DBT Distress Tolerance Skills

DBT Distress Tolerance Skills

In her book, Cognitive Behavioral Treatment of Borderline Personality Disorder, Marsha Linehan explains the importance of Distress Tolerance skills:

DBT emphasizes learning to bear pain skillfully. The ability to tolerate and accept distress is an essential mental health goal for at least two reasons. First, pain and distress are part of life; they cannot be entirely avoided or removed. The inability to accept this immutable fact leads itself to increased pain and suffering. Second, distress tolerance, at least over the short run, is part and parcel of any attempt to change oneself; otherwise, impulsive actions will interfere with efforts to establish desired changes.

There are three goals of distress tolerance skills in DBT:

  • To survive crisis situations without making them worse
  • To accept reality, and replace suffering and feeling stuck with ordinary pain and the possibility of moving forward
  • To become free of needing to act on our desires, urges, and intense emotions

In DBT, there are two types of distress tolerance skills:

  • Crisis Survival Skills help us survive a crisis without making things worse

  • Reality Acceptance Skills help us reduce suffering by accepting the reality of things that are outside of our control

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