Bandai Choi
Clinical Psychologist | Board-approved supervisor
Breathe-n-Smile Psychology, Essendon North, Footscray and telehealth
What can you do when your emotions are so intense that clear thinking is difficult? Distress-tolerance skills are short-term ways to lower the immediate pressure without pretending the problem has disappeared. They can help you get through the next few minutes safely, then decide what support or next step is needed.
TL;DR
- Choose a small action that matches your level of activation rather than trying to solve everything at once.
- Body-based pauses, movement and grounding can make the next choice easier.
- If you might act unsafely or cannot get through the moment alone, seek urgent support.
What distress tolerance is for
Distress tolerance is a DBT term for getting through a difficult emotional moment without making it worse. It is not the same as accepting poor treatment, suppressing feelings or solving a long-term problem in one sitting. Its job is narrower: create enough space for choice to return.
These skills can be useful when your body is signalling danger: racing thoughts, a tight chest, anger, panic, an urge to send a message immediately or a sense that you cannot cope. When the intensity has eased, you can return to boundaries, problem-solving, rest or a conversation with someone you trust.
Three skills to try
Use a brief, safe temperature shift
Some DBT approaches use temperature as a way to interrupt a surge of arousal. You might hold a cool pack wrapped in cloth against your cheeks, or splash your face with comfortably cool water, then pause and notice your breathing. Laboratory face-immersion studies show that this can affect heart-rate and autonomic responses, but the response varies and it is not a cure for anxiety.
Move the stress response through the body
Try one minute of brisk walking, climbing stairs, shaking out your hands or pressing both feet into the floor. The aim is not fitness. It is giving the activated body a bounded, safe outlet before you make a decision.
Make the next exhale longer
Without forcing a deep breath, let your exhale run a little longer than your inhale for several breaths. Pair it with one concrete observation: name five blue things, feel the back of the chair or describe what you can hear. The Dropping Anchor exercise offers another structured way to reorient when thoughts are pulling you away.
Choose another skill if cold is not suitable. Avoid ice baths, breath-holding and sudden cold exposure. If you have heart or circulation concerns, a history of fainting, an eating disorder or uncertainty about safety, choose a different grounding strategy and ask a health professional.
Supporting a distressed colleague without taking over
If someone at work looks overwhelmed, start quietly and specifically: “Would it help to step somewhere quieter for two minutes?” Offer options rather than instructions, such as water, a short walk, sitting nearby, or help contacting a manager or support person. Do not press for personal details, diagnose them, or assume that touch, cold water or breathing exercises will suit them.
You can be kind without becoming their sole support. If the situation is unsafe or beyond what work can hold, involve the appropriate workplace or emergency support.
A few practical tips
- Create a two-minute plan before you need it: one body skill, one grounding skill and one person or service you can contact.
- Put the plan in your phone. A short plan is more usable than a perfect plan you cannot remember while distressed.
- Reduce immediate demands where possible. Delay an argument, step away from a screen or move to a quieter place.
- If panic, rage, shutdown or self-harm urges recur, bring examples to a psychologist, GP or another support service.
Frequently asked questions
Are distress-tolerance skills meant to make feelings disappear?
No. Their purpose is to make the immediate moment more manageable so you can respond with more choice.
Should I use cold water whenever I feel anxious?
No. It is one optional, brief strategy for some people. Use a gentler grounding skill if cold exposure is uncomfortable or medically unsuitable.
What if the skill does not work straight away?
Try a different small skill, reduce demands where possible and contact support. A skill not working instantly does not mean you have failed.
You may also be interested in
- Dropping Anchor for a structured grounding exercise when thoughts pull you away from the present.
- Leaves on a Stream for a gentle way to notice thoughts without needing to argue with them.
- What is therapy? for an overview of how therapy can support recurring overwhelm.
Questions about therapy or support?
You can call 0431 828 769, email reception@breathe-n-smile.com, or use the contact form for a brief administrative question about appointments, therapy options, locations or fees. Please do not include sensitive clinical history or urgent information in ordinary email or website messages.
References
- Linehan MM. DBT Skills Training Manual. 2nd ed. Guilford Press; 2015.
- Hayashi N, et al. Face immersion increases vagal activity as assessed by heart rate variability.
- Jay O, et al. The human face and the diving response.
General information only. It does not replace individual psychological or medical advice.