Part 1: Distress Tolerance–Let’s Not Make It Any Worse

Distress tolerance is one’s ability to endure or withstand discomfort/stress. Distress tolerance skills are unique in that, rather than the goal being to make things better, the goal is to not make the situation worse. Learning to bear pain and discomfort skillfully is important because pain and distress are part of life and cannot be entirely avoided (Linehan, Distress Tolerance Skills,1993). One of the ways that we learn how to navigate the “bumps” in life is through building distress tolerance.

When in distress, emotions can run so high that we cannot think straight. This would be described as Emotion Mind.  Emotion mind is when our thoughts and behaviors are controlled only by our emotions. Have you ever found yourself making a decision in the ‘heat of the moment’ and in hindsight wishing you’d thought it through?  When we’re in emotion mind, we struggle to reason rationally and may make ineffective decisions. Fortunately, distress tolerance skills allow us to decrease the emotions around a situation, which then gives us space to think rationally and prevents us from making the situation worse. There are a multitude of effective distress tolerance skills that are beneficial to learn.  In today’s blog, I will discuss one such important distress tolerance skill, T.I.P.P.  In our next blog (Part 2: Distress Tolerance), I will review two additional skills to help build our distress tolerance “toolbox.”  

TIP THE TEMPERATURE of your face with COLD WATER* (to calm down fast)

    • Holding your breath, put your face in a bowl of cold water, or hold a cold pack (or zip-lock bag of cold water) on your eyes and cheeks. 
    • Hold for 30 seconds. 
    • Keep water above 50°F.

INTENSE EXERCISE (to calm down your body when it is revved up by emotion)

    • Engage in intense exercise, if only for a short while. 
    • Expend your body’s stored up physical energy by running, walking fast, jumping, playing basketball, lifting weights, etc. 

PACED BREATHING (pace your breathing by slowing it down) 

    • Breathe deeply into your belly. 
    • Slow your pace of inhaling and exhaling way down (on average, five to six breaths per minute). 
    • Breathe out more slowly than you breathe in (for example, 5 seconds in and 7 seconds out). 

PAIRED MUSCLE RELAXATION (to calm down by pairing muscle relaxation with breathing out) 

    • While breathing into your belly, deeply tense your body muscles (not so much as to cause a cramp). 
    • Notice the tension in your body. 
    • While breathing out, say the word “Relax” in your mind. Let go of the tension.
    • Notice the difference in your body

Next time your emotion mind starts to take over, give T.I.P.P. a try.  Once you start to settle your negative emotions, you will be much better able to tolerate distress and not make things worse.

Celes Smith

Licensed Clinical Social Worker (LCSW)