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Alcohol and Mental Health

What Are DBT Distress Tolerance Skills? Your Ultimate Guide

Published:
August 31, 2023
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19 min read
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Reframe Content Team
A team of researchers and psychologists who specialize in behavioral health and neuroscience. This group collaborates to produce insightful and evidence-based content.
August 31, 2023
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19 min read
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Certified recovery coach specialized in helping everyone redefine their relationship with alcohol. His approach in coaching focuses on habit formation and addressing the stress in our lives.
August 31, 2023
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19 min read
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Recognized by Fortune and Fast Company as a top innovator shaping the future of health and known for his pivotal role in helping individuals change their relationship with alcohol.
August 31, 2023
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19 min read
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Reframe Content Team
August 31, 2023
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19 min read

It's Friday evening, and Emily’s just showed up to her friend’s dinner party. As the bottle of Merlot makes its way around the table, Emily momentarily loses herself in thought. It's been a week since she committed to reducing her alcohol intake. Each passing day has tested her resolve, with cravings sneaking up on her in unexpected moments. Tonight, the challenge seems amplified by the need to fit in.

Yet, as the bottle approaches, Emily makes a conscious choice. She declines and instead pours herself a glass of sparkling water. While outwardly, it might seem like a simple gesture, Emily is internally navigating a sea of emotions and distressing thoughts. This is where her recently acquired DBT distress tolerance skills come into play. Relying on them, Emily manages to stay grounded, enjoying the evening while staying true to her commitment.

What Are DBT Distress Tolerance Skills?

Understanding the complexities of human emotion and behavior has always been a central focus in psychology. Within this vast field, dialectical behavior therapy (DBT) emerges as a pioneering therapeutic approach, shedding light on how we deal with distressing situations. 

Origins of Dialectical Behavior Therapy

To comprehend distress tolerance, it's essential to recognize DBT's roots. Dr. Marsha Linehan, in the late 1980s, developed DBT to address the specific needs of individuals diagnosed with borderline personality disorder (BPD) who often struggled with self-harm or suicidal tendencies. Her goal was to create a therapy that would enable these individuals to regulate their emotions, develop healthier relationships, and improve their overall quality of life.

However, as the efficacy of DBT became evident, therapists began to employ its techniques for a broader range of issues. Substance misuse, in particular, emerged as a field where DBT showed significant potential. The reason? Many parallels exist between the emotional turbulence often faced by those with BPD and the distressing triggers that can lead someone to misuse substances.

DBT's Cornerstone: Distress Tolerance Skills

Distress tolerance, as a component of DBT, focuses primarily on building resilience and improving our capacity to withstand challenging situations without resorting to negative behaviors. Instead of trying to change or eliminate distressing feelings immediately, this approach emphasizes enduring them in a more adaptive and less destructive manner.

Let's consider the metaphor of an athlete training for a marathon. The runner doesn't begin by attempting the full 26.2 miles right away. Instead, they train incrementally, building stamina, muscle strength, and mental tenacity. Similarly, distress tolerance skills are like the "training regimen" for our emotional and psychological well-being, equipping us with tools to handle life's challenges.

The Four Key Aspects of Distress Tolerance

Distress tolerance comes down to four things: distraction, self-soothing, improving the moment, and considering pros and cons. Let’s consider each of these factors:

  • Distraction: During heightened moments of distress, our thoughts can become overwhelming, forming a vicious cycle of negativity. Distraction techniques involve diverting the mind temporarily from these distressing thoughts. This isn't about avoidance but offers a temporary break, allowing us to return to the issue with a clearer, calmer mind.

  • Self-soothing: This revolves around the idea of comforting ourselves in healthful ways. It might involve engaging the five senses: listening to calming music, having a warm drink, or even just feeling the texture of a comforting blanket. These actions, though simple, can have profound effects on calming the mind.

  • Improving the moment: Sometimes, the direct removal of a distressing factor isn't possible. In such scenarios, this technique focuses on finding ways to make the current situation a little more bearable. It could be as simple as reciting positive affirmations or using visualization techniques to picture a happier scenario.

  • Considering pros and cons: When faced with an immediate urge to resort to harmful behaviors, like grabbing that tempting glass of wine, we can weigh the short-term and long-term benefits and consequences. This rational analysis often provides the clarity needed to make a healthier choice.


Why Distress Tolerance Skills Matter

In a world rife with unpredictable challenges, possessing the ability to tolerate distress is invaluable. Whether it’s dealing with the loss of a job, a breakup, or everyday stresses like traffic jams, these skills offer a framework to process emotions healthily.

