Chicago CRED

Cognitive Behavioral Intervention

Tolerating Distress

Have you ever been in a situation where you had a serious problem but you couldn't fix it right away? How did you feel? What did you do?

This is the definition of a crisis situation: when something bad happens or you have a serious problem, but you can't solve it immediately.

Perhaps someone that you love is sick, injured, or has died. Maybe you got into a bad car accident and you have to wait for help to come. Or what if you lost your job, and you can't get a new one right away? You feel a sense of urgency to fix the problem, and your emotions are really strong, which can make the problem feel even worse.

We all go through crises in our lives. When we find ourselves in a painful or problem situation that we CAN'T FIX right away, the most important thing to do is to survive the situation without making it worse.

This is what we call Distress Tolerance.

What are some ways that we can make a crisis situation worse? Here are a few....

Yell at others
Become violent
Use drugs or alcohol in a dangerous way
Spend money that you don't have on "retail therapy"
Complain so much that others don't want to talk to you
Eat too much
Give up on solving the problem entirely

Distress tolerance is an important LIFE SKILL, and can also be used for NON-CRISIS situations that involve some kind of pain or difficulty, like painful emotions or discomfort (such as the kind that make you want to AVOID).

This skill is especially important when you want to make changes in your life or accomplish a goal.

Distress Tolerance in Action

Below are three clips from the movie "42" about Jackie Robinson, the first African American to play professionally in Major League Baseball. You probably know the story of Jackie Robinson - how he broke the color barrier in American baseball, and faced a ton of racism along the way. He knew that he wasn't just playing for himself - he was playing for all the other black men who also wanted to be able to play major league baseball, and for progress in the fight against racism all over the world.

The first clip shows how Jackie felt inside as he began to face the challenges in front of him. The second two clips shows how he learned to tolerate the distress that he experienced so that he could accomplish his goals, and how his teammates had to learn to do this too. As you watch, think about how each character is using distress tolerance, or making the situation worse, and how it relates to your life.

Trigger Warning: The following clips contain offensive language.

Clip #1:

How Jackie really feels.

Clip #2:

How Jackie tolerated the distress to accomplish his goals, while his teammates began to experience some of his distress too.

Clip #3:

How Jackie taught his teammates how to tolerate distress and take the high road.

Inspiring, huh?

Now, you may be asking yourself, "But how exactly do I do Distress Tolerance? What can I do to keep myself from just acting on my feelings and making the situation worse?"

Here are a few ideas.

Radical Acceptance

Good news - you already know how to do this one! You learned all about Radical Acceptance last week. Choosing to accept problems that are out of your control can reduce your anxiety, anger, and sadness, and make them easier to get through.

Keep in mind, acceptance is NOT the same as forcing yourself to like a situation. It simply means you stop trying to change the things you can't change, and free up that energy for something else, like not making things worse.

Self Sooth with your senses

Find a pleasurable way to engage each of your 5 senses. This will change your body chemistry and calm your emotions.

Try to focus on being in the present moment, instead of worrying about things that happened in the past or might happen in the future.

Distract Yourself with A.C.C.E.P.T.S.

Painful feelings usually pass, or at least get less intense, over time. It can be helpful to distract yourself temporarily until they subside, or until you are in a better place to handle them.

You can use the acronym A.C.C.E.P.T.S. to think of ways to distract yourself. This video explains how it works.

Activities - find an activity to focus on other than the distressing situation.

Contributing - focus on helping someone or something other than yourself.

Comparisons - look at your situation in comparison to something worse.

Emotions - do something to create a different emotion.

Pushing Away - push negative thoughts out of your mind.

Thoughts - as you do something distracting, focus on your thoughts instead of your feelings.

Sensation - find safe physical sensations to distract you from the negative emotions.

Most things in life that are WORTH HAVING require some kind of effort and struggle. You can use distress tolerance skills to get through short term discomfort to help you be more SUCCESSFUL in reaching your GOALS.

Example #1

Let's say you want to become a professional basketball player (LeBron status). That means you will likely have to spend years and years practicing, pushing yourself to get better. There will likely be days that you don't feel good, don't want to play, or lose games. You may have to sacrifice other things you want to do in order to spend time practicing.

These moments and situations may be distressing, and you may feel like quitting so that you don't have to deal with the stress. BUT, if you felt like the goal was IMPORTANT enough to you, you might choose to tolerate the distress, knowing it is only SHORT TERM, so that you can reach your goal in the LONG TERM.

Example #2

You want to get a good paying job so you can support your family. That means you need to get a high school diploma, and probably some additional education like college or trade school. Learning new things can be stressful, boring, or difficult. There will be days when you don't want to do your homework or go to class or training.

Once you have your education, then you have to apply for jobs, and you will probably get rejected from some of the jobs you apply for. Finding a job is scary and stressful, and you may be so nervous that you don't want to even risk rejection. BUT, if it is IMPORTANT enough to you to get a good paying job to support your family, you will find a way to get through those boring and hard classes, and you will risk being rejected, because you know that you won't succeed if you never try.

You may be asking yourself... "So how do I know when I should tolerate distress, or avoid it? "

That's a great question! There are a few things to consider...

Think about your current goals and ask yourself the following questions...

Are there any goals you are currently working towards where you are experiencing distress?

If yes, how important is this goal to you?

How much distress are you in? (on a scale of 0-10: 0= no distress, 10=the most I've ever felt)

What urges are you having that might make the situation worse? Are you considering quitting or giving up on your goal?

Are there any coping skills you could use to tolerate the distress? If so, what are they?

Now weigh out the pros and cons...

What are the PROS AND CONS of acting on the urges you are having to give up or make the situation worse?

What are the PROS AND CONS of using a coping skill to tolerate the distress and keep working towards your goal?

After weighing out the pros and cons, which one wins? Will it be worth it in the long run for you to tolerate the distress?

Now is your chance to apply this to your life.

After reading the session above, answer the reflection questions below.

Be sure to complete all sections and click "SUBMIT" at the end. You will get a confirmation message once you have submitted the form.

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