What Are Distress Tolerance Skills?

The Nystrom & Associates provider consulted for this article is Melissa Johnson, Psy.D, LP, Dialectical Behavioral Therapy and Outpatient Therapist  Uncomfortable situations are bound to happen in life. Whether it is as simple as running out of your favorite creamer for your coffee, or as painful as losing a loved one, we all experience stressful and uncomfortable times. However, our ability to handle challenging emotions is where distress tolerance comes in.  Distress tolerance skills are part of the four modules taught in Dialectical Behavioral Therapy (DBT). DBT teaches individuals how to regulate their behaviors and emotions effectively. In addition, DBT treats a wide array of mental health disorders, such as personality disorders, chronic depression, and anxiety disorders, eating disorders, and addictions. The other three modules include interpersonal effectiveness, emotion regulation, and mindfulness. 

Related: 3 Emotion Regulation Mindsets to Adopt in 2022

What Is Distress Tolerance?  

First, let's dive into what distress tolerance is. Essentially, distress tolerance is the ability to manage real or imagined emotional distress. While everyone experiences stressful times, such as losing a job, getting into an argument, or making a mistake, your ability to handle those situations without making it worse is distress tolerance.  Those with low distress tolerance have a challenging time handling stressful situations and may find them overwhelming. This can lead to unhealthy ways of coping, such as substance abuse, avoidance, and anger.   Related: 5 Ways to Prevent Substance Abuse  As put by Melissa Johnson, the desired outcome is to apply a variety of skills to the situation at hand.
The goal with distress tolerance is to not make the situation worse. If you got through a difficult situation without making it worse... Congratulations, you used distress tolerance. So, when you are evaluating your effectiveness keep that in mind. Once the distress is down you need to move into using other skills to change the situation, regulate emotions, or address issues with others.
For instance, there are many skills that can be learned to decrease distress. For more information on distress tolerance, visit the distress tolerance specialty page.  

What Are Distress Tolerance Skills?  

Distress tolerance skills are in-the-moment ways to slow down the emotional response to a situation. They are not meant to use as problem-solving tools, rather, they work to manage difficult emotions.   “Distress tolerance skills are not a lifestyle. They are a set of skills to use when there is no option, we are not able to use other skills, or the timing is not right for solving a problem.” In other words, these skills are utilized to work through the emotion at the moment, so more effective tools can be used later solve the problem at hand.  For example, some specific distress tolerance skills include:  
This skill helps people shift their focus to a more positive or neutral state. So, rather than sit with uncomfortable emotions, you distract yourself with an enjoyable activity such as a hobby, self-care practice, or visiting with friends.
Second, self-soothing involves utilizing the five senses to handle difficult moments. Sight, sound, taste, touch, and smell are all ways you can nurture yourself in the moment and self-soothe. For example, light your favorite candle, sip a cup of tea, or focus on the feeling of a soft blanket.
Improving the Moment
Next, you can implement the skillset of improving the moment. The acronym for the third distress tolerance skill is IMPROVE.
  • Imagery: Visualize yourself in a soothing place and picture stress melting away.  
  • Meaning/purpose: Find the positive in a situation, aka, the unseen benefit.  
  • Prayer: You can choose to say a prayer to a higher power for strength. 
  • Relaxation: Practice relaxation techniques such as mindful breathing or listening to calming music.  
  • One thing: Focus on one thing in the present moment.   
  • Vacation: Take a mental break from the situation. This could be through your imagination or taking time for yourself.  
  • Encouragement: Talk to yourself in a compassionate, positive manner. 
Related: 5 Effective Stress Management Tips
Focusing on Pros and Cons
Finally, the last skill includes making a list of the pros and cons of tolerating the distress and not tolerating the distress. Looking at the long and short-term effects of successfully managing emotions can help reduce impulsive reactions.

A Word From Nystrom & Associates 

You can learn to apply these skills and improve your relationships and well-being. Distress tolerance skills are taught in DBT, which is available at Nystrom & Associates. Request an appointment online or call 1-844-NYSTROM to get scheduled with a qualified professional.  Related: How Interpersonal Effectiveness Improves Your Relationships 

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