Distress Tolerance: Avoiding The Negative Effects Of Stress

Medically reviewed by Arianna Williams, LPC, CCTP
Updated March 25, 2024by BetterHelp Editorial Team

Unresolved trauma and unmanaged stress can potentially chip away at mental and physical health. Adults often respond to stressful situations in the same way they did as children. That’s because these response patterns become ingrained, whether beneficial or otherwise. 

There are helpful ways to cope with stress and shield the body from its effects. Specifically, distress tolerance is a strategy taught by many dialectical behavior therapists to help clients overcome stressors. This article explores distress tolerance skills and tips that might help. 

Stress affects everyone

Radical acceptance

Radical acceptance refers to accepting events and situations you can’t change. It may involve positioning your perspective inside a larger picture and considering all angles. 

Even though life may be unfair at times, humans have an innate tendency to desire justice, and seemingly unfair life outcomes can cause stress. For example, suppose you were hired five months before your coworker, but your coworker earned a promotion before you did, despite your hard work, overtime hours, and commitment to the company. 

One reaction to this situation might be: "My boss can't do this to me! It’s so unfair. I did everything right. I need to start looking for a new job." 

While you may experience initial frustration, a radical acceptance response might be: "I wish I would have gotten the promotion. I worked hard, but I acknowledge that my coworker did too. I accept that my boss felt they would be a better fit."

The first reaction could potentially stimulate a stress response and release a flood of stress hormones into the bloodstream. The second reaction, however, may be conducive to overall health and well-being by helping you stay calm and avoid excess upset. With some practice, you may be able to apply radical acceptance to your life and stay above the fray of things you can't change. 

Radical acceptance can be challenging. It may help to remember that it doesn’t mean giving up or forgiving someone you feel has wronged you. If you’re passed over for that promotion at work, accepting and acknowledging it may reduce your stress. However, doing so might take a lot of practice and overcoming many potential barriers. 

It may help to consider what could make radical acceptance more challenging for you. Perhaps you don't want to let someone off the hook or think you must forgive them to accept the situation. You might view anger as a form of self-defense or believe that acceptance is agreement. 

These things don’t need to be true. You can be angry or hold someone accountable while still accepting a situation. If you struggle with these things alone, a mental health professional may be able to help you find the right balance. 

Sensory engagement

Sensory engagement refers to a mindfulness-based approach that uses the five senses to engage with the world around you. Instead of focusing on the past or worrying about the future, it may help you become fully immersed in the sight, sound, touch, taste, and smell of the current moment. It can be used as a part of DBT distress tolerance because it’s a beneficial self-soothing technique that anyone can use without lengthy training.

The main component of sensory engagement is often mindfulness. One thing that might make it easier is creating a sensory self-soothing toolkit. This toolkit can become your go-to to help in times of distress. Here are some things you might include: 

  • Sight: You might add calming images of things like beautiful landscapes, your dog, or your favorite person. 
  • Sound: Keeping a chime, bell, or list of your favorite music can help you find sound to relax into. 
  • Touch: You may want a favorite soft blanket or stuffed animal in your toolkit – whatever you enjoy feeling against your skin. 
  • Taste: You could have a piece of your favorite candy, a packet of instant hot chocolate, or even a small gift card to your favorite coffee shop or bakery.
  • Smell: Consider adding something with a scent you like, such as a candle, incense stick, or essential oil. 

If you don’t want to or can’t keep a literal toolkit with you, a list of things you would include might be helpful in a stressful moment away from home. 


Sometimes, one of the most helpful things to do when you’re in the midst of stress is to distract yourself. Stressful events can become less so when you focus on other things instead of ruminating on them. DBT practitioners have developed the acronym ACCEPTS as a reminder of the distraction technique. It stands for: 

  • A - Activities: Engage in projects that require concentration.
  • C - Contributing: Volunteer at your workplace, school, or community.
  • C - Comparison: Look at your current situation in relation to something worse.
  • E - Emotions: Stir up another competing emotion, such as comfort.
  • P - Pushing away: Push negative thoughts out of your mind.
  • T - Thoughts: Focus on your thoughts instead of your emotions.
  • S - Sensations: Ground yourself in your environment by touching the ground, your chair, your clothing, etc.

Distraction can potentially offer short-term relief as well as long-term stress reduction. In the immediate term, you may want to get up and take a short walk or step away momentarily. You could breathe slowly and count to 10 or visualize yourself standing in an open meadow. For the long-term, you might try volunteering or joining a group with a cause you support, consider getting regular exercise, or joining friends more often for social events.


The physical impact of stress

The stress response within the human body starts a biochemical cascade of hormones and physiological changes, some of which can impair mental clarity. 

A loss of clarity may lead to poor decisions, overreacting, and the inability to be effective in every aspect of your life. An estimated 60-70% of all visits to primary care physicians may have a stress-related component. However, according to one study, just 3% of these patients receive stress management care. 

Stress can potentially compromise your immune system, increase the risk of cardiovascular disease, contribute to headaches, increase the risk of obesity, and intensify pain. Chronic stress may also lead to sleep disturbances, sadness, and depression.
Getty/Vadym Pastukh
Stress affects everyone

See an online counselor for advanced distress tolerance

These three techniques may help you build a distress tolerance foundation. If you’d like to explore this skill further, talking to a counselor might help. Mental health professionals can help teach strategies that you can use throughout your life as a shield against stress. 

If you're stressed out, you may have a hectic schedule, and adding another in-person appointment to the calendar may be challenging. This is where online therapy has its advantages. You can speak to a licensed mental health professional from home with internet-based counseling. It can also save you time since you won’t have to make the commute or sit in a waiting room before your session. 

This type of therapy is backed by research in the mental health field. One study found that online cognitive behavioral therapy (CBT) and acceptance commitment therapy (ACT) are associated with a positive reduction in overall stress levels and mental health results. 


Stress can potentially affect everyone, but you can change how it affects you. A licensed counselor like those from BetterHelp can teach you stress management techniques to take back control of your life. Answer a few brief questions to get matched with a therapist today.
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