Distress Tolerance Skills: Examples for Managing Emotions

Distress tolerance is your ability to cope with emotional pain. It can help you get through a tough situation without doing something harmful to yourself or someone else. If you can’t tolerate distress, you may feel overwhelmed and like you can’t handle difficult emotions.

Distress tolerance skills are a core part of dialectical behavior therapy (DBT). DBT can help you manage harmful thoughts and behaviors and reduce impulsivity.

There are many different distress tolerance skills you can learn. Some examples of distress tolerance skills include:

• Distraction
• Self-soothing
• Acceptance
• Crisis survival skills

One popular distress tolerance technique is called TIPP. It involves changing your body chemistry to manage intense emotions. This article will explore the TIPP technique and other practical DBT skills you can use every day.

Understanding Distress and the Need for Tolerance

We all experience emotional distress from time to time. But what is it, really, and why is it so important to develop the ability to tolerate it?

Defining Emotional Distress

Emotional distress involves intense negative emotions that feel overwhelming. You might feel anxious, sad, angry, or even a mix of these feelings all at once. When you feel this way, it can be hard to think clearly or make good decisions.

When you have low distress tolerance, you might find yourself acting impulsively or engaging in behaviors that are ultimately harmful. People sometimes do self-destructive things to escape the discomfort of intense emotions, even though they know it’s not the best choice in the long run.

Factors Contributing to Low Distress Tolerance

Low distress tolerance isn’t just a matter of willpower. It can stem from a combination of biological and psychological factors. Some people might be biologically predisposed to react more strongly to stress. Things like past trauma and difficult childhood experiences can also play a big role in shaping how well you cope with distress.

Your environment and the coping skills you’ve learned (or haven’t learned) also have a huge impact. If you don’t have healthy ways to deal with difficult emotions, or if you’re surrounded by people who aren’t supportive, it can make it even harder to tolerate distress. Social isolation and a lack of access to resources can also make things worse.

DBT’s core distress tolerance skills

Distress tolerance skills are an important part of dialectical behavior therapy (DBT). They’re designed to help you cope with intense emotions and difficult situations without making things worse. Here are some core distress tolerance skills you may learn in DBT:

Crisis survival skills

Crisis survival skills are tools you can use to get through a crisis. They’re not for everyday problems. The goal is to help you get through a tough time without making the situation worse.

One of the most important crisis survival skills is the STOP skill:

• Stop. Don’t react right away.
• Take a step back. Remove yourself from the situation, if possible.
• Observe. Notice what’s happening around you and inside you. What are you feeling? What are you thinking?
• Proceed mindfully. Now that you’ve taken a moment to observe, choose your next action carefully.

The STOP skill creates space between the urge to react and your actual behavior. It gives you a chance to make a more thoughtful choice.

Self-soothing techniques

Self-soothing involves using your five senses to comfort and calm yourself. It helps you ground yourself in the present moment and reduces emotional intensity.

Here are some examples of self-soothing activities:

• Listen to calming music.
• Take a warm bath or shower.
• Use aromatherapy (like lavender or chamomile) or perhaps consider Bach Flower Remedies.
• Look at pleasant images (like nature scenes or pictures of loved ones).
• Wrap yourself in a soft blanket.
• Drink a cup of tea.

Anything that brings you pleasure and relaxation can be a helpful self-soothing activity.

Acceptance skills

Radical acceptance means acknowledging and accepting reality as it is, without judgment. It’s not about liking the situation or approving of it. It’s about recognizing that resisting reality only increases your suffering.

Acceptance can help you reduce emotional reactivity and find a sense of peace. It allows you to focus on what you can control, rather than what you can’t. When you accept a difficult situation, you can start to figure out how to move forward in the best way possible.

Practical Distress Tolerance Techniques: ACCEPTS, IMPROVE, and TIPP

When you’re in distress, you’re not necessarily looking for a long-term solution. You’re just trying to get through the moment. These techniques can help.

ACCEPTS: Distraction Techniques

The ACCEPTS acronym is a handy way to remember different distraction techniques you can use. ACCEPTS stands for Activities, Contributing, Comparisons, Emotions, Pushing Away, Thoughts, and Sensations. Each one is a different way to shift your focus away from what’s bothering you.

• Activities: Get involved in something you enjoy. Watch a movie, read a book, work on a craft project, or play a game.
• Contributing: Do something for someone else. Volunteer your time, donate to a cause, or simply lend a helping hand to a friend.
• Comparisons: Think about people who are less fortunate than you are. Read stories about people who have overcome adversity. This can help put your own situation into perspective.
• Emotions: Do something that evokes a different emotion. Listen to upbeat music, watch a funny movie, or look at photos that make you happy.
• Pushing Away: Mentally block out the distressing thoughts or feelings for a short period. Imagine putting them in a box and setting them aside. Don’t try to ignore them forever, just give yourself a break.
• Thoughts: Engage your mind in something challenging. Work on a puzzle, read a non-fiction book, or practice a new skill.
• Sensations: Experience intense sensations. Take a cold shower, eat something spicy, or listen to loud music. Be careful not to hurt yourself.

