Dialectical Behavior Therapy (DBT) is one of the most popular forms of therapy used today. This psychotherapy practice helps treat patients with a number of mental health disorders, such as bipolar disorder, anxiety disorder, and depression. This therapy is comprised of four DBT modules: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. Each one teaches patients how to select skills to help them alter their behavior and better their life.
Life is full of stress and negative emotion at one point or another, which is why the module distress tolerance is so vital.
It’s impossible to go through life without experiencing distress. While many mental health treatments focus on changing distressing events, only DBT focuses on accepting, finding meaning for, and tolerating distress. Distress tolerance is simply learning to bear pain skillfully.
Most people, even those with mental disorders, can handle a normal situation. It’s when stressors, or negative events or emotions, appear that they begin to struggle. However, one can only go so far in life avoiding these. This is why DBT teaches patients how to handle pain and distress.
In DBT, distress tolerance is a natural development after mindfulness. Once patients have learned to accept both oneself and the current situation in a nonjudgmental way, they can begin to cope with distress.
This nonjudgmental stance means that patients neither approve nor resign themselves to the distress they experience. The goal is to calmly recognize the negative situation and its impact rather than becoming overwhelmed by it or running from it. This helps individuals make wise decisions on how to act rather than make destructive emotional reactions.
There are quite a few skills and tools patients learn in DBT to help with distress tolerance. They can distract themselves with ACCEPTS (Activities, Contribute, Comparisons, Emotions, Push away, Thoughts, Sensations) to temporarily distract oneself from unpleasant emotions.
Self-soothing is another skill DBT teaches to help with distress tolerance. This skill teaches patients to comfort and nurture themselves in a king and gentle way. It’s similar to how babies are taught to self-soothe when they’re young. Patients must figure out what activities or sensations help soothe them.
Other skills include IMPROVE (Imagery, Meaning, Prayer, Relaxation, One thing in the moment, Vacation, Encouragement), pros and cons, radical acceptance, turning the mind, and willingness vs. willfulness.
During DBT treatment, each module is focused on for about six weeks. However, as patients learn each skill they build off of and reinforce the ones they just learned. Distress tolerance is typically good to teach after mindfulness, as the idea of acceptance is important.