What Is Distress Tolerance?

What is distress tolerance? Get the definition, plus learn about distress tolerance techniques to help you stand up to emotional distress.

January 17, 2025 · 10 min · 2083 words · Daniel Wells

Table of Contents

Table of ContentsView AllTable of ContentsWhat Is Distress Tolerance?Factors that Impact Distress ToleranceTechniques to Improve Distress ToleranceHow to Practice New SkillsPsychotherapyFinal Thoughts

Table of ContentsView All

View All

Table of Contents

What Is Distress Tolerance?

Factors that Impact Distress Tolerance

Techniques to Improve Distress Tolerance

How to Practice New Skills

Psychotherapy

Final Thoughts

Close

How Well You Tolerate Stress Indicates Your Level of Distress Tolerance

Everyone experiences a wide variety of stress in life. These stresses can range from daily annoyances to significant events such as a job loss, divorce, or the death of a loved one.

Whether the stress is large or small, your ability to tolerate distress can affect how you manage the situation. Strong negative emotions such asshame,fear,anger, anxiety,guilt, and sadness can be difficult to manage. The stronger these emotions are, the more difficult they can be to control.

Poor Distress Tolerance

It can be challenging to identify the specific emotions you’re experiencing. This can make them feel even more frightening, unpredictable, and out of your control.

Sometimes, people rely on unhealthy behaviors, such as deliberateself-harm,binge eating,substance use, orother impulsive behaviors, as ways of coping with intensely distressing emotions.

Unfortunately, the relief these self-destructive measures provide is short-lived, and to make matters worse, the distressing emotions often return even stronger, with additional feelings ofshame and guilt, which is more upsetting.

Healthy Distress Tolerance

The good news is that learning distress tolerance techniques can help you:

Research has found that distress tolerance can be effective in helping people better regulate anger and impulsivity.Reducing impulsivity may also have other helpful benefits, such as making people less likely to engage in unhealthy or even risky behaviors as a way of coping with distress.

Factors Impacting an Individual’s Distress Tolerance

While research has shown that distress tolerance can be beneficial in the treatment of a variety of psychological disorders, there are a number of factors that can make building these skills challenging.

Biological Influences

Distress tolerance may have biological influences. Research suggests that biology can play an essential role in influencing how well a person tolerates feelings of emotional distress.

Neural networks, brain chemistry, and specific brain structures may be associated with behaviors such as pursuing rewards or escaping distress.

Research also indicates that babies are born with a particulartemperamentwhich is hard-wired and with them at birth. Temperament is a strong predictor of personality traits that develop down the road. There are three main temperaments including:

These brain differences and varying temperaments indicate that some people might struggle with a heightened reaction to stressors, and building their distress tolerance skills is more challenging. This doesn’t mean those skills cannot be developed—but it might take longer or require more effort.

Distorted Beliefs

There are thinking patterns that can make it more challenging to cope with emotionally upsetting events. These automatic thoughts arecognitive distortions, which everyone has to some degree.

Examples of distress-intolerant beliefs can include:

Note when you use words on the extreme end of the spectrum like “always,” “never,” “love” and “hate.” Such distress-laden beliefs can lead to escape behaviors such as withdrawal, avoidance, and sometimes self-harm.

Types of Distress Tolerance Techniques

Learning distress tolerance skills can make a very positive difference in your ability to handle difficult emotions. Distress tolerance techniques that may be helpful include distraction, self-soothing, radical acceptance, and more.

Learning distress tolerance skills can help you get through emotional crises and bring more enjoyment into your life.

Distraction

Improving the Moment

This strategy involves using a variety of strategies to help make the stressful situation more tolerable. Visualizing a relaxing scene, looking for the silver lining, or taking a mental break to do something pleasant are all examples of ways that you can improve the moment.

Weighing the Pros and Cons

This distress tolerance technique involves considering the potential pros and cons of tolerating or not tolerating distress. It can be a good tool for weighing the short-term and long-term consequences of an action.

Radical Acceptance

Rather than focusing on things that cannot be changed or that are out of your control, radical acceptance involves just accepting things as they are and letting go of feelings of regret, anger, or bitterness.

Press Play for Advice On Radical AcceptanceThis episode ofThe Verywell Mind Podcastshares how to practice radical acceptance to reduce suffering. Click below to listen now.

Press Play for Advice On Radical Acceptance

This episode ofThe Verywell Mind Podcastshares how to practice radical acceptance to reduce suffering. Click below to listen now.

