Life can be challenging, as it’s full of ups and downs, meaning most people will have to navigate through emotionally draining or difficult situations.
From the array of daily stressors in life, like routine chores or managing personal finances, to bigger life challenges, such as navigating a break-up, move, loss of a job, or death of a loved one, developing the ability to manage stress is crucial to mental well-being.6
But as with many challenges in life, it’s not the severity of these situations as much as how we react to them that makes all the difference. And learning how to meet and work through emotionally challenging situations in a healthy way is at the core of most distress tolerance skills.
Distress tolerance is the ability of someone to navigate a stressful situation without becoming emotionally dysregulated.1 Just as people have certain tolerance levels for pain, medication, or substances, so too do people develop a level of tolerance for dealing with emotional distress or intense emotions.
There is no “right” way to handle complex emotional situations like losing a loved one. Still, there are ways to navigate those heavy emotions, using distress tolerance skills, without causing further harm to yourself or others.
Distress tolerance skills can be helpful for those with post-traumatic stress disorder.
There is no “right” way to handle complex emotional situations like losing a loved one. Still, there are ways to navigate those heavy emotions, using distress tolerance skills, without causing further harm to yourself or others.
When feelings of fear, anger, sadness, or embarrassment cause the body’s nervous system to enter a “fight, flight, or freeze” mode, this level of emotional distress often makes it challenging to continue to function.6 Normal everyday tasks can feel overwhelming when the nervous system is distressed. This is why developing the crisis survival skills necessary to self-soothe through emotionally trying times is important.
What is distress intolerance?
People with distress intolerance can become easily overwhelmed by stressors and may turn to harmful coping mechanisms to help them escape their situation.2
People who lack the ability to emotionally regulate may choose to avoid or ruminate on their stressors, which are behaviors linked to eating disorders like anorexia nervosa (AN).3 Many eating disorder behaviors can present themselves in times of emotional distress. For example, some people may turn to food for comfort during an emotionally overwhelming time or escape into compulsive or intense exercise to try and quiet the negative emotions.
The good news is that you can improve, develop, and fine-tune your distress tolerance skills anytime, through work in therapy and on yourself. So even if you have areas of emotional regulation that you’re working on or aware of, know that help is available.
How distress tolerance skills help
Once distress tolerance levels are developed, an individual can typically handle an emotionally trying situation in a way that doesn’t make things worse. And, optimally, they can take things in a way that can help them learn and grow from the experience.3
Distress tolerance skills are meant to help build a better way of regulating big emotions, which can help people better cope with difficult situations in several ways. The ability to better manage difficult feelings can help someone more quickly return to a state of emotional equilibrium.
A state of mental balance helps encourage more measured thoughts and behaviors, allowing the brain to relay messages more freely between its emotional and cognitive—or more reasoning-based—centers.5
But distress tolerance skills can also help people when feeling distressed. Many distress tolerance strategies emphasize the idea of acceptance, which can help people deal with fraught emotional situations.
If someone feels things are out of control—or, at least, out of their realm of control—accepting that they cannot change the current circumstances can help foster a sense of peace or relaxation. And if someone feels overwhelmed, practicing radical acceptance may help them more calmly evaluate their situation and understand what they want or need.
Regardless, these practices aim to help people engage with difficult situations without resorting to harmful coping mechanisms to get by.
Need help for an eating disorder but don't know where to start?
There are many types of distress tolerance skills to help people feel more comfortable and more confident in their ability to handle stressful situations. Below are a few distress tolerance skills that are helpful to develop, especially when it comes to navigating an eating disorder.
Self-soothing is developing a personal strategy to calm down, reground, or re-center yourself quickly, and it is a central strategy to many distress tolerance skills.6 Self-soothing will look different for each person. It can include breathing exercises, listening to music, walking, taking a bath, or doing mental grounding exercises. Speaking with a therapist about self-soothing is an excellent way to identify the techniques that might suit your needs.
Radical acceptance is the practice of accepting unchangeable things as they are, relinquishing control, and realizing nothing else can be done.7 Certain circumstances, like loss, or terminal illness, are unchangeable, and accepting that fact can feel like a release in many ways. Accepting what happened, or what is happening, is a part of healing. The hope is that radical acceptance helps ease the pressure to fix things or the overwhelming feeling to act.
As the name suggests, this distress tolerance skill is based on finding ways to make an uncomfortable moment more tolerable. Concepts like visualization, looking for silver linings, or taking a mental break from emotional pain are often thought to help in this way.
Making a pros and cons list can sometimes help people navigate through emotional decisions. With this strategy, patients are taught to weigh their choices carefully and consider all the possible consequences—good and bad—that may arise. It can be easy to get stuck in a place of fear when you are distressed, so sometimes, listing all the pros next to those fears can help ground the decision.
Generally recommended as a last resort when someone feels overwhelmed, this strategy is essentially just what it sounds like. Distraction methods could involve physically leaving a stressful situation, reading a book, going for a walk, calling a friend, or doing anything else that will help keep your mind off the source of emotional stress.
Speak to a therapist, or eating disorder specialist, for specific help in developing emotional distress tolerance skills. Together, you can build an action plan for when you feel emotionally distressed and need to ground yourself.
How to practice distress tolerance skills
As with any new skill, distress tolerance techniques must be learned. And the more someone practices these concepts, the more easily they can be summoned in times of stress.
Concepts like improving the moment can be practiced daily through strategies like journaling. Looking for a silver lining or something to be grateful for every day can help someone more naturally seek out positive aspects of a situation.
Dialectical behavior therapy can help you hone your distress tolerance skills and may be part of your eating disorder treatment plan.
Radical acceptance can also be worked on through strategies like mindfulness and meditation. These practices help instill the concept of letting go and focusing only on the present moment. Even self-soothing can be arranged ahead of an emotional crisis by thinking of particular objects, songs, or other things that may help improve someone’s mood in a bad situation.
Enrolling in certain types of therapy, such as dialectical behavior therapy (DBT), can also be a helpful tool for honing these skills and utilizing the guidance of a trained practitioner. DBT distress tolerance skills may be taught as part of eating disorder treatment.
But in any case, a little work can go a long way toward turning a potentially harmful situation into a more manageable—and possibly even helpful—scenario.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
We live in a culture where diet culture is pervasive. We talk about what, when, where, why, and how we eat or don’t eat, as well as weight and our bodies. Not to mention how exercise or movement permeates our everyday conversations with friends, partners, co-workers, family members, and even strangers. Whether you’re in recovery from an eating disorder or are simply trying to embrace body positivity or body neutrality, dealing with conversations related to weight, dieting, appearance, and physical activity can feel stressful and isolating–not to mention actually harmful to your well-being and exacerbating mental health issues.
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