Distress Tolerance - DBT Therapy


Our DBT therapists here at Cityscape Counseling are waiting to equip you with distress tolerance skills to help you manage any intense urges, cravings, impulses or emotions you may be struggling with such as: urges to self-injure, urges for bingeing and purging, cravings for drugs and alcohol, impulses for compulsive activities, and intense anger, panic and sadness.


Marsha Linehan, founder of DBT, says that the 2 main goals of DBT Distress Tolerance are to help you:

  1. “SURVIVE CRISIS SITUATIONS without making them worse”

Examples of how acting on intense emotions can make crisis situations worse:

  • You find out you’ve just lost your job, you decide to go out for a night of drinking and then you drive home while intoxicated and receive a DUI.

  • Your partner breaks up with you and in order to numb the pain, you impulsively have unprotected sex with a stranger you just met.

  • You receive a rejection letter from the Grad school of your dreams and to punish yourself, you engage in self-injury or disordered eating which only leads to more guilt and shame.


     2.“ACCEPT REALITY in order to reduce overall emotional suffering”

Emotional pain in life is inevitable, but we oftentimes unintentionally turn our pain into suffering by the way we choose to respond to it. Your DBT therapist can teach you the skill of radical acceptance to help free you from the exhausting struggle that results from a continuous rejection of reality. The goal of radical acceptance is not eliminating your pain— if there was a magic formula for that, we’d certainly share it. Rather, the goal is to provide you with skills to interact with your pain in such a way that your time and energy increase to focus on building a more enriching life in spite of your pain, which ultimately will reduce your suffering.

Our DBT therapists can teach you Distress Tolerance skills to be used in the following situations:

  • When you are experiencing urges for harmful behaviors or intense emotional pain

  • When acting on intense emotions/urges will only increase your suffering

  • You are feeling extremely overwhelmed but you still have tasks to complete

Here’s a Quick Example of a skill our DBT Therapists love to teach, adopted from the DBT Skills Training Manual

Riding the Wave of Your Emotions


Emotions are like the waves in an ocean. Just as ocean waves can be calm/tranquil one moment and stormy/turbulent the next, so can your emotions. Emotions often transition from waves of peace to waves of distress suddenly and without warning, so of course it feels jarring! One moment you’re coasting the waves of contentment and the next moment you might find yourself being swept away by waves of panic.

Like waves in the ocean, your emotions will not remain at the exact same intensity forever. You can be assured that your emotions will approach, rise to a peak, and then naturally fall and move on, just like a wave does. While you can’t stop the waves from coming, you can learn to surf the waves of your emotions to decrease your suffering!

Next time you notice an intense emotion wave approaching, try the steps below:

  • Observe your Feeling

  • Rate the intensity on a scale of 1-10

  • Notice it, Step back, Get unstuck

  • Experience your feeling as a wave coming and going

  • Try not to block the feeling

  • Don’t try to get rid of it

  • Don’t try to push it away

  • Don’t try to hold on to it

  • Don’t try to make the feeling bigger

  • Remember, you are not the feeling

  • You don’t need to act on it

  • Rate the intensity of your emotion again – has it increased, stayed the same, or decreased?

  • Remember times when you have felt differently

  • Become more familiar with your feeling

  • Don’t judge it

  • Radically accept it as a part of you

  • Name your feeling

  • Invite it to hang out with you and sit alongside you

  • Re-rate the intensity of your emotion

  • Repeat the steps until you notice a change

If you can ride the wave long enough, eventually your emotion will subside.

Remember, intense emotions/urges/cravings rarely remain at a level 10 longer than a few minutes (unless you retrigger the emotion by struggling against it)

if you're looking for a dbT therapist in chicago, Cityscape counseling would love to work with you.

We know that seeking out therapy can be a daunting endeavor so we're dedicated to helping you each step of the way.


Start by calling or emailing us to set up your first appointment