There’s a certain kind of moment most of us know well: the wave of panic before a hard conversation, the flash of rage in traffic, or the grief that hits with little to no warning. In those moments, part of you wants to do something, anything, to make the feeling stop. Send a text you might regret later. Slam the door. None of that makes you a bad person. It’s what intense feelings do to all of us when we don’t have another way to work through them.
This has a name in psychology: distress tolerance. It isn’t a fixed personality trait some people are born with, and others aren’t. Research describes it as a skill, one that can be strengthened with practice to improve emotional control.[1]
To help you better understand the concept, this article will explore:
Distress tolerance involves two things:[1]
Researchers have broken this down further into five related but distinct areas, and you’ve probably felt all of them at some point:[1]
What’s important to recognize is the idea underlying them all: distress tolerance isn’t one single switch. It shows up differently depending on what kind of discomfort you’re facing. You might sit calmly through a delayed test result and completely lose patience in a slow queue. The five separate capacities each have their own limit.
A common misunderstanding about distress tolerance is that it’s about suppressing emotions or willing them to go away. It’s actually about surviving the moment without causing more distress, while a separate set of skills works to change or ease the emotion itself.
You may have heard “distress tolerance” and “emotional regulation” used to mean the same thing. They don’t, and the difference is worth understanding because it might explain why some coping advice hasn’t quite worked for you before.
Distress tolerance is about getting through the emotion as it is, especially in moments when you can’t change it fast enough to make a meaningful difference. Emotional regulation is about changing the emotion by:[2]
Dialectical Behavior Therapy (DBT) actually builds this difference right into how it teaches these skills. Distress tolerance and mindfulness are grouped as acceptance skills, while emotion regulation and interpersonal effectiveness are grouped as change skills. The two are meant to work together, not compete.[2]
Recent research helps illustrate why the two get confused. One study found that people with lower distress tolerance reported putting in more effort toward regulating their emotions and finding it more difficult. However, this doesn’t necessarily mean they were less successful at it.[3]
Low distress tolerance doesn’t mean regulation fails; it means regulation feels harder to do. That’s an important distinction, and one that’s kinder, too.
If tolerating hard emotions feels more of a struggle for you than it seems to be for other people, you’re not imagining it; it’s a pattern researchers have traced.
For example, a large study of 1,000 adults found that people with higher sensitivity to anxiety (a stronger fear of their own anxious sensations) tend to have lower distress tolerance.[4] As another example, early environment shapes the capacity for distress tolerance. If your emotions weren’t given much room growing up by being dismissed, punished, or ignored, it makes sense that you might not have picked up the internal tools for handling distress. That’s not something you were supposed to figure out on your own.[2]
Thankfully, those internal tools can be built later in life, at any age. That’s exactly what the skills below are designed to do.
Many distress tolerance coping skills for emotional dysregulation trace back to DBT therapy, where distress tolerance is one of four core skill sets alongside:
Together, these skills are meant to help you survive a crisis, while other work addresses the underlying problem in that instant.[2]
These skills might be organized into four practical categories:
Here’s what each looks like in daily life.
Distraction (sometimes referred to as refocusing) means temporarily redirecting your attention away from painful thoughts through activities. For example, you might do something kind for someone else or watch a funny video during a wave of sadness.[5].” url=”https://psychiatry.ucsf.edu/sites/psych.ucsf.edu/files/DISTRESS%20TOLERANCE%20SKILLS%20MANUAL%20e-version.pdf”] It’s a short-term tool for getting through an acute moment safely so you have room to deal with the real issue later.
Self-soothing is similar, though it’s a gentler, more nurturing option. It means deliberately engaging your senses in comforting ways. For example, you might listen to calming music or take a warm bath.[5].” url=”https://psychiatry.ucsf.edu/sites/psych.ucsf.edu/files/DISTRESS%20TOLERANCE%20SKILLS%20MANUAL%20e-version.pdf”]
Distraction and self-soothing help you get through the worst moments. The next two skills go a step further, helping you actively shift how that moment feels.
Improving the moment means intentionally adding something small and positive into a hard stretch of time, rather than waiting until you feel better to act. You might, for example, start a pleasant activity you enjoy amidst an emotionally distressing time, because actions can shape emotions just as much as emotions shape actions.
