Distress Tolerance Skills

The Importance of Distress Tolerance for Mental Health

Throughout their lives, all people experience varying degrees of psychological distress. This distress produces unpleasant mental and physical effects. Some people are well-equipped to handle these effects. However, others lack a strong ability to tolerate psychological distress. In some cases, this lack of tolerance can contribute to the onset of serious mental illness.

Fortunately, it is possible to develop better distress tolerance skills. A form of psychotherapy called dialectical behavior therapy, or DBT, is often used to achieve this goal. DBT provides a benefit because it helps you improve your ability to manage your emotional state.

Psychological Distress Basics

Psychological distress is a common human experience. It occurs when you undergo emotional or psychological discomfort. That discomfort, linked to changes in your mood, has an impact on your ability to function. Most of the time, this impact is relatively minor, and low levels of distress are normal and expected.

However, all people have a limit to their ability to handle psychological distress. If that limit is exceeded, you run the risk of developing significant mental health issues. In fact, high levels of distress are associated with the development of serious illnesses such as:

• Anxiety disorders
• Major depression
• Somatization disorder
• Schizophrenia

High psychological distress also increases your risk for developing problems with drugs or alcohol.

There is no single measure of psychological distress. This means that a situation that distresses someone else might not cause that reaction in you. The opposite is also true. For these reasons, the experience of distress is always subjective.

If you feel overwhelmed by distressing emotions, your natural urge may be to avoid them. However, if you try to do this, you may actually increase your level of distress. This is true because your efforts may have a kind of boomerang effect. Instead of escaping, you may end up returning to the same feelings in a more intense form.

What Is Distress Tolerance

Distress tolerance is the ability to maintain your life direction while undergoing psychological distress. It rests on your capacity to manage your feelings of distress. Successful management of these feelings helps you function in emotionally painful circumstances. It also helps you avoid doing things to make your situation worse.

A number of factors help determine your distress tolerance levels. One potential influence is your genetic background. Research shows that some people may be born with higher levels of tolerance than others. People born with low tolerance may be more susceptible to negative emotional states. This susceptibility can increase the odds that you will:

• Feel negative emotions
• Have an intense reaction to those emotions
• Be affected by those emotions for relatively long amounts of time

Your experiences while growing up may also play a role. For example, as a child, you may have lived in a chaotic environment filled with stressful situations. You may also have had parents who did not teach you effective stress coping skills. In contrast, you may have grown up in a stable, relatively predictable family environment. You may also have had parents who taught you how to deal effectively with emotional discomfort.

Another potential factor is your experience of life as an adult. At some point in their lives, more than half of all adults will go through highly distressing, traumatic situations. Exposure to these situations can easily outstrip your established level of emotional tolerance.

There is a good chance that this increased state of vulnerability will not last for long. However, some people are much more seriously affected. If this happens to you, you are at-risk for developing PTSD, which is known for its link to distressing emotions. You may also have heightened risks for developing depression or an anxiety disorder.

Symptoms of Intolerance to Distress

How can you tell if you are affected by distress intolerance? The list of potential symptoms includes:

• Perceiving distressing or upsetting emotions as impossible to endure
• Being frightened by your distressing or upsetting emotions
• Noticing that most other people seem to handle distress better than you do
• Feeling ashamed of your reactions to distressing emotions
• Thinking you would do anything to avoid or stop distressing emotions
• Believing that nothing is more terrible than distressful emotions
• Being completely overwhelmed by your distressing or upsetting feelings

You may also experience other symptoms of intolerance to distress. But be aware that distress intolerance is not itself a mental illness. It is an emotional response with the potential to put you at risk for mental health and substance problems.

Techniques for Tolerating Distress

If you are affected by distress intolerance, you are not doomed to remain that way. Over the years, a range of techniques for tolerating distress have been developed. No matter your current level of symptoms, these techniques can help you improve. In fact, it is fair to say that developing emotional tolerance skills is important for everyone.

What types of distress tolerance skills should you focus on? Options that you may find helpful include:

• Self-soothing
• Radical acceptance
• TIPP skills
• Purposeful distraction

In self-soothing, you rely on one or more of your five senses to ground yourself emotionally. For example, you may decide to focus on the colors of certain nearby objects. You can also focus on:

• The sound of your own breathing
• What it feels like to touch or be touched
• The taste of a food you like
• Smells in your local environment

In radical acceptance, you give up trying to change how you feel. Instead, you simply try to accept what is happening to you. It may sound counterintuitive, but not trying to escape your feelings may make them easier to tolerate.

TIPP is an acronym for a set of four actions you can take to relieve your distress. These actions are:

• Temperature changes through contact with cold water or ice
• Intense exercise
• Paced breathing
• Paired muscle relaxation

In its own way, each action decreases your ability to stay in a highly distressed mental state.

In purposeful distraction, you shift your attention in order to distract yourself from distressing situations. The specific things you shift your attention to are not set in stone. You can choose anything, as long as it works and will not harm you in other ways. Potential examples include:

• Listening to music
• Talking to your friends or loved one
• Reading a book
• Playing a game

The goal of the distracting activity is to help you calm down. Once you feel calmer, you can then confront the distressing situation in a more balanced manner.

DBT and Distress Tolerance

All of the distress tolerance skills we have discussed can be used as part of dialectical behavior therapy. Mental health experts first developed DBT as a treatment for borderline personality disorder. The therapy is now successfully used to treat other mental illnesses. It is also used to help people with dual diagnosis. This is the term for substance problems combined with additional mental illness.

In DBT, you learn how to accept your current emotional reality. Crucially, you also learn how to change that reality for the better. Identifying and managing distress are essential to the therapy’s working model. In fact, improving distress tolerance is one of the key goals of the therapy. Other skills you focus on in DBT include:

• Becoming more mindful of what is happening to you in any given moment
• Improving your ability to regulate your emotional state
• Developing a greater ability to interact with others in healthy ways

Treatment with DBT takes place in gradual stages. In the first stage, you work on gaining basic control over your behaviors. In stage two, you begin to learn how to integrate all of your emotions into your conscious experience. In stage three, you learn how to make your newly gained skills a durable part of your daily life.

Developing Emotional Tolerance Skills: Your Personal Journey

Dialectical behavior therapy is not the same for everyone. This is true because everyone has their own experiences and tendencies. When you first begin DBT, your treatment team will develop an approach that meets your needs. That approach will likely include the development of specific distress tolerance skills. It will also probably include the development of the other three core DBT skills.

It takes time to complete a full course of dialectical behavior therapy. Six months of weekly sessions are the norm for most people. Depending on your situation, you may also receive a shorter or longer course of therapy.

Strengthen Distress Tolerance at Emerald Isle

Are you or your loved on affected by high levels of psychological distress? The experts at Emerald Isle Health & Recovery can help. We provide psychiatric assessments and evaluations designed to detect any significant problems. These tests will help give you a full picture of your current and future risks.

Emerald Isle also specializes in the treatment of conditions linked to low distress tolerance. Our many options include a course of DBT customized for your unique situation. We use this therapy as part of a comprehensive treatment plan designed to support an effective recovery. To learn more about ways to improve your distress tolerance skills, call us today.