Distress tolerance describes your ability to cope with emotional distress and crises without making the situation worse. It’s about getting through tough times without using harmful coping mechanisms. Distress tolerance isn’t about ignoring or suppressing your emotions. It’s about managing them effectively.
Distress tolerance is a core component of dialectical behavior therapy (DBT). DBT offers a structured way to learn and practice distress tolerance skills.
In this article, we’ll explore a variety of distress tolerance skills, including crisis survival strategies, reality acceptance skills, and tolerance-building techniques. We’ll also discuss the benefits of each activity and how you can apply them to real-life situations.
Understanding Distress Tolerance
What is Distress Tolerance?
Distress tolerance is your ability to get through emotionally difficult experiences without doing something that will ultimately make the situation worse. It involves accepting the present moment as it is, without judging it. It’s about surviving a crisis effectively.
Distress Tolerance vs. Emotion Regulation
It’s important to know the difference between distress tolerance and emotion regulation. Distress tolerance helps you manage crises in the moment. Emotion regulation helps you change your emotional responses over time.
You can use distress tolerance skills as a bridge to more effective emotion regulation strategies.
Signs of Low Distress Tolerance
How do you know if you have low distress tolerance? You may:
- engage in impulsive behaviors
- have difficulty managing intense emotions
- tend to make difficult situations even worse
Examples of these behaviors include misusing drugs or alcohol, potentially requiring something like rescue remedy, hurting yourself, or lashing out at other people when you feel overwhelmed. You may also have a hard time tolerating physical discomfort.
Your thought patterns can also signal low distress tolerance, potentially requiring techniques to reprogram your subconscious mind. You may find yourself catastrophizing, thinking in black-and-white terms, and struggling to see beyond the immediate crisis. You might think, “I can’t handle this” or “This is unbearable.” A sense of hopelessness and helplessness often contributes to low distress tolerance.
Distress Tolerance Skills in DBT
Dialectical behavior therapy (DBT) emphasizes distress tolerance skills, which are coping mechanisms that can help you get through emotional crises without making things worse. These skills are divided into two main categories: crisis survival strategies and reality acceptance skills.
Crisis Survival Strategies
These strategies are designed to help you cope with intense emotions in the short term.
- Distracting Activities: Shift your focus away from whatever is causing your distress. You could listen to music, watch a movie, read a book, or do a puzzle. The goal is to divert your attention long enough to prevent the situation from escalating.
- Self-Soothing: Use your five senses to comfort yourself. You could take a warm bath, listen to calming music, smell essential oils, eat your favorite food, or hold a soft object. The idea is to provide sensory input that helps you relax.
- TIPP Skill: This acronym stands for Temperature, Intense Exercise, Paced Breathing, and Progressive Muscle Relaxation.
- Temperature: Put cold water on your face to activate the diving reflex, which slows your heart rate.
- Intense Exercise: Do some brief, vigorous physical activity to release pent-up energy.
- Paced Breathing: Slow your breathing to reduce anxiety.
- Progressive Muscle Relaxation: Tense and release different muscle groups to relieve tension.
- RESISTT: This is another mnemonic for remembering additional crisis survival skills. It stands for Relaxation, Evaluate, Substitute, Involve, Socialize, Think, and Take a break.
Reality Acceptance Skills
These skills focus on accepting difficult situations as they are, which can help you reduce suffering and move forward.
- Radical Acceptance: Accept reality without judgment or resistance. Acknowledge that you can’t change what’s already happened. This doesn’t mean you have to like the situation, but it does mean accepting that it exists.
- Turning the Mind: Consciously choose to accept reality and move on. Make a conscious decision to shift from resisting reality to accepting it. This requires willingness and commitment.
- Willingness vs. Willfulness: Understand the difference between being willing to accept reality and being willful in resisting it. Willingness involves openness and flexibility, while willfulness involves rigidity and resistance.
Building Distress Tolerance
Distress tolerance isn’t something you’re born with; it’s a skill you can develop over time. Here are some strategies to help you build your distress tolerance muscle:
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Practicing Mindfulness: Mindfulness means paying attention to the present moment without judging it. Notice your thoughts, feelings, and sensations as they come and go. Mindfulness helps you observe your distress without immediately reacting. Try a guided meditation or simply focus on your breath for a few minutes each day.
