How to Tolerate Distressful Moments

Crisis Survival Skills are about getting through a difficult moment without making it worse. If you think about the things that make a situation worse, they usually involve some sort of avoidance such as not attending to responsibilities or escaping in some fashion that may involve substance use, risky behavior, or withdrawal.

It is important to be in Wise Mind when addressing problems. If you are not in wise mind, then you need to get there. That is what distress tolerance is for.

Use crisis survival skills sparingly. Not every situation is a crisis. As you become more skillful with problem-solving, you will need them less and less.

It helps to keep this framework and structure in mind:

• Distress Tolerance
  • Crisis Survival Skills
    1. Distraction
    2. Self-Soothe
    3. Improve the moment
    4. Pros and cons
    5. Half smile
  • Accepting Reality Skills
    1. Radical Acceptance
    2. Turning the mind
    3. Willingness

Once you are back in wise mind, it is then necessary to address the problem. It is not skillful or effective to avoid problems. It is skillful to take a break to gather your thoughts and then return to the situation, using problem-solving skills in the most effective way.

Distress tolerance is about taking a break. DBT does not advocate avoidance.