Distress Tolerance

Distress Tolerance skills come in handy when the intensity of an emotion or urge leads to a considerable amount of internal discomfort or an increased likelihood of ineffective behaviours occurring. These skills are especially valuable in situations where an individual is unable or unwilling to change a situation – and so it becomes necessary to manage crises and tolerate painful emotions instead.

Unlike the change-based Emotion Regulation skills whereby the aim is to change a situation or emotion, Distress Tolerance skills are acceptance-based and targeted predominantly at getting through a crisis without worsening the situation.

  • These are the ‘Crisis Survival‘ Distress Tolerance skills:

STOP Skill:
     Stop
     Take a Step Back
     Observe
     Proceed Mindfully

TIPP Skills:
(extreme) Temperature – ice diving/ freezing cold shower
                   Intense Physical Exercise
                   Progressive Muscle Relaxation
                   Paced Breathing

Wise Mind ACCEPTS Distraction Skills:
        Activities
        Contribute
        Comparisons
        Emotion (act opposite to)
        Push Away
        Think other Thoughts
        Sensations

IMPROVE-ing The Moment:
        Imagery
        Meaning
        Prayer
        Relaxation
        One Thing In The Moment
        Vacation (mini)
        Encouragement

Self-Soothe: using the 5 senses
       Sight
       Smell
       Hearing
       Taste
       Touch

Pros And Cons Skill: 
If urges to engage in a behaviour are high, write out a list of both the Pros and Cons of engaging in the behaviour, as well as the Pros and Cons of not engaging in the behaviour. This can provide both a space to pause between urge and action. It also may help you take a step back to analyse whether behaving in this way is in line with your long term goals or not, and if the benefits outweigh the risks.

(This Pros and Cons skill can also be used in making decisions that aren’t necessarily urgent within an immediate crisis.)

  • These are the ‘Reality Acceptance‘ Distress Tolerance skills:

Radical Acceptance:
1) Accepting the reality of a situation for what it is.
2) Accepting that the pain evoked by the situation has a valid cause.
3) Accepting that life is still worth living, even though it can also be painful.

Turning the Mind

Willingness

Half-Smiling and Willing Hands

Allowing the Mind: Mindfulness of Current Thoughts

2 thoughts on “Distress Tolerance

  1. Pingback: ‘Contributing’ Is Not Just a DBT Skill, It’s a Life Skill! | Living with Borderline Personality Disorder

  2. Pingback: Happy New Year! Favourite Art Inspirations | Lucia reaches for Freedom

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