Symptoms & Diagnosis

Better Distress Tolerance through DBT

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You know the feeling — that rollercoaster feeling of when a situation is starting to feel out of control. Perhaps you’ve been exposed to something you know to be one of your triggers, or maybe something just plain old crummy that would drive anyone nuts has reared its ugly head.

In any case, well-meaning friends and family members may suggest you “just get over it” or “pay no attention” to it. We all know this is far, far easier said than done. Meanwhile, you can feel your stress level rising.

When you can’t change a situation, there is one thing you can do: accept that which you can’t control and endeavor to change your reaction. Techniques for achieving this are taught in Dialectical Behavior Therapy (DBT).

Dialectical Behavior Therapy, a core therapy used to treat Borderline Personality Disorder (BPD) combines standard Cognitive Behavioral Therapy (CBT) techniques with a set of skills derived from Buddhist meditative practice.

One of the skill sets taught in DBT is distress tolerance. Distress tolerance can help you to cope with intolerable or overwhelming situations through:

  • Distracting
  • Self-soothing
  • Improving the moment
  • Finding the pros and cons of a situation

Here are some ways you can have better distress tolerance through DBT:


Distracting deals with, well, just that: finding distractions. Find activities that distract you from your distress. A hobby, helping others, going for a run, watching a movie. Do something that can help you separate yourself from a distressing mind state or situation for a while.


Self-soothing deals with being kind to and respectful of yourself. Do something that makes you feel good on a sensory level. Savor a sweet bite of chocolate or a special coffee (taste). Find a place with a beautiful view and really take in every color, every line, pinpoint what is pleasing about it (sight). Listen to a favorite piece of music (sound). Pet your cat (touch). Go for a walk in the forest and breathe in the fresh, pine-scented air (smell).

Improving the Moment

Lasso your discomfort. One of the most damaging feelings is the sense of being out of control, but if you really connect with the discomfort you are feeling — identifying the level of discomfort, analyzing where it’s coming from, giving it a name (i.e., fear, anxiety) — you can stop it in its spiraling motion. This can be accomplished through mindfulness techniques you’ll also learn in DBT.

Finding Pros and Cons

Make a list of pros and cons. The DBT pros and cons list is a little different than a traditional pros and cons list, though. It’s about the pros and cons of tolerating the distress of a situation versus not tolerating it. “If I tolerate my stepsister’s presence at a family dinner, I won’t feel the need to get in an argument with her about her verbal judgment of my food choices. If I don’t tolerate her presence while I eat, I will be highly sensitive to every look, every word, and what could be an enjoyable dinner will turn into an uncomfortable dispute and split the family down the middle.”

What distress tolerance skills have helped you? Share them in the comments below.

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