A Deeper Dive Into Some DBT Distress Tolerance Skills
- Alyssa Silvera Akhavan, MS
- Aug 5
- 3 min read
Life is full of difficult moments such as conflict, loss, overwhelming emotion, and pain we can’t fix right away. In those moments, it’s not always about “feeling better” immediately, but rather, it’s about getting through it without making things worse. That’s where Distress Tolerance, one of the four core modules of Dialectical Behavior Therapy (DBT), comes in.These skills aren’t about solving problems or changing emotions. They’re about helping you ride out the storm. These are "in-the-moment" skills to utilize when you feel yourself at an 8, 9, or 10 out of 10 emotionally.
When Do You Use the Distress Tolerance crisis Survival Skills?
During a crisis or emotional overwhelm
When urges to self-harm, lash out, or escape are high
When you need to pause before making a decision
When you're unable to solve the problem right away
Some of the main components of distress tolerance involve fast-acting physical strategies, distraction and self soothing through engaging our senses.The next time you notice distress setting in, you can try out these skills!
TIPP Skill
When your body is in fight-or-flight mode, logic and self-control are hard to access. TIPP helps regulate your physiological response to emotional overload, like an emergency brake for big feelings. This happens through accessing our parasympathetic nervous system, which is our rest-and-digest system. When the physiological arousal is lower, then our emotions come down a notch. TIPP stands for:
Temperature: Dunk your face in ice cold water while holding your breath. When that is difficult to access, you can also try splashing cold water on your face or hold an ice pack to quickly lower arousal, making sure to have the water/ice be under your eyes
Intense Exercise: Do jumping jacks, jog in place, or run up stairs for a few minutes.
Paced Breathing: Breathe in and out slowly, making sure your out-breath is longer than your in-breath.
Paired Muscle Relaxation: Tense a group of muscles as you inhale, release as you exhale.
2. Use the S.T.O.P. Skill
STOP is about inserting space between a prompting event and reaction. It gives your brain a second to catch up and your emotions a moment to settle.Think of STOP as your mental “pause button” when everything feels overwhelming.
Stop: Pause before reacting.
Take a breath: Slow inhale, slower exhale.
Observe: Notice your body and surroundings.
Proceed mindfully: Intentionally choose your next action.
3. Self-soothe with the Five Senses
Self-soothing uses sensory experiences to ground and calm you. This serves as a reminder that you can still experience comfort, even in difficult situations. For example:
Sight: Look at calming images, watch the sky, light a candle.
Sound: Listen to calming music or nature sounds.
Touch: Wrap up in a cozy blanket, hold a stuffed animal, take a warm bath.
Smell: Use essential oils, bake cookies, smell clean laundry.
Taste: Sip tea, eat a mint, savor chocolate slowly.
You can even create a “crisis kit” to include all of your favorite sensory items to help you in these moments!
Distress tolerance skills are like life vests. You don’t wait to learn how to use them while drowning. It's helpful practice before the storm hits. Resilience and strength to use these skills is something you can build, one skill at a time.
