Building Resilience Through Distress Tolerance Strategies in Dialectical Behavior Therapy

Stress is a natural part of life. Often, the situations causing stress are beyond our control, and trying to change them can increase frustration. Dialectical Behavior Therapy (DBT) offers distress tolerance skills to help people face difficult moments without making things worse. These strategies build emotional resilience and help individuals navigate challenges more effectively. 

Understanding Distress Tolerance

Distress tolerance is the ability to endure emotional pain and stressful situations without immediately trying to escape or change them. It means accepting reality as it is, even when unpleasant or overwhelming, without judgment or approval. 

Marsha Linehan, the creator of DBT, describes distress tolerance as: 

• Perceiving your environment without demanding it be different 

• Experiencing your emotions without trying to alter them 

• Observing your thoughts and behaviors without trying to control them 

This approach reduces impulsive reactions, allowing you to tolerate difficult circumstances and build emotional strength over time. 

Why Distress Tolerance Matters

Trying to avoid or fix distressing events can increase suffering, especially when situations are unchangeable, such as:

• Waiting for medical test results 

• Coping with a difficult coworker 

• Dealing with traffic, long lines, or chronic illness 

Distress tolerance helps you: 

• Stay grounded 

• Make better decisions 

• Avoid harmful behaviors like substance use, self-harm, or emotional outbursts 

How to Build Distress Tolerance Skills

1. Distract Yourself – Shift focus temporarily to regain control using ACCEPTS: 

• Activities: Hobbies, exercise, chores 

• Contributing: Help someone or volunteer 

• Comparisons: Remember past challenges or others’ struggles 

• Emotions: Watch uplifting media 

• Pushing Away: Set distress aside mentally 

• Thoughts: Solve puzzles, read 

• Sensations: Hold ice, take a hot shower, chew gum 

2. Self-Soothing – Comfort yourself using the five senses: 

• Sight: Calming images or nature 

• Sound: Music or nature sounds 

• Smell: Pleasant scents 

• Taste: Enjoy treats mindfully 

• Touch: Soft blankets, warm baths 

3. Improve the Moment – Make the present more bearable: 

• Deep breathing, meditation, or gentle exercise 

• Repeat calming phrases (“This too shall pass”) 

• Visualize peaceful places or outcomes 

4. Accept Reality – Acknowledge situations without fighting them: 

• Remind yourself: “It is what it is” 

• Focus on what you can control, like your response 

• Practice mindfulness to stay present without judgment 

Acceptance doesn’t mean giving up; it allows you to respond more effectively. 

Applying Distress Tolerance in Daily Life

You can use these skills during everyday stressful moments, such as being stuck in traffic, receiving criticism, or managing illness or financial challenges. To cope, try distracting or self-soothing to manage emotions, accept reality to focus on practical solutions, and wait without adding unnecessary suffering. 

Building Long-Term Resilience

Regular practice of distress tolerance strengthens emotional resilience, improves relationships, and supports overall mental health. Incorporate these strategies into daily life by practicing mindfulness or meditation, planning distraction activities, creating a self-soothing kit with comforting items, and reflecting situations where acceptance helped you cope. With consistent practice, distress tolerance becomes a natural response to life’s challenges.

Ready to put these tips into action? Take a coaching journey! Email coaching@peersupportfl.org or visit www.pscflcoach.com/tnc.

References 

Linehan, M. M. (2015). DBT® skills training manual (2nd ed.). The Guilford Press.