Distress Tolerance Skills

Skills Training: Distress Tolerance

Distress tolerance skills are used when something unpleasant is happening, there is no way to solve the problem or get rid of the stressful situation at this time and you need to cope with it. Distress tolerance should not be used when a problem can be solved. If you can solve the problem, solve it! Goals of distress tolerance include crisis survival and accepting reality.

Crisis Survival Skills

DISTRACTING – A way to remember these is skills is the phrase “wise mind ACCEPTS

  • with Activities - Exercise, engage in hobbies, cleaning or doing chores, call or visit a friend, games, write, etc.
  • with Contributing – Practice generosity, do something for someone else.
  • with Comparisons – Practice gratitude by comparing yourself to others or to a time you were worse off. Count your blessings.
  • with Emotions – Read emotional books (novel) or watch emotional movie (making sure either is OPPOSITE to current emotion), watch cartoons, listen to upbeat music.
  • with Pushing Away – Practice patience by letting go of the situation for a while. Leave situation mentally, build an imaginary wall between self and situation, censor ruminating, put situation on the shelf, box it up.
  • with Thoughts – Count to 10, count colors in surroundings, do puzzles, watch TV.
  • with Sensations - Come down to earth and get grounded by experiencing a very intense sensation. For instance, hold ice in your hand, squeeze a rubber ball, take hot shower, listen to loud music, snap elastic band on wrist.


  • With Imagery – Imagine relaxing scenes, imagine secret room inside yourself and see how it is decorated – go in and close the door, imagine everything going well, imagine coping well, make up a fantasy world that is calming and beautiful and let your mind go with it, imagine hurtful emotions draining out like water out of a pipe.
  • With Meaning - Find purpose or meaning in pain, read about, remember or listen to spiritual values, focus on positive aspects of situation and repeat them over and over, make lemonade out of lemons.
  • With Prayer - Open the heart to great wisdom, the universe or a higher power – either God or your own wise mind. Ask for strength to bear pain in the moment. Turn things over to a higher power.
  • With Relaxation – Tense and relax muscle groups starting with hands and arms going to top of head then working down, listen to relaxation tape, exercise hard, take hot bath, drink hot milk, massage neck, scalp, hands, calves, breathe deeply, half-smile, change facial expression.
  • With One Thing in the Moment – Focus entire attention on what you are doing right now, keep in the very moment you are in, stay in the present, focus entire attention on physical sensations that accompany tasks that require little thinking, such as walking, doing dishes, playing sports, cleaning, be aware of how body moves, do awareness exercises.
  • With a brief Vacation - Go to bed for 20 minutes, pull up covers, lie around with magazine or newspaper, get in bed and eat chocolates while reading, unplug the phone, take one hour break from things that must be done.
  • With Encouragement – Cheerlead yourself: “I can stand it!”; “It won’t last forever”; “I will make it out of this”; “I’m doing the best I can!”

SELF - SOOTHING -  with the 5 senses

  • Vision – Look at flowers, light a candle and watch the flame, go out and watch stars, look at beautiful pictures, be mindful of all sights- not lingering on any.
  • Hearing – Listen to beautiful, soothing, or exciting music, listen to sounds of nature, sing, hum, play instrument, call 800 numbers to hear human voice – be mindful of sounds, letting them go in one ear and out the other.
  • Smell – Perfume, lotion, scented candles, oil furniture, potpourri, boil cinnamon, bake cookies, chew gum, suck on a peppermint, smell flowers, walk in wooded area and breathe mindfully.
  • Taste – Have a good meal, favorite soothing drink (no caffeine or alcohol), dessert, get a special good treat, eat mindfully.
  • Touch – Take a bubble bath, clean sheets, pet dog or cat, get a massage, soak feet, lotion entire body, put cold compress on head, feel silky clothing/furry clothing, brush hair for a long time, hug someone, experience whatever you are touching, notice touch that is soothing.