#LookAfterYourself: Distress Tolerance

You may have heard of Cognitive Behavioural Therapy (CBT) - it's the most widely used non-pharmaceutical therapy for disorders such as depression, anxiety, eating disorders, OCD, etc.  However, you may not have heard of Dialectical Behavioural Therapy (DBT).  DBT is a type of CBT, but it offers futher coping strategies such as mindfulness, emotion regulation and distress tolerance skills that are not covered in traditional CBT. 

While I am no expert in this field, my psychology placement experiences have taught me a lot about the benefits of DBT and I feel by sharing some of the skills taught in DBT, it could be helpful to those with diagnosed mental health issues, or even for anyone wanting to improve their general well-being!

I'm going to focus on distress tolerance skills, which aim to help you deal with overwhelming emotions, thoughts and situations.  It's important to remember that these skills are not designed to help you overcome and solve your problems but they may help you to react more rationally and constructively to overwhelming thoughts and events.

Two of the ways in which DBT suggests you can overcome or tolerate distress, at least in the short term, is using distractions or self-soothing activities.  Self-soothing encourages you to use your senses to soothe yourself.  For example, you may listen to some calming music (auditory), light a scented candle (olfactory), go to a picturesque spot or look at your favourite pictures (visual), savour your favourite meal or snack (gustatory), or pamper your body with a silky moisturiser (tactile).  The idea is to focus on these activities mindfully - fully engage in the sense you're stimulating and relax in the present moment.

The second distress tolerance skill - distraction - can help you to temporarily be lifted of your worries and anxieties by engaging in a pleasurable experience.  Distractions give you time to find an appropriate coping response to a distressing situation - they allow you to calm your emotions so you're in a better place emotionally to deal with any overwhelming thoughts and situations.  Even if you're not experiencing an overwhelming thought or event, I think it's important to set yourself some time to yourself so you don't get overloaded with everyday stressors and worries!

Here are some examples of how I personally like to distract myself from life's and my own stresses and anxieties:

1. Cook or bake something yummy

2. Take a nap! Sometimes a nap can solve everything

3. Take a bath - candles, music, face mask and magazines all necessary!

4. Blogging/reading others' blogs

5. Speak to a friend/family/boyfriend - just have a chat! It can really take your mind off things

6. Retail therapy - even little things like a special treat from the supermarket or a piece of jewellery

7. Exercise/yoga - yoga is a new one for me, but it really is very relaxing and puts me in a great mood

8. Paint my nails

9. Music - be it playing, listening or writing! (Cheeky plug to my Youtube channel here)

10. Look through old photos - here are some of my favourites!

I'd love to know if this post has helped you in any way! Leave me a comment down below with your feedback.  What do you do when you're feeling stressed out?


  1. I take anxiety/panic attacks during events, in particular TRAINING! I work as a Care Assistant, which means I have to travel two hours from home for classes in moving and handling etc. It's a hard slog, I have to wake up at 6am to be there on time (thank you morning traffic).

    I went last Monday for my first session, and all was fine until an hour into the class.. next thing I know I'm rushed out of the room and placed in a chunky chair with a bucket. I was mortified, and all my work colleagues witnessed the ordeal (they claim I was as white as a ghost haha).

    However this time I have decided to use anxiety tablets in the hope they work. It's just pinpointing what I can do in a classroom environment that will allow me to calm down without being disruptive, I can't begin to tell you how many times I apologized to our teacher haha :) I've tried sitting back in my chair and using breathing techniques but I just don't feel as though it's enough :( x


    1. Hi Rebecca :)

      Sorry to hear you're having such a hard time! It must be really rough :/ anxiety tablets (such as SSRI's) can be really effective for some people and I hope they work for you!

      There are also lots of things you can do when you feel a panic attack coming on, such as breathing exercises (have a look online or Youtube for resources), that can really help. I went through a 2-year phase of having panic attacks and when I felt the symptoms of the attacks coming on, instead of panicking further I would get into a routine of using breathing exercises which calmed me down. Of course what helps will differ from person to person though. Another technique called Visualisation and Imagery helped me too. Check out this website for some more information: http://www.minddisorders.com/A-Br/Anxiety-reduction-techniques.html

      Good luck with everything! x

  2. Oh my gosh, I need DBT in my life! Honestly, I get so overwhelmed easily and then I don't know what else to do to calm down until I have an anxiety attack. I also want to try CBT because right now, all I'm doing is going to sessions where I dump all my crap onto the psychologist.


    1. DBT and CBT can be so effective when administered properly! They are good long-term solutions (generally anyway!) By the sounds of it you would benefit from CBT, so it might be worth mentioning this to the psychologist next time. The only problem is there can often be a long waiting list. I know some places may offer group therapy in the meantime though, which can also be very effective. However, if you want to look into more self-help stuff, I can recommend the following book:

      Overcoming Anxiety self-help course - Dr Helen Kennerly (the "Overcoming" series is endorsed by the Royal College of Psychiatrists so is definitely worth a look at if you can get your hands on it)

      There is also a lot of information and resources online regarding CBT. In the meantime however, check out this website which offers a few short-term solutions to anxiety attacks: http://www.minddisorders.com/A-Br/Anxiety-reduction-techniques.html

    2. Good luck with it all Arianne :)