Getting Through, Not Around: The Purpose of Distress Tolerance in Dialectical Behavior Therapy (DBT)

It’s common to want to avoid pain or discomfort. When life gets difficult and murky, we rarely hear people say they embrace those moments. Maybe you hide your feelings, try distractions, or pull away from others. It’s a common reaction. These moments test our strength and bandwidth. That’s why learning how to handle distress in effective ways is so important.

DBT helps people manage tough feelings by teaching skills to get through those difficult moments. Central to this is distress tolerance. Instead of escaping or ignoring feelings, distress tolerance encourages us to tolerate the moment head-on. It’s about developing resilience—bouncing back from hardship—and shifting from avoidance to acceptance.

What Is Distress Tolerance in DBT?

Definition and Core Principles

Distress tolerance is a set of skills that helps you deal with emotional pain without making things worse. It’s not about ignoring how you feel but learning to sit with those feelings. Think of it like riding out a storm—as temperamental and intense as it can be. 

Core ideas include acceptance and mindfulness. Acceptance means acknowledging reality without fighting it. Mindfulness helps you stay present, aware of your feelings without judgment. This combo helps you survive tough moments without spiraling.

The Role of Distress Tolerance in Emotional Regulation

Distress tolerance is a key part of emotional regulation. When faced with a crisis, it helps stop impulsive reactions, like yelling or shutting down. Instead, it encourages you to stay grounded, focused, and calm.

By staying present, you can better assess your options and avoid making rash decisions. This skill is vital for keeping your mood stable and preventing feelings from taking over your life.

Common Misconceptions

Many think distress tolerance is the same as suppressing feelings. That’s wrong. It’s not about bottling up emotions. Ignoring and suppressing emotions is not effective. Instead, it’s about tolerating the pain without letting it control you.

Some also fear that showing vulnerability makes them weaker. But being honest with yourself during tough times truly builds strength over time.

Why Focus on Getting Through, Not Around?

The Limitations of Avoidance Strategies

Trying to dodge pain often backfires. It might provide temporary relief but usually leads to bigger problems later. Think about turning to alcohol, overeating, or withdrawing from friends. These methods only hide problems, not fix them.

Research shows avoidance can worsen anxiety and depression long-term. It’s like sweeping dirt under the rug—eventually, it piles up.

Building Resilience Through Acceptance

Enduring distress helps build emotional muscle. When you face tough feelings instead of avoiding them, you learn that you can handle more than you think.

For example, someone battling anxiety might use distress tolerance skills to sit through a panic attack, realizing they don’t have to escape the feeling. Over time, this makes future crises easier to handle.

The Concept of "Getting Through" in Practice

Getting through difficult moments involves using specific skills that help you persevere. It’s about patience, perspective, and believing that the storm will pass.

A good tip is to create a “crisis plan.” This might include simple steps like taking deep breaths, focusing on the present, or calling a friend. It’s about having tools ready to face pain.

Core Distress Tolerance Skills and Techniques

Distraction

Distracting your mind temporarily lets you pause and breathe. Find activities or thoughts that take your focus away from pain. Examples are doing a hobby, listening to music, or counting objects nearby.

A distraction kit with favorite toys, scents, or pictures can help during crises. Use it whenever distress peaks.

Self-Soothing

Self-soothing uses your senses to calm down. It’s like giving your mind and body a gentle hug. Listening to calming music, touching soft fabrics, or smelling relaxing scents work well.

Make routines that include self-soothing. Familiar habits make it easier to stay calm in tough times.

Improving the Moment

This skill helps you make a distressing situation feel less overwhelming. Techniques include visualization—imagine a peaceful place—or using prayer or affirmations.

For example, picturing a calm beach when anxious can reduce immediate distress and bring a sense of peace.

Accepting Reality

Radical acceptance means fully accepting what’s happening without judging yourself or others. It doesn’t mean liking the situation, just accepting its reality.

Simple steps include mindfulness exercises, repeating acceptance phrases, or journaling feelings. This helps you stay grounded instead of fighting reality.

Tipping the Balance: Pros and Cons

Different skills work better in different situations. If you’re overwhelmed, distraction might help. When intense feelings hit, self-soothing and acceptance are better.

Choosing the right skill depends on how you feel. Experts advise testing different strategies and adjusting them as needed.

Implementing Distress Tolerance in Daily Life

Building a Personal Toolbox

Create your own set of go-to techniques. Think about what helps you stay calm or focused. Practice these often so they become second nature.

Start small—try one new skill a week—and stick with it. Over time, your toolbox will grow stronger.

Overcoming Barriers

Shame, impatience, or doubt can block progress. Remember, learning takes time. Stay patient and keep trying.

Support from friends, family, or a therapist makes a big difference. Don’t hesitate to seek help when needed.

Measuring Progress

Keep track of your emotional responses. Notice when distress feels less intense or shorter.

Ask your therapist for feedback or journal your experiences. Seeing progress motivates continued practice.

Getting through emotional distress is tough. This isn’t easy and it is possible. It can be crucial for growth. When you face your feelings directly, you build resilience and strength. Using skills like distraction, self-soothing, and acceptance makes all the difference.

Start small—practice regularly—and don’t be afraid to ask for support. Over time, distress becomes less overwhelming — a chance to learn, grow, and strengthen your mental health.

Reference

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