For those of us changing our relationship with alcohol, the journey is often marred with triggers — social scenarios, personal setbacks, or even specific emotions. Each time we choose not to give in to the pull of the substance, we’re effectively flexing our "distress tolerance muscle." Over time, this repeated action strengthens our resilience, decreasing the alcohol’s allure.

The Transformative Science-Backed Benefits of Distress Tolerance Skills

The strength of distress tolerance skills lies not just in theory but in their palpable, transformative power. These skills aren’t just therapeutic techniques; they are tools of empowerment, transformation, and growth. Here are some of the biggest benefits.

1. Fostering Resilience: Building Emotional Stamina

Imagine resilience as a shield. The thicker and stronger this shield, the better we can deflect life’s challenges without crumbling. One of the most potent benefits of distress tolerance skills is the development of this emotional resilience.

  • Understanding emotional triggers: Distress tolerance skills equip us with the ability to recognize emotional triggers. By identifying what sets off emotional spirals, we can proactively develop strategies to deal with them.

  • Building emotional endurance: Just as a marathon runner trains to develop physical endurance, distress tolerance skills serve as a training regimen for emotional stamina. Through repeated exposure and the application of these skills, we can build the ability to endure challenging emotional states without immediate mitigation.
  • Bouncing back: Resilience isn’t just about enduring; it’s also about recovery. Distress tolerance skills help us not only weather emotional storms but also bounce back from them more rapidly.


2. Breaking the Cycle: Offering an Alternative Coping Mechanism

For many of us struggling with our alcohol intake, there's a cyclic pattern: emotional distress leads to alcohol use as a coping mechanism, which results in short-term relief but long-term negative consequences, leading to more distress. Distress tolerance skills offer a way to break this harmful cycle. Here’s how:

  • Delaying gratification: One of the foundational aspects of distress tolerance is the ability to delay immediate gratification in favor of long-term benefits. Instead of reaching for that drink to find quick relief, these skills allow us to sit with our discomfort, realizing that it's temporary and will pass.

  • Developing healthier coping strategies: Distress tolerance introduces a repertoire of healthier coping strategies, such as deep breathing, distraction, or grounding exercises. By offering alternatives, it reduces the reliance on maladaptive behaviors.

  • Reducing relapse rates: For those in recovery from substance abuse, distress tolerance skills have shown to reduce relapse rates. By providing tools to deal with distressing triggers, the likelihood of resorting back to alcohol use diminishes.


3. Boosting Self-confidence: A Journey of Self-belief and Mastery

When we consistently employ and succeed in using distress tolerance skills, there's a remarkable growth in self-confidence. This isn’t just anecdotal but rather is backed by countless research findings.


  • Mastering skills and celebrating small wins: Every time someone successfully employs a distress tolerance technique to navigate a distressing scenario, it's a victory. These small wins accumulate over time, contributing to a sense of mastery and competence.

  • Shifting self-perception: Over time, we begin to view ourselves not as victims of our emotions or circumstances but as empowered beings capable of handling challenges. This shift in self-perception is monumental in boosting self-confidence.

  • Empowerment in choices: With increased confidence, we realize we have choices. We are no longer at the mercy of our impulses but can make empowered decisions about how to respond to situations.

The Power of Saying No to Alcohol With DBT

Alcohol, for many, is a double-edged sword. While it offers a temporary escape from distressing emotions or situations, its long-term implications on physical and mental health are undeniable. DBT's distress tolerance skills come to the forefront in this battle against alcohol reliance.

  • Understanding the underlying emotions: Often, the urge to drink stems from deeper, unaddressed emotions. Distress tolerance skills provide the tools to introspect and understand these underlying feelings.
  • Providing immediate tools for intervention: When the craving strikes, it's crucial to have immediate tools for intervention. Whether it's a grounding technique, a breathing exercise, or simply the ability to distract ourselves, these skills can be the crucial difference between reaching for a drink and choosing a healthier coping mechanism.

  • Building a support system: DBT often involves group therapy, where individuals learn from peers, share experiences, and build a supportive community. Knowing we aren't alone in the journey can be incredibly empowering.

Practicing Distress Tolerance Skills

Navigating the stormy waters of distress can be challenging, but with the right techniques, it's possible to sail through with grace and fortitude. Here's a deeper dive into how we can hone these much-needed distress tolerance skills.

1. Self-Soothe With the Senses

  • Sounds: Sounds, especially calming ones, have a therapeutic effect on the mind. Whether it's the rustling of leaves, soft instrumental music, or the gentle hum of a fan, tuning into these sounds can center the mind.

  • Touch: From the soft caress of a pet's fur to the textured surface of a favorite blanket, touch has a grounding effect. Simple tactile activities, like kneading dough or immersing hands in a bowl of cool water, can also help recalibrate emotions.
  • Smells: Scented candles, essential oils, or even the comforting aroma of freshly baked bread can evoke feelings of warmth, security, and nostalgia. Choosing scents like lavender, chamomile, or eucalyptus can especially calm the nerves.