IMPROVE: Improving the Moment

IMPROVE (Imagery, Meaning, Prayer, Relaxation, One thing in the moment, Vacation, Self-encouragement) offers additional strategies for coping. These strategies help make the current situation more bearable.

• Imagery: Picture a peaceful place in your mind. Imagine the sights, sounds, smells, and textures of that place.
• Meaning: Try to find some meaning or purpose in your suffering. Can you learn something from this experience? Can it make you stronger or more compassionate?
• Prayer: Connect with a higher power or spiritual source. Pray for guidance, strength, or comfort.
• Relaxation: Practice deep breathing exercises, meditation, or progressive muscle relaxation.
• One thing in the moment: Focus all your attention on one small task or sensation. Wash the dishes, feel the sun on your skin, or listen to the birds singing.
• Vacation: Take a mental or physical break from the situation. Read a book, take a walk, or listen to music. If possible, take a day trip or a longer vacation.
• Self-encouragement: Offer yourself positive affirmations and self-compassion. Tell yourself that you are strong, capable, and worthy of love and happiness.

TIPP: Managing Physiological Arousal

TIPP (Tip the temperature, Intense Exercise, Paced Breathing, Paired Muscle Relaxation) uses physiological techniques to reduce extreme emotions, and this technique is effective for managing anxiety and panic.

• Temperature: Plunge your face into a bowl of ice water for 30 seconds. This triggers the “dive response,” which slows your heart rate and calms your nervous system.
• Intense Exercise: Engage in vigorous physical activity for 20-30 minutes. This releases tension and energy, and can help you feel more relaxed.
• Paced Breathing: Slow down your breathing to 6-8 breaths per minute. Inhale deeply through your nose, and exhale slowly through your mouth. Focus on your breath and let go of other thoughts.
• Paired Muscle Relaxation: Tense and release different muscle groups in your body. Start with your toes and work your way up to your head. This helps reduce physical tension and promote relaxation.

Distress tolerance skills versus coping strategies: What’s the difference?

People often confuse distress tolerance skills with coping strategies. While both aim to help you deal with difficult situations, they work in different ways.

Coping strategies try to fix the problem that’s causing you distress, while distress tolerance skills help you deal with the emotions that come with the problem. Distress tolerance is about getting through a tough time without making it worse, even when you can’t immediately make things better.

For example, imagine you’re feeling super anxious about an upcoming exam. A coping strategy would be to study and prepare as much as possible. A distress tolerance skill, on the other hand, would be to use paced breathing or another grounding technique to manage your anxiety while you’re waiting for the exam to start.

So, when should you use each approach? Distress tolerance skills are best when you can’t immediately solve or change the problem causing your distress. Coping strategies are more helpful when there’s a clear solution you can work toward.

Common questions and concerns about distress tolerance

Are distress tolerance skills only for people with BPD?

There’s a common misconception that distress tolerance skills are only for people with borderline personality disorder (BPD). That’s just not true. While distress tolerance is a core component of dialectical behavior therapy (DBT), which is often used to treat BPD, these skills are helpful for anyone who experiences intense emotions or has difficulty managing stress.

Can distress tolerance skills help with anxiety and depression?

Yes! Distress tolerance skills can be helpful for anxiety, depression, post-traumatic stress disorder (PTSD), and many other mental health conditions. These skills help you handle intense emotions that come along with these conditions.

What are the goals of distress tolerance?

The main goals of distress tolerance are:

• accepting reality
• managing crises
• reducing impulsivity
• building resilience

These skills are meant to empower you to navigate difficult situations with more emotional stability. Instead of reacting impulsively or getting overwhelmed, you can learn to ride out the wave of intense emotion and make choices that are in line with your values and goals.

Frequently Asked Questions

Putting It All Together

Life throws curveballs; to prevent feeling overwhelmed, it’s important to have essential self-care tips. It’s inevitable. But how you react to those challenges makes all the difference. Distress tolerance skills are vital for navigating those uncomfortable, painful, and downright awful situations without resorting to behaviors that ultimately make things worse. They give you the power to manage those intense emotions without reaching for that drink, sending that text, or engaging in any other destructive coping mechanism you might have.

Learning and practicing distress tolerance skills isn’t a one-time fix; it’s an ongoing process that builds your emotional resilience. The more you use these techniques, the better you become at managing difficult emotions and achieving greater emotional stability. Think of it like exercising a muscle: the more you work it, the stronger it gets.

Mastering distress tolerance isn’t just about gritting your teeth and getting through the pain. It’s about understanding yourself better, learning what triggers you, and developing healthy strategies for coping. It’s about building a stronger sense of self, one that’s capable of weathering the storms of life without breaking. It’s a journey of personal growth, and it’s one that’s well worth taking.