Distress tolerance is a dialectical behavioral therapy (DBT) skill. It refers to an individual’s ability to tolerate and manage distressing (anxious or upsetting) emotions that result from situations that are out of one’s control. Distress tolerance is an important skill that allows individuals to regulate their emotions and manage stressful situations effectively. It involves being able to withstand emotional hardships without resorting to unhealthy coping mechanisms such as substance abuse or self-harm. Distress tolerance can be developed through a variety of techniques.
Distress Tolerance Techniques
Radical Acceptance
One effective technique is radical acceptance. This technique involves fully accepting a difficult or unpleasant situation without judgment or resistance. It involves acknowledging and embracing the reality of the situation, even if it not what we would like it to be. This skill can be challenging, but is a powerful tool for managing difficult emotions and reducing stress. It helps us let go of what we cannot control, focus on what we can control, and therefore lead to a greater peace of mind and emotional well-being.
Self-Soothing with Senses
Another technique is self-soothing with your senses. This refers to using healthy coping mechanisms to calm oneself down during times of distress. The five senses – sight, sound, touch, taste, and smell – can be powerful tools for self-soothing. Here are some ways to self-soothe with each of the senses.
Sight
Visual stimulation can be calming and soothing for some people. Some ideas include watching calming videos such as nature scenes or a peaceful aquarium. You can also try looking at calming colors such as blue or green, or simply taking a break and looking out the window at nature.
Sound
Sounds can be used to create a calming environment. Some people find soothing sounds such as white noise or nature sounds to be helpful. Relaxing music, guided meditations, or even simply listening to the sound of your breath can also be effective.
Touch
Tactile sensations can be soothing and grounding. Some ways to self-soothe with touch include hugging a pet, taking a warm bath or shower, using a weighted blanket, holding a stress ball or other fidget toy, or simply touching and feeling different textures, such as soft fabrics or smooth stones.
Taste
Taste can be a powerful sense for self-soothing. Some ideas include drinking a warm cup of tea or hot chocolate or enjoying a favorite comforting food or snack. You can also try chewing gum, or simply savoring a piece of candy or chocolate.
Smell
Aromatherapy and scent can be a powerful tool for self-soothing. Some ideas include using essential oils and lighting candles with soothing scents. Try taking a relaxing bath with bath salts, or simply smelling some fresh flowers.
Distraction (A.C.C.E.P.T.S.)
Distraction is a useful distress tolerance skill that involves diverting attention away from the source of distress and focusing on something else. A.C.C.E.P.T.S is an acronym that outlines six different types of distractions that can be used as a coping mechanism in moments of emotional distress.
- Activities
- Contributing
- Comparisons
- Emotions
- Pushing away
- Thoughts
- Sensations
Examples include engaging in a favorite hobby or activity (Activities), doing something nice for someone else (Contributing), comparing a current situation to a previous, less stressful one (Comparisons), or simply focusing on the sensations in the body, such as the feeling of the breath (Sensations). The key to using this skill effectively is in choosing distractions that are healthy and positive. Then, use them as a temporary measure to reduce the intensity of distress until you are able to address the underlying issue. Distraction can be an effective tool for managing difficult emotions and promoting distress tolerance.
Review of Distress Tolerance Techniques
Distress tolerance skills are a critical component of emotional well-being and can help individuals manage difficult emotions in healthy and positive ways. Radical acceptance involves acknowledging and accepting difficult realities without judgment or resistance, which can be challenging but ultimately leads to greater peace of mind. Self-soothing with the senses involves engaging the senses to create a calming environment and manage distress, while distraction (A.C.C.E.P.T.S) involves diverting attention away from the source of distress and focusing on something else. By practicing these skills, individuals can develop greater resilience and emotional strength, leading to improved well-being and a greater ability to handle life’s challenges. It’s important to remember that developing distress tolerance skills is a process that takes time and practice, but with dedication and perseverance, anyone can improve their ability to manage difficult emotions and live a more fulfilling life.
About Therapist Bethany Winter, MA, LPC Barnum Counseling
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(n.d.). DBT distress tolerance skills (worksheet). Therapist Aid. Retrieved March 30, 2023, from https://www.therapistaid.com/therapy-worksheet/dbt-distress-tolerance-skills