What Is Distress Tolerance?

In Dialectical Behavior Therapy (DBT), distress tolerance skills are utilized when a situation is likely not going to change. It helps us to cope and survive in crisis by allowing us to tolerate the short or long term emotional pain.

Distress tolerance skills are generally separated into two different types of strategies:

  1. Strategies to accept life in the moment

  2. Strategies to tolerate and survive the crisis

The reason we want to implement these skills instead of avoiding the pain we feel, is that pain and distress are a natural part of life. Often times, denying this fact can lead to increased pain or suffering. We want to tolerate the moment without engaging in unhealthy coping mechanisms or ‘problem’ behaviors.


Acceptance Skills

By accepting a situation, we are not going to automatically change it. Rather, we are accepting that maybe we did not get what we wanted or things did not turn out how we wanted. When we acknowledge, endure, and accept painful situations, the pain usually decreases rather than increasing.

Acceptance is not:

  • Judging the situation to be good

  • Giving permission for the situation to continue indefinitely

  • Giving up on your options

Acceptance skills include specific activities that help you become more accepting, as well as principles for understanding and accepting reality. This can be: breathing exercises, half-smiling exercises, and awareness exercises. These exercises aim to assist you in accepting and tolerating yourself, the world, and reality. This will help you to stop fighting reality, so you can choose to accept and respond to the situation as it is.


Tolerating The Crisis

Crisis survival skills are just that - doing what works to help you get through the moment of crisis in a healthy way. This can include: distracting yourself, self-soothing, improving the moment, or evaluating pros and cons. These skills aim to reduce contact with things that upset you, help you comfort and nurture yourself, improve your thoughts on the crisis, and keep you motivated to get through it.


To work with a therapist who specializes in distress tolerance, click here.