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Distress Tolerance Skills: Cope with Crisis Situations WITHOUT Making Them Worse

Updated: Oct 21, 2021

Learn how to accept certain realities (especially the really difficult ones) and how to weather life’s storms when facing challenging experiences and are feeling flooded with emotions through the distress tolerance skills listed below.

Half smile and willing hands are two DBT skills that focus on using our bodies to communicate with our brains that we are okay. They can help us regulate our systems, accept situations, and feel better at the moment.

  1. Relax the muscles in your face, from your forehead down to your jaw and chin.

  2. Allow the corners of your mouth to turn up ever so slightly.

  3. Adopt a peaceful facial expression.

Willing Hands
  1. Seated: Place your hands on your laps, palms up and fingers relaxed and slightly curved, as if you are receiving.

  2. Standing: Drop your shoulders down. Unclench your hands and turn the palms out, relaxing your fingers.

  3. Lying down: Unclench your hands, turn your palms up, and relax your fingers.

Radical Acceptance skill

It allows us to keep that pain from becoming suffering.

While pain is part of life, radical acceptance allows us to keep that pain from becoming suffering. By accepting the facts of reality without responding by throwing a tantrum or with willful negligence. In other words, it is what it is.

Radical acceptance is NOT approval, but rather completely and totally accepting with our mind, body and spirit that we cannot currently change the present facts, even if we do not like them. By choosing to radically accept the things that are out of our control, we prevent ourselves from becoming stuck in unhappiness, bitterness, anger and sadness and we can stop suffering. pain from turning into suffering.

Here are the #10StepstoPractisingRadicalAcceptance according to #DBTfounder, #MarshaLinehan:
  1. Observe that you are questioning or fighting reality (“it shouldn’t be this way”)

  2. Remind yourself that the unpleasant reality is just as it is and cannot be changed (“this is what happened”)

  3. Remind yourself that there are causes for the reality (“this is how things happened”)

  4. Practice accepting with your whole self (mind, body, spirit) - Use accepting self-talk, relaxation techniques, mindfulness and/or imagery

  5. List all of the behaviours you would engage in if you did accept the facts and then engage in those behaviours as if you have already accepted the facts

  6. Imagine, in your mind’s eye, believing what you do not want to accept and rehearse in your mind what you would do if you accepted what seems unacceptable

  7. Attend to body sensations as you think about what you need to accept

  8. Allow disappointment, sadness or grief to arise within you

  9. Acknowledge that life can be worth living even when there is pain

  10. Do pros and cons if you find yourself resisting practising acceptance



When you feel that your emotions seem to be in control, stop! Don’t react. Don’t move a muscle. Just freeze especially those muscles around the mouth. Freezing for a moment helps prevent you from doing what your emotions want you to do (which is to act without thinking). Stay in control. Remember, you are the boss of your emotions. Name the emotion – put a label on it.

Take A Step Back

When you are faced with a difficult situation, it may be hard to think about how to deal with it on the spot. Give yourself some time to calm down and think. Take a step back from the situation. Get unstuck from what is going on. Take a deep breath and continue breathing deeply as long as you need and until you are in control. Do not let your emotions control what you do. It is a rare incident, indeed, wherein we need to make a split-second decision about anything. Hence, it is okay to take our time to decide how to respond.


Observe what is happening around you and within you, who is involved, and what are other people doing or saying. Listen to the Automatic Negative Thoughts (ANTs) that occur…remember those are based on an outdated Belief System that was programmed before you were seven. To make effective choices, it is important NOT to jump to conclusions. Instead, gather the relevant facts so you can understand what is going on and what options are available.

Proceed Mindfully

Ask yourself, “What do I want from this situation?” or “What are my goals?” or “What choice might make this situation better or worse?” or “What act will allow for success?” Stay calm, stay in control, and when you have some information and how that may impact your goals, you will be better prepared to deal with the situation effectively. Remember your brain needs time to think all of this through.



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