Distress Tolerance: Riding the Wave Without Crashing

Welcome back to our DBT blog series! In our last post, we talked about Mindfulness—the foundation of all DBT skills. This week, we’re moving into a new area: Distress Tolerance. These skills are all about getting through tough moments without making them worse.

What is Distress Tolerance?

Distress Tolerance helps you survive emotional pain. We all face intense emotions—anger, sadness, fear, shame. Sometimes they hit like a wave, fast and strong. In those moments, we might be tempted to lash out, shut down, or escape through unhealthy behaviors. Distress Tolerance teaches you how to ride that wave, safely and skillfully.

This isn’t about pretending everything’s fine. It’s about accepting that pain is part of life—and building the strength to face it head-on.

Why is Distress Tolerance Important?

When emotions overwhelm us, we’re more likely to do things we regret: say something hurtful, act impulsively, or turn to self-destructive habits. Distress Tolerance skills help us pause, breathe, and make wiser choices—even when things feel out of control.

These skills are especially helpful when:

• You can’t fix the problem right away.
• Your emotions are intense.
• You’re feeling urges to act on impulse.
• You just need to get through the moment.

DBT Distress Tolerance Skills

Here are a few key tools you can start practicing right away:

1. STOP Skill

• Stop: Freeze. Don’t react yet.
• Take a step back: Breathe. Give yourself space.
• Observe: What are you thinking? Feeling? What’s the situation?
• Proceed mindfully: Move forward with intention.

2. TIPP Skills

Change your body’s chemistry to calm your mind:

• Temperature: Splash cold water on your face or hold an ice cube.
• Intense exercise: Jumping jacks, brisk walking—get your heart rate up.
• Paced breathing: Slow, deep breaths (inhale 4 seconds, exhale 6 seconds).
• Paired muscle relaxation: Tense, then release muscles while breathing out.

3. Self-Soothing with Your Senses

Use your five senses to comfort yourself:

• Sight: Look at calming images or nature.
• Sound: Listen to soothing music or sounds.
• Smell: Light a candle, smell a favorite lotion.
• Taste: Sip tea or eat something comforting slowly.
• Touch: Wrap yourself in a blanket, take a warm shower.

4. Distraction (ACCEPTS)

Sometimes we just need to take a mental break:

• Activities (draw, clean, play a game)
• Contributing (help someone else)
• Comparisons (remember past challenges you’ve survived)
• Emotions (watch a funny video)
• Pushing away (put the problem on a shelf for a while)
• Thoughts (count backwards from 100)
• Sensations (hold something cold or textured)

A Gentle Reminder

Distress Tolerance doesn’t fix everything—it helps you survive the now so you can address the root issue later. Think of it like emotional first aid. When you’re hurting, these skills can help stop the bleeding.

Next week, we’ll explore Emotion Regulation, where we’ll learn how to better understand and influence our emotional experience—not just survive it.

Until then, be kind to yourself. You are doing the best you can—and that matters.