Text Link

Learn more about the results we get at Within

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Learn more about the results we get at Within

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Learning to develop distress tolerance skills

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.

Last updated on 
March 3, 2023
Distress tolerance skills
In this article

What is distress tolerance?

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

Distress tolerance skills

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?
Learn about virtual treatment >

How to develop better distress tolerance skills

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-soothe
Radical acceptance
Improving the moment
Identify the pros and cons
Distraction
Work with a therapist

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.

Resources

  1. Kiselica, A. M., Rojas, E., Bornovalova, M. A., & Dube, C. (2014). The nomological network of self-reported distress tolerance. Assessment, 22(6), 715–729.
  2. McHugh, R. K., Reynolds, E. K., Leyro, T. M., & Otto, M. W. (2012). An examination of the association of distress intolerance and emotion regulation with avoidance. Cognitive Therapy and Research, 37(2), 363–367.
  3. Prefit, A.-B., Cândea, D. M., & Szentagotai-Tătar, A. (2019). Emotion regulation across eating pathology: A meta-analysis. Appetite, 143, 104438.
  4. Cool, J., & Zappetti, D. (2019). The physiology of stress. Medical Student Well-Being, 1–15.
  5. Society for Neuroscience. (2020, September 28). How the brain balances emotion and reason. ScienceDaily. Retrieved February 23, 2023.
  6. Iovino, E. A., Koslouski, J. B., & Chafouleas, S. M. (2021). Teaching Simple Strategies to Foster Emotional Well-Being. Frontiers in Psychology, 12.
  7. Görg, N., Priebe, K., Böhnke, J. R., Steil, R., Dyer, A. S., & Kleindienst, N. (2017). Trauma-related emotions and radical acceptance in dialectical behavior therapy for posttraumatic stress disorder after childhood sexual abuse. Borderline Personality Disorder and Emotion Dysregulation, 4(1). 

FAQs

Further reading

Bulimia treatment at home

Bulimia nervosa (BN) is an eating disorder characterized by cycles of binge eating and purging, with these...

Anorexia home treatment

Treating anorexia nervosa (AN) is often a tricky prospect. While weight restoration and recovery from this...

Within Summit Q&A with Kevin Hines: The power of lived experience

Many people have said this story saved or changed their lives. People recognize they too can overcome...

Eating disorder support groups: Finding healing in community

Eating disorders like binge eating disorder (BED), anorexia nervosa (AN), and bulimia nervosa (BN), can be...

Within Summit Author round-up

Looking to deepen your wisdom from the Within Summit? Speakers from this year and last year’s Summit share...

Within Summit Q&A with Dr. Luana Marques: Understanding avoidance

I grew up in Brazil with a single mother, and moved in with my grandmother at 15. I faced a lot of adversity..

Within Summit Q&A with Dr. Kate Truitt: The power of gentle, soothing touch

Anybody can learn the self-havening protocols, which involve different kinds of gentle, soothing touch, and...

Within Summit Q&A with Eric Wood: Envisioning a new model for college campus counseling

The trauma of the pandemic has definitely contributed to the increased need for mental health services...

Emotion-focused therapy for eating disorders

Emotion-focused therapy (EFT), sometimes called emotionally-focused therapy, is a type of therapy that...

Experiential therapy for eating disorders

Experiential therapy is a form of insight-driven or action-based therapy that immerses a patient in an...

Comparing the different levels of care in eating disorder treatment

While all eating disorders are serious mental health conditions, eating disorder symptoms may present at...

Can a therapist diagnose an eating disorder?

Struggling with an undiagnosed eating disorder is often a difficult thing to talk about. Even if you're...

Bulimia self-help recovery

Like other eating disorders, bulimia nervosa (BN) has the power to significantly affect a person’s life and...

10 ways to be gentle with yourself during eating disorder recovery

Eating disorder behaviors are often characterized by profound shame, guilt, and isolation. Eating disorder...

Overcoming food aversion

Food aversion is an intense dislike of a particular food. People may experience this emotion with foods...

