Distress Tolerance

A crucial focus of Dialectical Behavioral Therapy is tolerating distress. Many people who struggle with Borderline Personality Disorder and other mental illnesses often feel intense distress and lack the skills to tolerate it effectively. DBT teaches many skills that can help you get through difficult instances without resorting to ineffective coping mechanisms.

Distress Tolerance

Distress happens. There’s no getting around it. Everyone has positive emotions and everyone has negative emotions. It’s just part of life. Feeling these emotions so strongly and lacking the skills to tolerate the pain can make you want to avoid these emotions. Avoidance, however, makes the suffering last longer. Instead, Dialectical Behavioral Therapy (DBT) gives you the skills to get through distress more smoothly.

Improving your tolerance to distress can radically change your life for the better. Oftentimes, people use techniques that are ineffective and possibly destructive to tolerate painful emotions, such as self-injurious behaviors. These behaviors become habitual and detrimental to your quality of life. DBT provides more effective methods for coping to use in place of those other behaviors. Over time, you can learn to let go of those negative skills and live a better life as a result.

Out of the following skills, you will probably want to try most everything, and then pick some that especially work for you. It’s important to practice these skills when you are not in distress so that you can really get a good handle on how to use them. Then you will be ready to deploy them during times of distress.


An acronym of choices for how to distract from your distress.


Treat your five senses to get through your distress.

Pros and Cons

Use this four-square to see the pros and cons of tolerating or not tolerating your distress.

IMPROVE the Moment

An acronym of choices to help you reframe your distress.

Willingness & Half-Smile

Being open is key to DBT.

Radical Acceptance & Turning the Mind

Acceptance, though challenging, can help reduce your suffering.

Alternate Rebellion

How to act out without damaging your life.


Reduce your distress by changing your body.

Additional Resources

Mental Health Resources
We aren't the only mental health resource out there. Check out these books, websites, social media accounts, and more for additional support. Read More
DBT Flashcards

Making DBT skills second nature takes practice. Use these flashcards on their page, download your own to print out, or purchase our pre-made set from our shop. Read More

DBT Encyclopedia

DBT has its own lingo which can be hard to understand for beginners. Visit our homemade DBT Encyclopedia to figure out what a term means. Read More

Mindfulness Exercises

Mindfulness practice is key to DBT. You don't have to meditate in silence everyday, though. Try these Mindfulness exercises to guide you. Read More

Diary Cards

Diary cards help track your emotions, urges, behaviors, and skill use. They help you see patterns. Learn how to use them and get samples. Read More


Need a little extra support?

Online DBT Courses provides online DBT group, self-paced DBT courses, and one-on-one DBT skills coaching from a DBT-trained therapist.  If you are interested in learning new DBT skills or need a little help getting the most out of DBT, we can help.
Online DBT