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DBT Skills for Effective Living:
Distress Tolerance

All of us experience distressing emotions on a regular basis. We might react to something small like getting a parking ticket, or something larger like getting into a fight with a partner or friend. There are many ways that we feel loss in the emotional, physical, or spiritual realm--and that is painful. But did you know that you have a choice in how you manage your painful feelings?

We deal with pain in the best ways we know how—we are often unaware that there are better ways of handling distress. It is natural to want to feel better as quickly as possible when we feel bad. However, our attempts to take away our pain often lead us to do something impulsive and harmful. These behaviors may distract us from our pain in the short term, but usually lead to negative consequences. For example, when people experience uncomfortable emotions they may turn to drugs or alcohol, self-injurious behavior, abusive relationships, impulsive shopping or gambling, binging/purging or restricting food. These activities help ease the pain for the time being, but ultimately lead to increased suffering and a sense of one being disengaged from oneself and from life. It is possible to respond to pain wisely and mindfully by being more present in our lives.   

In DBT, we try to acknowledge that the pain exists, and then make a choice to deal with the painful feelings as gracefully as possible. Rather than impulsively trying to escape pain, we mindfully tolerate the pain.  Alternatively, we make a thoughtful decision to put our painful emotions aside for a later time.

It is important to remember that we experience all of our emotions for a reason: our emotions communicate powerful truths to ourselves and to others. When we dishonoring our emotions with impulsive actions, we miss out on important information about ourselves.  We don’t have the opportunity to acknowledge the problems in our lives and solve them. This keeps us stuck and prevents growth and change.

In the Distress Tolerance module of DBT, we learn how to whether crises accompanied by intense feelings. We learn how to experience the present moment to make it more tolerable for ourselves. We’re not changing or suppressing our emotions, we’re just figuring out how to survive the moment and allow our feelings to take there natural course. We also learn the powerful concept of Radical Acceptance, which helps us adjust our basic attitude toward the stresses of life. We don’t use up all of our energy protesting that pain has occurred.  When we accept the reality we are given, we heave the resources to skillfully cope with problems and move on.

You cannot stop the waves, but you can learn how to surf!

To learn more about group or individual DBT, contact Niquie Dworkin at

DBT Skills Training Group

Individual DBT

DBT Emotion Management Quiz



Interpersonal Effectiveness

Distress Tolerance

Emotion Regulation

DBT Consultation Group