How to choose the best eating disorder treatment program for your needs

When it comes to choosing an eating disorder treatment program, people’s specific needs may vary. A program...

Practicing mindfulness and mindful eating

The practice of mindfulness originated through Buddhist meditation, but its introduction into Western...

The health benefits of pet ownership

Coming home to a fur baby or animal companion can feel like coming home to unconditional love. And the...

How chanting helps with meaningful living

Chanting is a type of meditation that has been part of human behavior for thousands of years, practiced by...

Meditation and eating disorder recovery

Practicing meditation can help with internal healing by offering the opportunity to bring mind, body, and...

How yoga can improve mental health & help with eating disorder recovery

Practiced for thousands of years, yoga has long been heralded for its potential to improve mental, physical...

Eating disorder recovery and meaningful living

Eating disorder recovery is an incredibly personal and vulnerable journey, and everyone’s process may look...

The importance of intersectionality in eating disorder treatment and research

Eating disorders affect people of all genders, sexual orientations, races, cultures, weights, sizes, and...

Therapy for eating disorders

Overcoming an eating disorder can be a long and challenging journey. But there are many types of therapy...

Learning to develop distress tolerance skills

Life can be challenging, as it’s full of ups and downs, meaning most people will have to navigate through...

Using self-compassion and radical acceptance to overcome perfectionism in eating disorder recovery

Perfectionism is a trait many people can have and is associated with eating disorders. And often...

Learn about eating disorder treatment

There’s a reason people refer to eating disorder recovery as a journey. The path to getting well is...

Aftercare for eating disorders

When you approach the end of your residential or partial hospital program...

How to find a therapist for eating disorders

Eating disorders like anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) are...

Helpful interventions for eating disorders

If you suspect your loved one is suffering from an eating disorder, it can...

Trauma-informed care for eating disorders

There is a strong link between eating disorders, like anorexia nervosa...

Group therapy for eating disorders

Group therapy is a type of treatment used to treat many mental health...

What to look for in a quality eating disorder treatment program

With so many eating disorder treatment programs available today, both...

Exercise addiction treatment & recovery

Exercise addiction is an eating disorder that can do serious damage to the body, with up...

Night eating syndrome treatment

Night eating syndrome (NES) is a highly disruptive eating disorder affecting as many as...

Treatment of pregorexia, pregnancy-related eating disorders

Pregnancy-related eating disorders, also called pregorexia, encompass any eating disorders...

Orthorexia treatment plan

Orthorexia nervosa (ON) is a serious eating disorder that can be very tricky to detect, as...

Diabulimia treatment & recovery

Diabulimia is a complex eating disorder that involves the deliberate underuse or...

Anorexia nervosa treatment therapy options with proven results

Anorexia nervosa (AN) is a serious mental health condition that manifests in a number of physical, mental...

Bulimia treatment therapy plans with proven results

Bulimia nervosa (BN) is a dangerous and potentially deadly disorder, affecting someone’s mental, physical...

How to find a binge eating disorder treatment plan

Treatment plans for binge eating disorder (BED)—or other eating disorders and mental health conditions—are...

ARFID treatment: avoidant restrictive food intake disorder

Avoidant restrictive food intake disorder (ARFID) is an eating disorder that involves a severely limited...

Self-help and eating disorder treatment

Human resolve can be a formidable force in any endeavor. Recovering from an...

Partial hospitalization programs for eating disorders

Partial hospitalization programs (PHPs) are highly-structured day therapy programs that can be used for...

Intensive outpatient treatment for eating disorders

While all eating disorders are serious mental health conditions, symptoms span a spectrum of severity. To...

Inpatient care for eating disorders

Mental health conditions of all types, including eating disorders, occur on a spectrum of severity...

Group therapy for eating disorder treatment

Eating disorders are complex mental health conditions that have deep impacts on many people. By some...

The role of the care partner in ED recovery

Struggling with an eating disorder can be a lonely and isolating experience...

The importance of community during eating disorder recovery

Often, stories of eating disorder recovery focus on the individual, what they...