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DBT Distress Tolerance

Crisis survival skills to tolerate painful emotions and urges without making things worse.

Core Distress Tolerance Skills

TIPP - Change Body Chemistry

  • • Temperature - Cold water to calm quickly
  • • Intense exercise - Burn off stress hormones
  • • Paced breathing - Longer exhales to relax
  • • Progressive muscle relaxation

ACCEPTS - Distract from Pain

  • • Activities - Do something engaging
  • • Contributing - Help someone else
  • • Comparisons - Perspective on your situation
  • • Emotions - Create different feelings
  • • Pushing away - Mental distance from pain
  • • Thoughts - Count, do puzzles
  • • Sensations - Safe physical sensations

IMPROVE - Make the Moment Better

  • • Imagery - Visualize peaceful scenes
  • • Meaning - Find purpose in the pain
  • • Prayer - Connect with higher power
  • • Relaxation - Release physical tension
  • • One thing at a time - Focus on now
  • • Vacation - Brief mental break
  • • Encouragement - Self-compassionate talk

Radical Acceptance

Accept reality as it is, without approval or resignation. Stop fighting what you cannot change and focus energy on what you can control.