DBT Distress Tolerance Skills: An Overview

DBT Distress Tolerance is about Expanding Your Nervous System's Window of Tolerance

What Are Distress Tolerance Skills in DBT?

Distress tolerance skills are a core part of Dialectical Behavior Therapy (DBT) and are designed to help people cope during moments of intense emotional pain or crisis. When emotions feel overwhelming and a situation cannot be immediately resolved, distress tolerance skills offer practical ways to get through the moment safely without making things worse. Rather than eliminating distress, these skills focus on helping you survive emotional surges with greater stability, choice, and self-compassion.

Within an integrative mental health approach, DBT distress tolerance skills work alongside nervous system regulation and trauma-informed care to support safety during periods of high emotional intensity.

Understanding Dialectics in DBT

First, lets define dialectic. Dialectic means to be able to believe there are two (or maybe multiple) ideas or thoughts or feelings that can be true at once. And learning to tolerate this ambiguity.

We all know what it’s like to have mixed feelings about something or to have mixed thoughts about what is “right.” We’ve all had the feeling of being so angry in an argument that we are put into fight or flight mode and then we can only see one point of view. We are blinded by the physiology of our emotions. In fight or flight mode, our focus narrows so we can defend or flee. Our minds and emotions close down.

This either/or reaction is also known as black and white thinking, which is a symptom of depression and other mental health conditions. Getting stuck in black and white thinking shrinks your world and feeds the mental health disorder with a continuous loop of bad feelings. The antidote to feeling overwhelmed from the trap of black and white thinking is leanrign how to tolerate uncomfortable feelings. It's about allowing your nervous system and expansion of your window of emotional tolerance. You learn to accept and tolerate a fuller spectrum of experience. You allow an opening up and allow for other possibilities, thoughts and feelings to exist at once.

But, you say ! I can’t stop the overwhelm that comes with black and white thinking from happening!

So, the DBT Distress Tolerance skills can help you! They are great tools to further your emotional intelligence and reduce psychic pain in your life.

Yes, and some individuals, due to their inherent temperament, upbringing, or a mix of both, can navigate life's spectrum with less distress. However, many can gain from skills training that systematically teaches emotional intelligence and behavioral skills.

With training, we can all get better at tolerating distress. By practicing DBT skills, you can learn to tolerate distress more skillfully and effectively. So you can lead a better life, and not be constantly derailed from your goals by tidal waves of emotion.

When Distress Tolerance Skills Are Most Helpful

Distress tolerance skills are best used during moments when emotions feel intense and there is no immediate solution. When stress, fear, or emotional pain rises quickly and the nervous system shifts into survival mode, these skills offer support for getting through the moment without making things worse. Their purpose is not to fix the situation, but to help stabilize and protect you until it becomes possible to respond with greater clarity and care.

One of the basic ideas behind Distress Tolerance is that pain and distress are a part of life and they can’t be entirely avoided or removed.

So, the first thing about acquiring the ability to tolerate distress is to realize that pain and suffering is part of life and can’t be avoided or removed. And learning to detach from the situation and not judge yourself and others for their reactions helps move you through the immediate crisis.

Distress Tolerance is about tolerating acceptance of yourself, others and situations as they really are. And it’s important to understand that acceptance doesn’t mean approval. There is a learning about the dynamic between acceptance and change.

Learning to tolerate distress is that you use the skills so that you can help yourself move forward, don’t feel stuck in terrible psychic pain and don’t do something impulsive to make things worse.

Distress Tolerance Skills are coping skills to use:

• short term

• when you’re feeling an emotional tsunami

• when all you can is STOP yourself from doing something destructive

• when all you can do is know what NOT to do

• when you can’t think of anything positive to do

• to help you survive a crisis situation without making things worse

• to help yourself survive terrible psychic pain

• to quiet your fight or flight response

• when things feel unfair and all is stacked against you

• when you feel overwhelmed and stuck in bad feelings

• when your thinking brain is offline

What does non-judgmental acceptance of a situation do for you in your life? It helps you live a realistic life where there is still normal pain (as pain is part of life) but not that awful feeling of overwhelm and being stuck. Linehan (2015) describes it like:

Pain + Non-Acceptance = LOTSA suffering and STUCKNESS

Pain + Acceptance = Normal pain (still intense) but

Moving Forward is possible