Self-Soothing

Finding ways to calm yourself and keep negative emotions in check is an important part of building distress tolerance. Different sensory experiences, such as sight, sound, smell, taste, or touch, can all be used to self-soothe during difficult moments.

How to Practice Emotional Acceptance

How to Practice Distress Tolerance Skills

Many practical and effective behaviors for distracting you from intense emotions are emphasized in DBT and other types of therapy, including:

The goal of distress tolerance is to become more aware of how your emotions influence your response to distressing situations. Other stress management techniques that may help you build greater self-awareness and manage emotional stress more effectively includemeditation,progressive muscle relaxation,deep breathing, and stretching exercises.

How to Boost Your Self-Awareness

You can learn and practice any of these techniques on your own, but they can also be incorporated into different forms of psychotherapy that focus on teaching distress-tolerance skills. Some of these forms of therapy are discussed in the next section.

Psychotherapy to Improve Distress Tolerance

Although research on distress tolerance is still emerging, it has already shown that poor distress tolerance plays an important role in both the development and maintenance of a number of mental health conditions, including:

For example, one key theory suggests that the inability or unwillingness to tolerate emotional distress is the key mechanism underlying the development ofborderline personality disorder(BPD).

Because of this, a number of different types of therapy have emerged that incorporate aspects of distress tolerance skills-building. Some of these include:

More About Dialectical Behavior Therapy

Dialectical behavior therapy(DBT) can provide you with skills directly focused on increasing your distress tolerance. DBT is a technique that was initially developed to treatborderline personality disorder(BPD) but has also been used to treat a range of other conditions, including anxiety and mood disorders, PTSD, substance use, and other personality disorders.

It is a form ofcognitive behavioral therapy(CBT) that incorporates four skills:

More About Interoceptive Exposure

Interoceptive exposurecan help increase your ability to tolerate the effects of intense negative emotions on your body, such as increased heart rate and muscle tension. It is another form of CBT that involves gradual exposure to physical sensations associated with threats or stress.

Stress can cause physical sensations that influence how people think about and respond to stressors. By eliciting these sensations, people can work to identify the unhelpful thoughts and actions associated with these feelings.

The goal of interoceptive exposure is to desensitize people to these physical sensations and help them learn that while these feelings might be uncomfortable, they can be managed.

Everyone has some stress, and we learn ways to manage stressors throughout our lives. Researchers continue to learn more about how distress tolerance develops and contributes to the etiology of different mental disorders. As a result, new treatments designed to help people build their abilities to tolerate distress will continue to emerge.

If you struggle with managing your emotional reactions to stress, try some of the techniques we mentioned in this article or try working with a therapist. The goal of treatments such as dialectical behavior therapy is to identify these distress-intolerant beliefs and replace them with more helpful, realistic thoughts. DBT and other treatment methods also address the resulting behaviors and attempt to replace them with more effective coping skills.

5 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jamilian HR, Malekirad AA, Farhadi M, Habibi M, Zamani N.Effectiveness of group dialectical behavior therapy (based on core distress tolerance and emotion regulation components) one expulsive anger and impulsive behaviors.Glob J Health Sci. 2014;6(7 Spec No):116-123. doi:10.5539/gjhs.v6n7p116Trafton JA, Gifford EV.Biological bases of distress tolerance. In MJ Zvolensky, ABernstein, AA Vujanovic (Eds.),Distress tolerance: Theory, research, and clinical applications(p. 80–102). The Guilford Press; 2011.Thomas A, Chess S.Temperament and Development.Brunner/Mazel; 1977.Lynch TR, Mizon GA.Distress overtolerance and distress intolerance: A behavioral perspective. In M.J. Zvolensky, A. Bernstein & A.A. Vujanovic (Eds.),Distress tolerance: Theory, research, and clinical applications. New York: Guilford Press. 2011.Leyro TM, Zvolensky MJ, Bernstein A.Distress tolerance and psychopathological symptoms and disorders: A review of the empirical literature among adults.Psychol Bull. 2010;136(4):576-600. doi:10.1037/a0019712Additional ReadingGreen N.Practical skills for helping clients: DBT inspired techniques for working with clients - DT skills. Emory University; 2023.Vujanovic AA, Bernstein A, Litz BT.Traumatic stress. In M.J. Zvolensky, A. Bernstein, & A.A. Vujanovic (Eds.),Distress Tolerance: Theory, Research, and Clinical Applications. Guilford Press; 2011:126-148.

