Distress tolerance skills are techniques used in Dialectical Behavior Therapy (DBT) to help you cope with intense emotions and stressful situations without making them worse. They’re most helpful during moments of emotional overwhelm, anxiety, conflict, or uncertainty when you can’t immediately change what’s happening.
Rather than trying to eliminate difficult emotions, these skills help you stay grounded until you’re able to respond thoughtfully instead of reacting impulsively. Below, we’ll explain what distress tolerance skills are, when to use them, and some of the most common strategies taught in DBT.
What Are Distress Tolerance Skills?
Distress tolerance is the ability to manage difficult emotions and stressful situations without making them worse. It is one of the four core skill areas in Dialectical Behavior Therapy (DBT).
These skills are not designed to eliminate emotional pain or make difficult situations disappear. Instead, they help you tolerate distress long enough to make intentional choices rather than reacting in ways you may later regret.
When Are Distress Tolerance Skills Helpful?
Distress tolerance skills are especially helpful when emotions are intense and there isn’t an immediate solution to the problem.
You may use these skills when you’re:
- Feeling emotionally overwhelmed
- Experiencing anxiety or panic
- Navigating conflict in a relationship
- Receiving upsetting news
- Coping with uncertainty or major life changes
- Feeling the urge to avoid, withdraw, or react impulsively
The goal isn’t to solve the problem right away—it’s to get through the moment safely and effectively.
What Is the Difference Between Distress Tolerance and Emotion Regulation?
Although these skills work together, they serve different purposes.
Distress Tolerance
Distress tolerance helps you get through difficult moments without making the situation worse. These skills are most useful during emotional crises or situations that cannot be changed immediately.
Emotion Regulation
Emotion regulation focuses on understanding and managing emotions over time. These skills help reduce emotional vulnerability and make it easier to respond to emotions in healthy ways before they become overwhelming.
What Are Some Common Distress Tolerance Skills Used in DBT?
DBT teaches several practical skills that can help you manage emotional distress. Below are some of the strategies commonly practiced in DBT skills groups.
How Can Self-Soothing Help During Stressful Moments?
Self-soothing uses your five senses to create comfort during emotionally difficult moments.
Examples include:
- Listening to calming music
- Drinking a warm cup of tea
- Wrapping up in a soft blanket
- Spending time in nature
- Using calming scents such as lavender
These small activities can help reduce emotional intensity and make stressful moments feel more manageable.
What Is Sensory Grounding?
Grounding helps bring your attention back to the present moment through your senses.
You might:
- Notice five things you can see
- Feel your feet on the floor
- Hold a textured object
- Focus on sounds around you
- Pay attention to the temperature of the air
Grounding can be especially helpful during anxiety, panic, or emotional overwhelm.
How Can Distraction Strategies Reduce Emotional Overwhelm?
In DBT, distraction is a temporary coping skill—not avoidance.
When emotions are too intense, shifting your attention to another activity can give your nervous system time to settle before returning to the situation.
Healthy distractions may include:
- Going for a walk
- Reading
- Exercising
- Working on a hobby
- Helping someone else
Once emotions become less intense, it is often easier to problem-solve effectively.
What Does “Improving the Moment” Mean?
Improving the moment means finding small ways to make a difficult situation feel more manageable.
This may include:
- Practicing mindfulness
- Using visualization
- Praying or engaging in spiritual practices
- Reflecting on gratitude
- Offering yourself encouraging self-talk
Even brief moments of comfort or hope can make emotional distress easier to tolerate.
What Is Radical Acceptance?
Radical acceptance means acknowledging reality as it is, even when it’s painful.
Acceptance does not mean approving of a situation or giving up. Instead, it means recognizing what cannot be changed so you can focus your energy on how you want to respond.
What Is Everyday Acceptance?
Acceptance isn’t only useful during major life events. It’s something we can practice every day.
Examples include accepting:
- Traffic and long lines
- Delays or canceled plans
- Other people’s behavior
- Unexpected schedule changes
- Everyday frustrations
Practicing acceptance in smaller situations can make it easier to cope with bigger challenges when they arise.
How Can Mindfulness Support Distress Tolerance?
Mindfulness helps you notice your thoughts, emotions, and physical sensations without immediately reacting to them.
By creating space between what you’re feeling and how you respond, mindfulness makes it easier to choose a coping skill instead of acting impulsively.
Some common DBT mindfulness techniques include: Wise mind, one mindfulness, and nonjudgmental stance.
Can Distress Tolerance Skills Help With Anxiety?
Distress tolerance skills may help people experiencing anxiety by providing practical ways to respond when emotions become overwhelming.
These skills can help you:
- Stay grounded during anxious moments
- Reduce emotional escalation
- Tolerate uncertainty more effectively
- Respond thoughtfully instead of reacting automatically
While distress tolerance skills won’t eliminate anxiety, many people find they feel more prepared to navigate stressful situations with regular practice.
How Are Distress Tolerance Skills Taught in a DBT Skills Group?
Learning these skills is often easier with guidance and regular practice.
In a DBT skills group, participants:
- Learn new skills in a structured setting
- Practice using them between sessions
- Discuss challenges and successes
- Receive encouragement and feedback
- Build consistency and accountability
Many people find that practicing alongside others helps them feel more confident using these skills in everyday life.
Learn more about our Virtual DBT Skills Group to see how structured practice can support your goals.
How Do You Know If You Could Benefit From Distress Tolerance Skills?
You may benefit from distress tolerance skills if you:
- Feel overwhelmed by strong emotions
- Struggle with anxiety or ongoing stress
- React impulsively when upset
- Get stuck in rumination or worst-case-scenario thinking
- Have difficulty accepting situations you can’t control
- Feel emotionally flooded during conflict
- Want healthier ways to cope with life’s challenges
Learning distress tolerance skills won’t prevent difficult emotions from happening, but it can help you navigate them with greater confidence and resilience.
Interested in Learning DBT Skills in a Supportive Environment?
At Marsh Psychotherapy, we offer individual DBT therapy as well as virtual DBT skills groups for adults across New York who want to strengthen coping skills, improve emotion regulation, and build healthier ways of responding to stress and difficult emotions. Contact us to learn more.
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