How To Master Distress Tolerance in Dialectical Behaviour Therapy

Whether you’re facing overwhelming emotions or confronting challenging situations, mastering distress tolerance can empower you to weather life’s ups and downs with greater resilience and effectiveness.

This guide is a starter guide to distress mastery, a phrase that would have made me shudder a couple of years ago. Let’s just dive in…

What is DBT Distress Tolerance?

Distress Tolerance is one of the four core modules of DBT, the other three being:

• Mindfulness skills
• Emotional regulation skills
• Interpersonal effectiveness skills

Distress tolerance skills and strategies are aimed at helping individuals cope with intense emotions and distressing situations without resorting to harmful behaviours. The module emphasises acceptance of reality and finding healthier ways to manage difficult emotions rather than trying to avoid or suppress them.

DBT Distress Tolerance teaches individuals to tolerate distressing emotions and situations by utilising a variety of techniques, such as mindfulness, self-soothing, and crisis survival strategies. These skills help individuals navigate challenging moments without escalating the intensity of their emotions or engaging in destructive behaviours.

What is Building Mastery?

In DBT lingo, building mastery involves setting and achieving small, attainable goals that boost our self-confidence and resilience. Whether it’s learning a new skill, mastering a hobby, or tackling a challenging task, each small victory reinforces our sense of competence and capability. 

By cultivating a growth mindset and embracing the process of learning and growth, we can cultivate a sense of mastery that empowers us to face life’s challenges with courage and resilience.

How To Master Distress Tolerance in DBT

So, using the DBT concept of building mastery that we’ve touched on above, how can we “master” distress tolerance in Dialectical Behaviour Therapy? Well, with practice.

To build mastery in distress tolerance skills, we have to use them. Even when we don’t want to, and when we don’t feel like it—even when they seem stupid. I can’t guarantee that it will help straight away, but I can guarantee that, if you start choosing to use these skills in times of distress, they will eventually become easier to use.

That’s what building mastery is all about.

Here’s a quick step-by-step to building mastery by clinical psychologists at Annabelle Psychology.

6 Distress Tolerance Skills (Brief Guide)

Accepting Reality

The first step in mastering distress tolerance is accepting reality as it is, rather than resisting or denying it. This fundamental shift in mindset allows us to acknowledge and validate our experiences without adding unnecessary suffering. 

By embracing the present moment with openness and acceptance, we free ourselves from the grip of unhelpful thoughts and emotions, paving the way for greater peace and serenity.

💡 Note: This does not mean we have to like or do nothing about the current situation we are in. In fact, accepting reality as it is allows us to then mindfully choose what we do with that information next in line with the facts of what is currently happening around and within us.

Self-Soothing Techniques

When the waves of distress threaten to overwhelm us, self-soothing techniques offer a lifeline of comfort and solace. From indulging in sensory pleasures to creating a cosy sanctuary of relaxation, there are countless ways to nurture and soothe ourselves in times of need. 

Whether it’s savouring a warm cup of tea, taking a leisurely stroll in nature, or wrapping ourselves in a soft blanket, self-soothing practices remind us that we are worthy of kindness and care.

Learn more: How to self-soothe

Improving the Moment

Sometimes, the key to mastering distress tolerance lies in simply improving the moment we are in, thereby reducing our distress. By shifting our focus towards what is pleasant, meaningful, or within our control, we can find refuge from the storm and rediscover moments of joy and contentment. 

As with many skills in DBT, improving the moment also comes with its own acronym:

Imagery

Meaning

Prayer

Relaxation

One thing at a time

Vacation

Encouragement

Whether it’s immersing ourselves in a favourite hobby, connecting with loved ones, or basking in the beauty of nature, finding ways to enhance the present moment can provide much-needed respite from distress.

Using Pros and Cons

The pros and cons skill offers a practical framework for evaluating the consequences of acting on distressing impulses. By weighing the short-term relief against the long-term consequences, we can make more informed decisions that align with our values and goals. 

This mindful approach to decision-making empowers us to resist impulsive urges and choose responses that serve our highest good in the long run.

In relation to distress tolerance, DBT Self Help says:

“In other words, it’s the pros and cons of tolerating the distress of a situation and the pros and cons of not tolerating the distress of a situation. When examining the pros and cons, you are looking at the consequences of potential actions.”

TIPP Skills

In moments of intense distress, the TIPP skills offer a lifeline of support, providing quick and effective strategies for regulating overwhelming emotions. The TIPP skill is as follows: 

Temperature

Intense exercise

Paced breathing

Paired muscle relaxation

From adjusting our body temperature to engaging in intense exercise, paced breathing, and muscle relaxation, these simple yet powerful techniques can help us regain a sense of control and equilibrium when emotions run high.

Crisis Survival Strategies

In times of extreme distress, having a toolbox of crisis survival strategies can be a lifesaver. From creating a safety plan to reaching out for support from trusted friends, family members, or mental health professionals, knowing how to navigate crises effectively can make all the difference in our ability to weather life’s storms. 

Remember, it’s okay to ask for help when you need it, and you are never alone in your journey towards healing and resilience.

Mastering Distress Tolerance & Mental Health Journaling

As we navigate the waters of distress tolerance, mental health journaling can serve as a valuable anchor, helping us to process our experiences, track our progress, and cultivate greater self-awareness. 

Consider setting aside time each day to reflect on your coping strategies, jot down moments of mindfulness and gratitude, or explore your thoughts and emotions in greater depth. Journaling can be a powerful tool for integrating distress tolerance skills into your daily life and nurturing your emotional well-being.

If you’re living with BPD (Borderline Personality Disorder), CPTSD, or any other type of emotional dysregulation, my BPD journal prompts guide could be useful!

You Might Like: The Little Guide to DBT Mindfulness Skills

Access the Real Power of DBT Mindfulness Skills with this Personal E-Book & Journal Prompts!

Begin, or complement, your journey of self-discovery and healing with this 30-page digital e-book – an accessible and cost-effective guide to unlocking the potential of DBT’s Mindfulness Skills. 

Crafted over 12 months with creativity and care, as I underwent a year long course of intensive DBT training, this guide goes beyond the basic clinical point of view, offering you a personalised guide enriched by real-life examples from my own journey with BPD and complex trauma recovery.

Available for instant download today.

Closing Thoughts

As we conclude our exploration of distress tolerance in DBT, I invite you to embrace the wisdom of riding the waves, knowing that you have the strength and resilience to navigate life’s storms with grace and courage. 

By mastering distress tolerance techniques and cultivating a mindset of acceptance and resilience, you can find solace in the midst of adversity and emerge stronger and more resilient than ever before. 

Remember, the sea may be rough at times, but with each wave you ride, you grow stronger and more resilient, ready to face whatever challenges lie ahead.