5 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jamilian HR, Malekirad AA, Farhadi M, Habibi M, Zamani N.Effectiveness of group dialectical behavior therapy (based on core distress tolerance and emotion regulation components) one expulsive anger and impulsive behaviors.Glob J Health Sci. 2014;6(7 Spec No):116-123. doi:10.5539/gjhs.v6n7p116Trafton JA, Gifford EV.Biological bases of distress tolerance. In MJ Zvolensky, ABernstein, AA Vujanovic (Eds.),Distress tolerance: Theory, research, and clinical applications(p. 80–102). The Guilford Press; 2011.Thomas A, Chess S.Temperament and Development.Brunner/Mazel; 1977.Lynch TR, Mizon GA.Distress overtolerance and distress intolerance: A behavioral perspective. In M.J. Zvolensky, A. Bernstein & A.A. Vujanovic (Eds.),Distress tolerance: Theory, research, and clinical applications. New York: Guilford Press. 2011.Leyro TM, Zvolensky MJ, Bernstein A.Distress tolerance and psychopathological symptoms and disorders: A review of the empirical literature among adults.Psychol Bull. 2010;136(4):576-600. doi:10.1037/a0019712Additional ReadingGreen N.Practical skills for helping clients: DBT inspired techniques for working with clients - DT skills. Emory University; 2023.Vujanovic AA, Bernstein A, Litz BT.Traumatic stress. In M.J. Zvolensky, A. Bernstein, & A.A. Vujanovic (Eds.),Distress Tolerance: Theory, Research, and Clinical Applications. Guilford Press; 2011:126-148.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Jamilian HR, Malekirad AA, Farhadi M, Habibi M, Zamani N.Effectiveness of group dialectical behavior therapy (based on core distress tolerance and emotion regulation components) one expulsive anger and impulsive behaviors.Glob J Health Sci. 2014;6(7 Spec No):116-123. doi:10.5539/gjhs.v6n7p116Trafton JA, Gifford EV.Biological bases of distress tolerance. In MJ Zvolensky, ABernstein, AA Vujanovic (Eds.),Distress tolerance: Theory, research, and clinical applications(p. 80–102). The Guilford Press; 2011.Thomas A, Chess S.Temperament and Development.Brunner/Mazel; 1977.Lynch TR, Mizon GA.Distress overtolerance and distress intolerance: A behavioral perspective. In M.J. Zvolensky, A. Bernstein & A.A. Vujanovic (Eds.),Distress tolerance: Theory, research, and clinical applications. New York: Guilford Press. 2011.Leyro TM, Zvolensky MJ, Bernstein A.Distress tolerance and psychopathological symptoms and disorders: A review of the empirical literature among adults.Psychol Bull. 2010;136(4):576-600. doi:10.1037/a0019712

Jamilian HR, Malekirad AA, Farhadi M, Habibi M, Zamani N.Effectiveness of group dialectical behavior therapy (based on core distress tolerance and emotion regulation components) one expulsive anger and impulsive behaviors.Glob J Health Sci. 2014;6(7 Spec No):116-123. doi:10.5539/gjhs.v6n7p116

Trafton JA, Gifford EV.Biological bases of distress tolerance. In MJ Zvolensky, ABernstein, AA Vujanovic (Eds.),Distress tolerance: Theory, research, and clinical applications(p. 80–102). The Guilford Press; 2011.

Thomas A, Chess S.Temperament and Development.Brunner/Mazel; 1977.

Lynch TR, Mizon GA.Distress overtolerance and distress intolerance: A behavioral perspective. In M.J. Zvolensky, A. Bernstein & A.A. Vujanovic (Eds.),Distress tolerance: Theory, research, and clinical applications. New York: Guilford Press. 2011.

Leyro TM, Zvolensky MJ, Bernstein A.Distress tolerance and psychopathological symptoms and disorders: A review of the empirical literature among adults.Psychol Bull. 2010;136(4):576-600. doi:10.1037/a0019712

Green N.Practical skills for helping clients: DBT inspired techniques for working with clients - DT skills. Emory University; 2023.Vujanovic AA, Bernstein A, Litz BT.Traumatic stress. In M.J. Zvolensky, A. Bernstein, & A.A. Vujanovic (Eds.),Distress Tolerance: Theory, Research, and Clinical Applications. Guilford Press; 2011:126-148.

Green N.Practical skills for helping clients: DBT inspired techniques for working with clients - DT skills. Emory University; 2023.

Vujanovic AA, Bernstein A, Litz BT.Traumatic stress. In M.J. Zvolensky, A. Bernstein, & A.A. Vujanovic (Eds.),Distress Tolerance: Theory, Research, and Clinical Applications. Guilford Press; 2011:126-148.

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