distress tolerance

Distress Tolerance

distress tolerance 2Distress tolerance are skills that are taught to a client when they are participating in DBT. These skills help those who tend to experience emotions that are negative as being extremely overwhelming and often times unbearable. Those who have a low level of tolerance for any kind of distress and feel overwhelmed even by medium levels of stress and they tend to react to negative behavior.

Traditional Treatment Lacking

Many of the more traditional treatments tend to focus on trying to avoid painful events or situation, however, with distress tolerance, people learn they are going to face times in life when pain is simply they can’t avoid and the top way to learn to accept this truth is to learn how to tolerate distress in their lives.

Main Key For Distress Tolerance

When it comes to distress tolerance, the main ingredient is the concept of total acceptance. This means that when a client experiences a negative situation that they learn to accept the truth of the experience. They also learn to understand that these experiences can’t be changed. When a client practices this kind of acceptance not fighting the reality of it, they will be far less of a victim to the negative and intense feelings.

There are four skills that can be found in distress tolerance that are listed below:

  1. Distracting oneself
  2. Self-soothing
  3. Improve the moment
  4. Focus on cons and pros

These goals of these skills are to help people to cope with any kind of crisis and learn how to experience distress in their lives without trying to avoid it or make it worse.


This first skill is intended to help people switch their focus from thoughts that are upsetting to more activities that are either neutral or enjoyable. Professionals teach this skill through this acronym ACCEPTS:

  • A – This is for activities that will distract a person by getting involved in enjoyable activities like exercise, hobbies, or visiting with family or friends.
  • C – Teaches clients to contribute and do things to help other people like volunteer work.
  • C – Compare themselves to others who are much less fortunate and find reasons for being grateful.
  • E – Emotions and identifying their negative emotions and to act in the opposite manner in which they normally do.
  • P – Push away the negative and then mentally leave the situation and focus on something that is more pleasant and is totally unrelated to their present circumstance.
  • T – This is for their thoughts and how to divert their attention away from their negative thoughts and feelings and replace them with neutral and unrelated thoughts.
  • S – Using sensations to help distract themselves with different physical sensations by using different senses.


This particular skill used with DBT is known as self-soothing. Clients are taught to use their five senses in order to nurture themselves in order to feel better about whatever negative situation they find themselves in.

  1. Vision – Clients are taught to use their vision to examine lovely things like art, landscape, flowers, or any kind of artistic performance.
  2. Hearing – People are encouraged to listen to some music. It can be soft or lively. They are also encouraged to listen to nature sounds like the waves crashing down on the seashore, water trickling from a fountain, or birds singing in the trees.
  3. Smell – Clients are encouraged to put on their favorite perfume or lotion. They also can light scented candles or bake something that’s very aromatic.
  4. Taste – Encouragement to eat an enjoyable meal or to indulge in a wonderful dessert. Clients are taught to experiment with new flavors or new textures and then focus on the food they’re eating.
  5. Touch – Clients are encouraged to pay attention to their pet or ask someone they know if they can visit with their pet. They also encourage them to give a hug to someone. They are also encouraged to get a massage or wrap up in their favorite blanket.

Improve the Moment

The goal of this third skill for distress tolerance is distress tolerance 3for people to stop using negative mental images and use positive ones instead. They use the acronym IMPROVE for this:

  • I – This is for imagery, like having a client visualize a scene that’s relaxing along with imagining feelings that make negative feelings melt away.
  • M – This is to help people create meaning or some sort of purpose for the difficult circumstance and find the positive in the situation.
  • P – Prayer or praying to their God or whatever higher power they might believe in. Praying to gain strength and to allow themselves to be open in the current moment.
  • R – Relaxation. Clients are encouraged to try and relax by deep breathing and then progressively relaxing all of their large muscles. They are also encouraged to listen to music they enjoy, watch something funny on TV, enjoy a massage or drink some warm milk.
  • O – This is for just one thing in the present moment. This means that the person tries to stay mindful and stay focused on some activity that is neutral at the current moment.
  • V – Vacation time. This means encouraging clients to take some sort of mental vacation from situations that are challenging by doing or imagining doing something that’s pleasant to them. This could be by taking a nice day trip somewhere, ignore emails or calls, even for just a couple of hours.
  • E – Encouragement. Clients are encouraged to encourage themselves. Speak to themselves in a supportive and positive fashion in order to cope with stressful situations.

Focus on the Cons and Pros of Situations

Focusing on cons and pros clients are asked to list both good and bad reasons for tolerating the distress and not tolerating it. Often it’s helpful for them to remember their past consequences of not tolerating the distress. Then imagine how it would feel to tolerate distress and avoid behaviors that are negative.

When clients learn to evaluate the short-term along with the long-term pros and cons, they learn to understand the benefits. These benefits come from tolerating their distress and pain and reducing their impulsive reactions to them.

In Conclusion

Distress tolerance skills can be very valuable tools for helping people to maintain balance when faced with a crisis. It teaches them to accept distress and how to cope with it in a much healthier fashion. When a person practices these skills, they can handle the stressful situations. They also experience less painful feelings. Along with fewer impulses that can be destructive.