Essential Dialectical Behavior Therapy Skills: Distress Tolerance and Mindfulness

Dialectical Behavior Therapy (DBT) is a therapeutic approach developed initially for individuals struggling with borderline personality disorder. However, it has proven effective in treating various mental health conditions, including depression, anxiety, and eating disorders. This article will explore two DBT skills that can benefit anyone, regardless of whether they have a diagnosed mental health disorder: distress tolerance and mindfulness.


Skill One: Distress Tolerance

Distress tolerance is one of the four primary modules of DBT. It is designed to help individuals cope with negative emotions more healthily and adaptively. It does not aim to eradicate distress but to manage and accept its presence.


Techniques for Building Distress Tolerance

One popular distress tolerance technique is the "STOP" skill. It stands for "Stop, Take a step back, Observe, and Proceed mindfully." When you start to feel overwhelmed by distress, pause what you're doing and create some mental space between you and the situation. Observe the situation objectively, without judgment. Finally, choose a course that aligns with your values and long-term goals.


Another effective distress tolerance technique is the "TIPP" skill, an acronym for "Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation." These are physical strategies designed to quickly change your body's arousal system, helping to reduce extreme emotional arousal.


Skill Two: Mindfulness

Mindfulness, another DBT core skill, involves bringing one's attention to the experiences occurring in the present moment without judgment. It is about fully engaging in what is happening here and now.


Practicing Mindfulness Daily

One common method of practicing mindfulness is through meditation. Spend a few minutes daily focusing solely on your breathing, observing each inhale and exhale without trying to change anything. When your mind wanders, gently bring your attention back to your breath.


"Mindfulness of current emotions" is another helpful practice. It involves observing and describing your feelings without judgment. If you're feeling sad, for example, acknowledge the sadness, sit with it, and remind yourself that it's okay to feel that way. Remember, emotions are not good or bad; they just are.


Mindfulness can also be applied to daily activities like eating, walking, or listening to music. The goal is to fully engage with the activity, paying close attention to each sensation it provides.


Advancing Distress Tolerance Skills

While distress tolerance techniques like "STOP" and "TIPP" can be beneficial for immediately regulating intense emotions, improving your distress tolerance in the long term often involves more complex methods.


Enhancing Emotional Endurance

An important aspect of building distress tolerance is the concept of "Radical Acceptance." This involves acknowledging reality as it is, even when it's painful or distressing. By accepting that distress is a part of life, we can reduce the suffering from resisting it.


Moreover, practicing self-soothing techniques can be another way to enhance your distress tolerance. This could include anything that calms you or comforts you, such as taking a warm bath, listening to calming music, or practicing deep breathing exercises.


Broadening Mindfulness Capacities

The practice of mindfulness is more than just meditation and observing current emotions. It's a mental state of openness, awareness, and focus, and it can be cultivated through several different approaches.


Incorporating Mindfulness into Everyday Life

"Observation," "description," and "participation" are considered the three "what" skills of mindfulness in DBT. Observation refers to noticing what is happening without adding interpretations or judgments. The description puts words to the observed phenomena. And participation is getting involved fully in the current activity.


For example, while having a conversation with someone, you could practice mindfulness by observing the person's facial expressions and tone of voice (observation), articulating what you notice in your mind (description), and responding appropriately in the conversation (participation).


Implementing these mindfulness techniques in everyday situations can help individuals remain present, improve their understanding of themselves and their surroundings, and enhance their interactions with others.


The DBT skills of distress tolerance and mindfulness are useful tools for those struggling with mental health conditions and those seeking to improve their emotional well-being. By developing these skills, individuals can learn to manage stress better, increase their resilience, and lead a more balanced, mindful life.

Grouport Offers Online Group Therapy & Online DBT Skills Group

Grouport Therapy provides online group therapy for anger management, anxiety, borderline personality, chronic illness, depression, dialectical behavior therapy, grief and loss, obsessive compulsive disorder, relationship issues and trauma and PTSD. Our licensed therapist leads weekly group sessions conducted remotely in the comfort of members' homes. According to participant feedback, 70% experienced significant improvements within 8 weeks.

You don't have to face these challenges alone. Join our community and work together towards a brighter future. Sign up for one of our courses today and begin your journey towards meaningful, lasting change and renewed hope.

Due to licensing restrictions, our online group therapy sessions are for Florida, New York, and New Jersey residents. If you are not a resident of either state, consider our dialectical behavior therapy skills group. It is a therapist-instructor-led online group that will teach you strategic new skills to replace behaviors and emotions causing friction in your daily life and relationships. It is excellent for interpersonal connections and building social skills concerning relationship issues.

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