Distress Tolerance skills are a set of Dialectical Behavioral Therapy skills that are strategies to help you get though difficult feelings and situations, and tolerate (deal with, sit with, accept) the things that you can’t immediately change. Emotions can be extreme and lead to behaviors that are ineffective. You may not be able to change the stressful situation you’re in, but you can change the way you feel. Distress Tolerance skills are aimed to make your response to distress more effective.

Distress Tolerance skills are divided into two categories: crisis survival skills and reality acceptance skills. Crisis survival skills are what you use when, well,  you’re in a crisis. But how do you know you’re in a crisis?

You’re in a crisis when you’re in a highly stressful, short-term situation that is pressuring you to resolve the crisis immediately. Perhaps it feels like you’re about to collapse under the pressure, like the walls are closing in around you. You can also recognize it’s a crisis when you want to use a Target Behavior. Crisis survival skills are intentional alternatives to target behaviors. 

Additional clues about when to use crisis survival skills:

• You’re in severe (emotional) pain that cannot be helped immediately
• You have the urge to act on your emotions but know in your Wise Mind that it will make things worse
• You’re drowning in Emotion Mind
• You are overwhelmed but have things to do
• You’re triggered/activated but the problem can’t be solved right away

DBT recommends that you don’t use crisis survival skills for everyday problems or every single problem that you encounter. They are to be saved for crises so that they are most effective in that moment. While the original DBT manual does not recommend using crisis survival skills to make your life worth living, there are aspects of certain skills that can be reconfigured for that purpose. For instance, tapping into Meaning (the M in IMPROVE the Moment) regularly can help you center yourself around what’s important to you. So yes, crisis skills are for crises, and important themes are present in crisis skills that can be applied to your life in general as well.