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Developing Healthy Coping Mechanisms: What do you do when you’re stressed? Instead of turning to unhealthy coping mechanisms, find positive strategies for managing stress and difficult emotions. This could be anything from exercise and journaling to spending time in nature or connecting with loved ones. Replace those less helpful habits with things that actually make you feel better in the long run.
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Setting Realistic Goals: Break down big goals into smaller, more manageable steps. Each small win builds a sense of accomplishment and self-efficacy, making you feel more capable of handling challenges. Celebrate those small victories to reinforce your progress.
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Actions Based on Values: When you’re feeling overwhelmed, it can be helpful to connect with your values. What’s truly important to you? Make choices that reflect those values, even when it’s difficult. This can give you a sense of purpose and direction during tough times.
Practical Applications and Tips
Using Distress Tolerance Worksheets
Distress tolerance worksheets offer a structured way to learn distress tolerance skills, gain a deeper understanding of yourself, reinforce what you’re learning in therapy, and personalize your approach to managing difficult emotions. These worksheets can help you:
- Track your progress
- Spot patterns in your reactions
You can use distress tolerance worksheets while you’re in therapy or as a tool for self-help.
Types of worksheets you might find helpful include:
- Crisis plans that outline what steps to take during a crisis
- Self-soothing checklists that remind you of activities that can calm you down
- Radical acceptance exercises to help you accept difficult situations
Integrating Distress Tolerance into Daily Life
Building resilience means practicing distress tolerance skills consistently in your daily routines. Start small with manageable exercises and gradually increase how challenging they are. Consistency is key to developing effective coping skills.
Here are some real-life strategies you can try:
- Physical activity: Releases endorphins and reduces stress.
- Volunteering: Provides a sense of purpose and connection.
- Self-soothing techniques: Offer comfort and relaxation.
- Positive affirmations: Promote self-esteem and optimism.
Distress Tolerance for Children and Teens
You can adapt distress tolerance techniques to be age-appropriate and understandable for kids and teens. Use simpler language and relatable examples, and focus on skills that are easily accessible and engaging.
Parents and caregivers play a critical role by modeling distress tolerance skills and providing a supportive environment. Show healthy coping mechanisms, and offer reassurance and validation.
Frequently Asked Questions
What are the physical activities for distress tolerance?
Physical activities can be fantastic tools for building distress tolerance. Consider intense exercise like running, swimming, or dancing to release pent-up energy. Yoga and Tai Chi can promote mindfulness and body awareness. Even simple activities like going for a walk, gardening, or engaging in a physically demanding chore can provide a distraction and help you cope with uncomfortable feelings.
What is a distress tolerance worksheet?
A distress tolerance worksheet is a tool used in therapy to help individuals identify and practice skills for managing intense emotions. Worksheets might include exercises for identifying triggers, practicing self-soothing techniques, listing pros and cons of impulsive reactions, and developing a plan for coping with future distress. They’re often used within Dialectical Behavior Therapy (DBT).
What is a game to practice distress tolerance?
While not a traditional “game,” activities that require focus and delayed gratification can help build distress tolerance. For example, completing a puzzle, building something with LEGOs, or playing a strategy game that demands patience and problem-solving can teach you to manage frustration and persist through challenging situations. The key is choosing something that requires your attention and prevents you from immediately reacting to distress.
What activities help children with distress tolerance?
Activities that help children with distress tolerance include playing with building blocks, engaging in sensory play (e.g., playdough, sand), reading books, doing art projects, and practicing deep breathing exercises. It’s crucial to provide a supportive and understanding environment, allowing children to express their emotions and learn healthy coping strategies at their own pace.
Wrapping up
Distress tolerance is all about learning to handle tough emotions and get through crises without making things worse.
It’s a really valuable skill for anyone who wants to feel more in control of their emotions and improve their overall well-being.
Building distress tolerance isn’t something that happens overnight. It takes practice and patience. But with consistent effort, you can develop the ability to cope with whatever life throws your way.