The Goals of Distress Tolerance

What Is Distress Tolerance?

Distress tolerance is the ability to navigate highly stressful and frustrating circumstances in life. It is a part of the human condition to experience low frustration tolerance occasionally. The key is adaptability in the face of distress. Persons with low distress tolerance often self-sabotage their circumstances further. In contrast, a person with high distress tolerance can tap into their resources accordingly.

Examples of Low Distress Tolerance

Low or poor distress tolerance is when a person responds impulsively and/or destructively to life’s troubles and/or pressures.2 Low distress tolerance skills often occur due to a person having attachment trauma in early life, adverse childhood experiences (ACES), genetic and/or temperamental predispositions.

For example, ACES are linked to poor attachment in early life. Our earliest attachment style contributes to our ability to relate to others later in life.3 Therefore a person with anxious attachment, avoidant attachment, or disorganized attachment will likely struggle with adaptation, especially in relationships.4

Examples of low distress tolerance include:

  • Binge eating
  • Substance misuse
  • Self-harm
  • Self-sabotaging behaviors
  • Impulsivity
  • Instability in relationships
  • Extreme anger and/or outbursts of rage
  • Paranoia
  • Dissociation

Examples of Healthy Distress Tolerance

Healthy Distress Tolerance can be defined as an ability to adapt well to adverse circumstances. Often, a person develops healthy distress tolerance skills through secure attachment in childhood and/or a more fluid temperament, likely based on genetics. While these positive pre-dispositions are ideal, a person’s resources and resiliency play a role as well. Therefore, healthy distress tolerance can be developed later on in life with enough insight and care.

Examples of healthy distress tolerance include:

  • Reality testing
  • Well-regulated emotions
  • Cultivate healthy relationships
  • Critical thinking
  • Problem solving
  • Assertive communication

What Is Dialectical Behavior Therapy?

Dialectical behavior therapy (DBT) is a type of cognitive therapy that brings together the regulation of emotions and behaviors, coupled with mindful practice and interpersonal skill building. DBT works in a multifaceted therapeutic form with individual therapy, group skills training, and coaching with a therapist in times of crisis.

The Goals:

The goals of DBT are to improve a person’s self-awareness and ability to move through adversity effectively. DBT’s approach to distress tolerance is part skill building and part coaching, in that specific skills are taught to foster self-awareness and coaching in order for persons to develop insight into when and how to use these skills in everyday life.

How to Practice Distress Tolerance Skills

Distress tolerance skills are applicable to everyday life. The biggest piece is being able to remember to do them when you need to. Part of this is setting an intention around your practice of these skills. For example, setting reminders in your phone of a few different skills you can utilize throughout the day. Not all situations and scenarios can afford us the time and space to practice skills as readily. Therefore, it is important to find practical means in our day-to-day life.

Practical ways to practice distress tolerance skills include:

  • Take a mindful moment: Build in a moment of self-soothing each day. Engage in grounding with your five senses, or allow a moment to tap into your sensations.
  • Engage in physical activity: Exercising for mental health can help with helpful distress tolerance. As discussed, physical activity helps to release pent-up tension in our bodies.
  • Help others: Doing for others is rejuvenating for our spirit and soul. No act of support and kindness to another is too small.
  • Daily Affirmations: Tell yourself the thing you most need to hear each day. Ensure it is something you can believe. For example, “I am braver than I believe”, and “I can do hard things”.
  • Radically accept to start your day: Reminder yourself each morning what is and what is not within your control. This gentle reminder can carry you into the day with a more grounded sense.
  • An act of self-care: Do one act each day that gives back to you. From a stretch to watching your favorite TV show or listening to your favorite podcast.
  • Breathe it out: Take five minutes a day to connect with your breath, into your body, especially if you experience stress.

When to Seek Professional Help

We all experience distress. There are times when distress and our emotions can get the better of us. If you find yourself easily overwhelmed, overreacting, feeling guilty thereafter, or engaging in impulsive behaviors, it may benefit you to seek support. Feelings of guilt and shame, low self-esteem, difficulties identifying who you are, persistent difficulties with persons in your life, and behaviors that are not aligned with who you believe yourself to be are all experiences where therapy can make a difference.

If you are not my client working with me in therapy, there are many different online therapy options to find a DBT practitioner. You can check out an online therapy directory to find care in your local area. In Vermont, the Vermont Counseling Network is a good place to start. Or, you can look at Psychology Today or Good Therapy.

In My Experience

In my experience, distress tolerance skills and DBT skill building can benefit everyone. It is a part of the human condition to protect ourselves. Society and our modern day have made things more complicated. I have found these carry a significant impact on already difficult circumstances in our lives. That being said, distress tolerance can build up our resiliency against many aspects of which we are not in control.

It may also be important and helpful for you to know, that I never offer therapy approach interventions that I have not used for myself, on my own journey of recovery and health & wellness.

Lastly, as a trauma-informed practitioner, I find these skills to be particularly helpful when managing trauma-related symptoms. I want to enforce that trauma responses are natural responses to an unnatural and horrifying experience. Exhibiting difficulties with emotional regulation and distress tolerance following trauma is understandable and should not be viewed from a place of deficit or weakness. Distress tolerance skills offer a means to more comfortably wade through the difficult waters of life.