2. Embrace the TIPP Technique

  • Cold splash, fresh perspective: A sudden change in temperature, like splashing cold water on the face or taking a cool shower, can act as a physical reset, jolting the system out of distressing emotions.

  • Physical exertion as emotional liberation: A quick sprint, some jumping jacks, or a brisk walk around the block can release pent-up emotions and produce endorphins, the body's natural mood lifters.
  • Breathing balance: Paced, deep breathing can act as an anchor, pulling us back from the overwhelming waves of distress.

  • Relaxation meets tension: Contracting and then relaxing different muscle groups can diffuse tension and bring awareness back to the body.

3. Find Clarity Through a Pros and Cons List

Putting pen to paper and visually seeing the repercussions of an impulsive decision can instill a pause, allowing time for reflection. This pause can be the critical difference between reacting impulsively and choosing a more balanced response.

Grab a pen and paper (or turn to the Notes section in your phone), and jot down a pros and cons list. This can steer you in the right direction and give you much-needed clarity in complex situations.

4. Stay Grounded With Proven Techniques

  • Sensory countdown: The "5-4-3-2-1" technique brings immediate awareness to the present. By naming tangible things around, we can pull ourselves out of spiraling thoughts and into the current environment.
  • Texture trails: Touching and describing various objects around can also bring us back to the present moment.


7. Embrace Radical Acceptance

While life can present unpleasant situations, recognizing and accepting them without judgment can pave the way for more balanced reactions.

It’s crucial to differentiate between "acceptance" and "approval." Acceptance is about acknowledging the reality as it stands, even if it's not liked or approved. The less we fight against reality and instead focus on how we respond to the world around us, the more peace we will unlock. 

DBT Distress Tolerance Kills: Glimmers of Hope on the Horizon

In life, everyone encounters patches of distress and turmoil. But with tools like the DBT distress tolerance skills, navigating these patches becomes less about floundering and more about navigating with grace, understanding, and resilience. For every moment we seek solace in a glass of wine or a bottle of beer, imagine the transformative power of having an array of cognitive tools instead. A world where every challenge, every distressing moment, is met with strength, clarity, and hope. With DBT's techniques at our fingertips, not only is this possible, but it's a horizon gleaming with promise and potential.

Summary FAQs

1. What are DBT distress tolerance skills?

These are a set of cognitive tools, derived from dialectical behavior therapy (DBT), designed to help us cope with and navigate through distressing emotions without resorting to impulsive behaviors.

2. Are DBT skills only useful for reducing alcohol consumption?


No, while they can be particularly effective in this context, they are versatile tools designed to help cope with a range of distressing situations and emotions.

3. How do we acquire DBT distress tolerance skills?

Typically, these skills are taught by trained therapists in a structured environment, though there are also self-help resources available.

4. Is it challenging to apply these skills in real-life situations?


Initially, it might be. Like any new skill, it requires practice. Over time, with consistent use, they can become an integral part of one's emotional toolkit.

5. Are there any resources to learn more about DBT and its techniques?


Certainly! Many books, online courses, and therapists specialize in DBT. 

Uncover True Resilience With Reframe!

Although it isn’t a treatment for alcohol use disorder (AUD), the Reframe app can help you cut back on drinking gradually, with the science-backed knowledge to empower you 100% of the way. Our proven program has helped millions of people around the world drink less and live more. And we want to help you get there, too!

The Reframe app equips you with the knowledge and skills you need to not only survive drinking less, but to thrive while you navigate the journey. Our daily research-backed readings teach you the neuroscience of alcohol, and our in-app Toolkit provides the resources and activities you need to navigate each challenge.

You’ll meet millions of fellow Reframers in our 24/7 Forum chat and daily Zoom check-in meetings. Receive encouragement from people worldwide who know exactly what you’re going through! You’ll also have the opportunity to connect with our licensed Reframe coaches for more personalized guidance.

Plus, we’re always introducing new features to optimize your in-app experience. We recently launched our in-app chatbot, Melody, powered by the world’s most powerful AI technology. Melody is here to help as you adjust to a life with less (or no) alcohol.

And that’s not all! Every month, we launch fun challenges, like Dry/Damp January, Mental Health May, and Outdoorsy June. You won’t want to miss out on the chance to participate alongside fellow Reframers (or solo if that’s more your thing!).

The Reframe app is free for 7 days, so you don’t have anything to lose by trying it. Are you ready to feel empowered and discover life beyond alcohol? Then download our app through the App Store or Google Play today!

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