Meanwhile, radical acceptance means accepting a painful reality. This is not the same as approving of it or agreeing with it. Instead, it means acknowledging what’s actually happening right now, in this moment, so you stop spending your energy fighting a reality that won’t budge. Doing so allows you to redirect that energy toward what you can influence.[2]
The theory behind this is straightforward: suffering tends to come from pain plus the refusal to accept that pain is happening. Fully accepting the present moment in this way is often where real change quietly begins.[2]
These skills give you something real to reach for instead of an impulsive reaction. For example, research shows that the more frequent use of distress tolerance and other DBT skills is associated with better treatment outcomes across a wide range of mental health conditions.[6]
People with bipolar disorder who completed DBT skills training in a group setting showed marked improvements in:[7]
These gains remained at follow-ups one month and three months later.[7] That durability matters; it suggests these aren’t fleeting improvements that fade once the sessions end.
One of the biggest reasons these gains tend to last comes down to a skill we’ve already mentioned: mindfulness.
Mindfulness and distress tolerance aren’t separate boxes to check; they’re closely intertwined. Picture two mornings. On the first morning, you rush out the door, already checking your phone and half-present for other thoughts.
On the second morning, you stop and notice the smell of your coffee and how the crisp morning air feels in your lungs before starting your day. This enables you to stay a little more anchored and present. Research suggests that this kind of day doesn’t just feel calmer; it’s connected to a real difference in how well you tolerate whatever stress shows up that day.[8]
People who felt more mindful than usual reported having less anxiety and a lighter mood, while also reporting a stronger ability to tolerate distress. Even more encouraging is how quickly these benefits can be felt. Just one day of being more present can genuinely shift how the rest of the week feels.[8]
Distress tolerance is what researchers call a transdiagnostic factor. This means it shows up almost everywhere emotional pain does. If you’ve ever felt like your coping difficulties don’t fit neatly into one category, that tracks with what the research shows.[4]
Take obsessive-compulsive disorder (OCD) as one example. For someone with OCD, an intrusive thought creates real distress, and acting on a compulsion often brings fast, if short-lived, relief. Building distress tolerance skills alongside traditional OCD treatment could help make that urge to give in to the compulsion easier to resist.[9] A skill built for one situation can also be effective in many other situations.
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A large study in the UK looked at what happened when everyday mental health clients worked through a short program of building distress tolerance skills.[10]
Over half saw real, lasting improvement. Those improvements held up just as well as what’s usually seen in standard psychotherapy, despite the program lasting only six to eight sessions.[10]
One of the most encouraging findings, especially if you feel like you have a long way to go, is that people who scored lowest when they started the program tended to improve the most. If you’re reading this and thinking your distress tolerance feels shaky at best, that’s a sign that should offer you a lot of encouragement.[10]
People who complete distress tolerance skills training are frequently more confident in managing stress by the end of the program.[11] What’s really encouraging is that confidence usually builds before other things start to feel easier, such as managing emotions in general or being gentler with yourself.[11]
Learning to tolerate distress may be one of the first real wins you feel on this path, a sign that things are moving in the right direction. It’s important to understand that relief doesn’t always arrive all at once, but it often starts sooner than you expect.
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Finding it hard to tolerate distress isn’t a personal failing. It’s a documented and well-researched pattern, and the skills covered here are concrete, learnable tools backed by real evidence. If you’ve read this far and find yourself wanting more structured, guided support in building these skills, AMFM (A Mission For Michael) Mental Health Treatment offers DBT-informed care across our residential, partial hospitalization, intensive outpatient, and outpatient level treatment programs.
We offer an intimate, focused mental health treatment experience for adults in home-like settings that are carefully maintained to be peaceful, comfortable spaces. Our team of expert clinicians believes in treatment persistence and will personalize your treatment plan so you can achieve lasting, life-changing outcomes.
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Reach out to us if you would like to start the admissions process or learn more about how we can support your mental well-being. Our compassionate team is available 24/7 to answer your questions and provide guidance with no obligation. We’re here for you each step of the way.
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