have a low distress tolerance since they aren’t sure how to deal with or cope with intense emotions. 

In fact, if we don’t know how to cope with our emotions, we are more likely to turn to unhealthy outlets, such as anger, drugs, and alcohol. 

Additionally, those diagnosed with mental disorders, such as depression or anxiety, may also have a low distress tolerance.

Personality and other variables may also play a role. For example, individuals diagnosed with ADHD often have a low distress tolerance and struggle to self-regulate their emotional states.

Related Article: Anger Management: 5 Healthy Ways You Can Deal in the Short & Long Term



How Do You Manage Distress? 

Luckily, you can manage your distress tolerance (or work with a therapist to figure out relevant coping strategies for you). Some distress tolerance skills include:

1. Self-Soothing Techniques

This involves relaxation techniques to help improve the clarity of thought. In turn, this can help you approach your situation from a less emotional state, as well as calm your initial reaction. Some ways to do this include:

  • Taking deep breaths and paying close attention to your breathing
  • Going to or visualizing places where you feel calm and relaxed
  • Listening to relaxing music
  • Hugging a friend or family member
  • Sitting in nature and simply listening to it and observing it
  • Playing with your dog or cat
  • Taking a warm bath
  • Journaling

Related Article: Are You Wondering How to Practice Visualization Techniques? We're Here to Help You


2. Distraction

There are tons of ways to do this. Basically, distracting yourself helps you calm down, then approach the situation from this state.

Here’s how you can use this:

  • Perform an immersive activity, such as pottery, craft, painting, or sports
  • People-watch in the park
  • Write a note of appreciation to a loved one
  • Watch a comedy or feel-good movie
  • Cook yourself a delicious meal


3. Practice Radical Acceptance

When you feel out of control, you can feel increased anxiety, fear, depression, and overwhelm.

You might even feel paralyzed. Yet, practicing this technique can help you overcome these extreme emotions and begin to move forward. 

That all-too-common phrase “it is what it is” absolutely applies here.

Often, there isn’t anything we can do but accept it. Whether this involves accepting a loss of a loved one or accepting a new change in your life, accepting what is allows you to take back control. The pressure you feel to “fix” the situation alleviates and you feel better.

And yes, this is hard to do. And yes, it takes practice!

A few strategies that can help here include mantras and journaling. You want to truly approach this situation without judgment and recognize that this has happened.

On the other side of it, you also can accept that it doesn’t have to define you if you don’t want it to. While the situation itself might be out of your control, you are always within your own control (as confusing as that might sound!).


4. The STOP Skill

STOP stands for:

  • Stop 
  • Take a step back
  • Observe your internal and external environment
  • Proceed mindfully

For example, maybe you’re so overwhelmed by work projects that your emotions have got the best of you.

You’re struggling to get anything done.

  • STOP by pausing, then taking a step back.
  • Breathe here.
  • Then, really tune into how you feel and examine what needs to be completed.
  • From there, you can proceed mindfully, determining the best action forward.


5. The TIPP Skill

TIPP is another common distress tolerance skill used by DBT therapists. TIPP stands for:

  • Temperature
  • Intense exercise
  • Paced breathing
  • Progressive relaxation

Basically, it’s a sequence of actions you can follow when you feel intense emotions.

For example, you notice your temperature is quite hot, and you’re sweating. After this observation, try a brief stint of intense exercise. You could bust out 10 burpees or go for a quick sprint round (whatever works).

After this, you use paced breathing to activate that parasympathetic nervous system (your rest and digest system). You can use the 4-4-8 method by breathing in through your nose to a count of four, pausing for a count of four, and exhaling for a count of eight.

Lastly, you perform a round of progressive relaxation. This involves tightening up one muscle group at a time and intentionally releasing and relaxing it. 



Learn How to Manage Your Distress Through DBT!

Use the above distress tolerance skills to improve your mental resilience and feel better.

If you struggle to do this on your own, there is absolutely no shame in seeking out the help of a professional therapist. In fact, we encourage it.

Your mental health matters. And so does your ability to manage your emotions. When you can stay in charge of your mental state, you truly can be capable of anything. In other words, the world is your oyster!

Read Next: Your Ultimate Mental Health Checklist & The 7 Components of Good Mental Health

Photo by Anastasia Shuraeva


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