Mastering Distress Tolerance: Essential Skills for Emotional Resilience and Recovery

Nearly 37% in Los Angeles report increasing levels of stress in the past year. Nearly 94% of young Californians experience mental health challenges. Life can feel overwhelming in the fast lane, but this is where distress tolerance becomes an indispensable tool in your arsenal. Distress tolerance enables you to mindfully manage your challenges and exhibit greater control over your life, thereby fostering resilience.

Distress tolerance indicates your ability to withstand negative emotions and experiences.

Linda Whiteside, Clinical Supervisor at the NuView Treatment Center, says, “Strong distress tolerance levels allow for managing these emotions without going into crisis mode. Whereas, weak distress tolerance levels can make you feel like you are not in control and resort to unhealthy behaviors like substance use and other self-destructive patterns.”

There are many ways in which you can develop distress tolerance, and it is one of the core skills of dialectical behavior therapy (DBT). When combined with other skills like mindfulness, emotion regulation, and interpersonal effectiveness, DBT can equip you with healthy coping strategies to manage stress and other negative experiences.

Distress tolerance is one of the main modules of DBT, and the skills you will learn in this module are as follows:

• Identifying Crisis: You learn to recognize the signs of crisis during the initial stages.
• Distraction: You will learn to distract yourself from emotionally disturbing circumstances and focus your energy on other activities.
• Self-Soothing: You learn to use your five senses to self-soothe before your emotions spiral out of control.
• Grounding: It allows you to connect with your present, especially as past and future thoughts can become unhealthy and unproductive.
• RESISTT: Under RESISTT, you learn to reduce unhealthy urges during times of crisis.
• TIPP: TIPP is a relaxation technique that utilizes temperature, intense exercise, paced breathing, and progressive muscle relaxation techniques to help your mind and body relax.
• Pros and Cons: You learn to do a cost-benefit analysis to understand the cons of negative behaviors and the benefits you stand to gain by reshaping or coping with them.
• Willingness vs. Willfulness: You become more willing to accept reality rather than veering toward the willfulness side and control everything around you.
• Radical Acceptance: You accept things as they are, especially those beyond your control. With radical acceptance, you can release negative emotions such as anger, shame, and others.
• Actions Based on Values: You take actionable steps that align with your principles so as to deal with distressing circumstances.

ACCEPTS, IMPROVE, and RESISTT are key distress tolerance skills. To elaborate:

ACCEPTS Skills

• Activities: Activities that distract you from emotionally distressing circumstances. It could be something as simple as cleaning your room or attending an event.
• Contributing: You find something altruistic to do, like helping someone in need or volunteering.
• Comparisons: When you compare your struggles to those of others who are not doing as well as you, it puts things into perspective.
• Emotions: You seek to evoke emotions opposite to negative ones by engaging in some activities, like watching a comedy or a scary movie.
• Push Away: You relax your mind and body, setting aside the things that distress you.
• Thoughts: You distract your mind by engaging in cognitively engaging activities like solving puzzles or finding something interesting to read.
• Sensation: You use your five senses to soothe yourself. For instance, walking in the rain can engage your senses while being intensely soothing.

IMPROVE Skills:

• Imagery: You use imagery to enhance the moment by envisioning a beautiful scene or a safe environment.
• Meaning: You try to find meaning in your difficulties, which makes them tolerable.
• Prayer: You draw a sense of peace from a higher power, which allows you to relax and develop a positive outlook.
• Relaxation: You use relaxation techniques, such as deep breathing or yoga, to relieve tension.
• One Thing in the Moment: You focus on one thing at a time, which prevents you from becoming overwhelmed.
• Vacation: It is a kind of escapism where you escape to beautiful getaways to experience a sense of peace.
• Encouragement: You motivate yourself with positive self-affirmations that boost your confidence.

RESISTT Skills:

• Reframing the Situation: You reframe the situations in your life by changing your perspective. For instance, instead of viewing a difficult event as black and white, you look for a silver lining.
• Engaging in a Distracting Activity: You engage in distracting but pleasurable activities to divert your focus away from the distressing events in life.
• Someone Else: You focus your attention on someone else, which takes away your focus from your own struggles. For instance, you can help someone in need or simply surprise a loved one by doing something special for them.
• Intense Sensations: You focus on intense sensations that are distracting but safe. For instance, taking a cold shower or going out for a walk in the rain or snow.
• Shut It Out: You remove yourself from environments that distress you and go somewhere more relaxed, peaceful, and safe.
• Neutral Thoughts: These are thoughts that do not add to the distressing events. For instance, you can count to ten or engage in mindfulness by focusing your attention on the environment around you.
• Take a Break: You simply take a break and engage in something that is good for you. This can be different for different persons. Perhaps you could take a day off and engage in self-care, or go for a walk in the woods.

Distress tolerance is key to your recovery in Los Angeles, where an estimated 1.4 million struggle with substance-related challenges, while 1 in 5 struggle with mental health challenges. 33% of the time, these conditions tend to overlap. Distress tolerance helps you manage intense emotions without turning to self-defeating coping behaviors in an otherwise fast-paced, stressful environment.

By honing and strengthening your distress tolerance skills, you can stay grounded, make healthier choices, and remain steady in your recovery - even when life in the fast lane feels overwhelming.

Linda Whiteside informs, “At NuView’s Los Angeles facility, we have observed that distress tolerance has broad applicability in treating substance use and co-occurring mental health conditions, and even significantly brings down relapse rates toward a lasting recovery.”

Distress tolerance skills can help you navigate life's challenges with clarity and control. At NuView, we will provide a safe setting where you can learn and hone these skills, as you lay a strong foundation for the life you are willing to embrace.

Please reach out to us at (323) 307-7997 to learn more about our programs today!

1. What factors impact the ability to tolerate distress?

Factors like your temperament and belief systems can impact your ability to tolerate distress.

2. Is distress tolerance effective even if I have tried other coping strategies before?

Yes, distress tolerance focuses on surviving negative emotions and experiences safely rather than eliminating them, making it effective even when other strategies have failed.

3. How long does it take to notice improvements in distress tolerance skills?

While we cannot put a time on this, many begin noticing better emotional control within weeks, especially when skills are practiced consistently in therapy and real-life situations.

4. Can distress tolerance help with triggers and stressors outside of therapy sessions?

Yes, distress tolerance skills are designed to be used in everyday, high-stress moments. They are effective in that they help you manage triggers and stressors before they escalate into something damaging, like relapse.

5. Can distress tolerance skills be tailored to fit my lifestyle in Los Angeles?

Yes, these skills can be adapted to your routines, stressors, and environment - whether it means pressures of a fast-paced life, social demands, or city-related stressors.