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How to Tolerate Distress

Updated: Jun 24

We all face times in our lives which cause us pain and distress. We might have physical pain from a fall or a medical illness or emotional pain from job loss or relationship conflict.  Life is full of painful events; some we are in control of and others we are not. While we may not be in control of what happens to us, we can control our response to it.  If you are someone who struggles with overwhelming emotions, you may be coping with your pain by using strategies that make your problem worse and cause you even deeper emotional pain.



Do you sometimes:

  • Spend a lot of time thinking about and dwelling on your negative thoughts, feelings, and circumstances and their causes or consequences?

  • Spend time worrying about what may happen in the future?

  • Isolate yourself and avoid what is causing you distress?

  • Use alcohol, drugs, or food to numb yourself and mask your emotions?

  • Take your anger, frustration, or other unpleasant emotions out on other people?

  • Resign to being a victim and living a miserable life?

There is a better way.  To avoid the consequences of using these problematic coping strategies and the long-term pain they cause, Wisdom Path teaches Marsha Linehan’s Distress Tolerance skills. These skills help us cope with emotional pain in such a way that we get “unstuck” and can reduce the intensity and duration of the suffering. Using these skills, you will better be able to survive a crisis, accept life as it is in the moment, and allow the possibility of change to be present! 


Distress Tolerance skills include:


  • Crisis Survival Skills:

  1. STOP: Stop, Take a step back, Observe, and Proceed mindfully

  2. Pros and Cons: weighing the negative and positive consequences of acting on and not acting on an urge during a crisis

  3. TIPP: Tipping the temperature of your body with cold water, Intense exercise, Paced breathing, Progressive muscle relaxation

  4. ACCEPTS: Distracting ourselves by using  Activities, Contributing, Comparisons (in a positive light), Emotions (opposite to the current unpleasant emotion), Pushing away from the situation, Thoughts, and Sensations

  5. Self-Soothing: Using the five senses to calm our nervous system

  6. IMPROVE: Improving the moment using Imagery, Meaning, Prayer, Relaxing actions, One thing in the moment, Vacation, and Encouragement 


  • Reality Acceptance Skills:

  1. Radical Acceptance: Complete openness and to the facts without attempting to control it.

  2. Turning the Mind: Choosing to make an inner commitment to accept

  3. Willingness: Being willing to respond in a way that is needed from a wise mind place.

  4. Half-Smiling and Willing Hands: Accepting reality with your body


  • Mindfulness of Current Thought: Allowing the mind to observe thoughts as thoughts and not trying to control them.


These are skills which enable us to survive a crisis without making things worse and are a more effective alternative to the unhealthy strategies we often use!

If you would like to learn more about how to use these skills, please ask us about the Dialectical Behavior Therapy Group that Wisdom Path offers on Thursday mornings. Please talk to your therapist about referring you to this group. 

*Referrals are only accepted from other therapists through our referral form. 


Kim Harshaw, LCMHCS is a seasoned psychotherapist at Wisdom Path who serves as the Clinical Coordinator and leads our Dialectical Behavior Therapy skills program. 

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