Distress tolerance
Getting through a bad moment without making the situation worse.
1 min read
Reviewed by Shariq Refai, MD, MBA, FAPA. Verify: ORCID, Wikidata, NPI Registry, all links.
Distress tolerance is the set of skills for surviving intense emotional states without doing something that makes them worse. It comes from dialectical behavior therapy. It is not about feeling better in the moment. It is about getting through the moment safely so that longer term work is possible.
Skills that reliably help
TIP
Temperature, intense exercise, paced breathing, paired muscle relaxation. Fast physiological shifts that turn down the dial when the mind cannot. Cold water on the face is the classic starter.
Distraction, on purpose
Activities, contributing, comparisons, opposite emotions, pushing away, thoughts, and sensations. Not avoidance. Deliberate short term relief so the urge passes.
Self-soothing through the five senses
Something to see, hear, taste, touch, and smell that comforts. Simple, effective, easy to forget in a crisis, so plan it in advance.
IMPROVE the moment
Imagery, meaning, prayer, relaxation, one thing at a time, vacation (a brief one), encouragement. Small pieces stacked to make an unbearable minute more bearable.
Pros and cons of the urge
Before acting on a destructive impulse, list the pros and cons of acting versus not acting. Written down. This delay alone breaks many patterns.
How to use this page
- The skills work best if you have practiced them when calm. Learn them before you need them.
- The goal in a crisis moment is not to feel better. It is to not make it worse. Small.
- After the moment passes, note what worked. You are building a personal toolkit, one hard hour at a time.
Worth knowing
Distress tolerance is not the whole treatment. It buys time. The rest of the work, changing what puts you in the crisis in the first place, happens over months and years. Buying time makes that work possible.
From Marsha Linehan's dialectical behavior therapy skills training. Widely used in individual, group, and self-help formats.
How to cite this page
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Distress tolerance. Shrinkopedia, medically reviewed by Shariq Refai, MD, MBA. https://shrinkopedia.com/library/distress-tolerance/- APA
Shrinkopedia. (n.d.). Distress tolerance. Medically reviewed by Shariq Refai, MD, MBA. https://shrinkopedia.com/library/distress-tolerance/- MLA
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