Practical DBT Strategies & Techniques

Distress Tolerance Skills

These skills help individuals handle distressing emotions without engaging in harmful behaviors. They focus on managing pain and crisis situations rather than trying to avoid or change the distress.

1. Radical Acceptance

Radical acceptance is acknowledging and accepting reality, even if it’s unpleasant, instead of resisting it. Acceptance reduces emotional distress and creates space to move forward peacefully. While resisting reality leads to stress and negativity, embracing it allows for adaptive, effective responses. Acceptance may be accompanied by loss, but it enhances effectiveness and our capacity to move forward.

2. Pros and Cons

The pros and cons skill helps evaluate choices by weighing immediate urges against long-term consequences. By listing benefits and drawbacks, you can make thoughtful decisions aligned with your values rather than impulsive ones.

3. TIPP

TIPP is a distress tolerance skill for managing intense emotions through physical and mental regulation:

• Temperature: Cool your body (e.g., splash cold water on your face).
• Intense exercise: Engage in physical activity to release tension.
• Paced breathing: Use slow, controlled breathing to calm your heart rate.
• Progressive muscle relaxation: Tense and release muscles to reduce stress.

4. STOP

STOP is a mindfulness tool for emotional regulation in crises:

• Stop: Pause and resist impulsive reactions.
• Take a step back: Create space by stepping away, either physically or mentally.
• Observe: Pay attention to your thoughts, feelings, and surroundings without judgment.
• Proceed mindfully: Respond calmly and thoughtfully, using awareness and logic.

5. ACCEPTS

ACCEPTS provides adaptive strategies to manage distress:

• Activities: Engage in a task or hobby.
• Contributing: Help others to shift focus.
• Comparisons: Reflect on times when things were better or worse.
• Emotions: Induce different feelings (e.g., watch a comedy).
• Pushing away: Temporarily set aside distressing thoughts.
• Thoughts: Focus on neutral or pleasant ideas.
• Sensations: Use sensory experiences to ground yourself (e.g., petting your dog).

6. IMPROVE

IMPROVE helps you make the most of the present moment:

• Imagery: Picture calming or positive scenes.
• Meaning: Find purpose or lessons in the situation.
• Prayer: Connect through spiritual practice.
• Relaxation: Use techniques to ease tension.
• One thing: Focus on one activity at a time.
• Vacation: Take a quick mental or physical break.
• Encouragement: Use positive affirmations to lift your confidence.

7. Self-Soothe

Self-soothing involves comforting yourself with sensory, mindful, or relaxing activities to manage emotional distress. This skill improves coping, emotion regulation, and overall well-being. Temporary strategies like lighting a candle, listening to calming music, or practicing mindfulness provide relief while building resilience.

Emotion Regulation Skills

These skills focus on understanding, reducing, and managing intense emotions to prevent them from overwhelming you.

1. Check the Facts

Pause and ask yourself if your emotions match the situation. This helps you see things more clearly and avoid reacting too strongly or irrationally.

2. Opposite Action

Do the opposite of what your emotions are pushing you to do. If anxiety makes you want to avoid something, face it instead. This helps you break the cycle of negative feelings and choose healthier responses.

3. Problem-Solving

When something is bothering you, figure out what the problem is, explore solutions, and take action. This helps you feel more in control and less overwhelmed.

4. Ride the Wave

When strong emotions hit, remember they’re temporary and will pass. Instead of fighting them, let yourself feel them and watch them fade like waves.