Distress tolerance is part trait and part trainable skill. How to practice sitting with discomfort, and the signs a feeling is telling you to act.
You learn to sit with discomfort in small, planned doses: let a feeling stay for two minutes without acting on it, then decide. Distress tolerance is partly a steady trait and partly trainable, and it's meant for discomfort you can't fix yet, not for warnings.
You probably know the moment. The reply that hasn't come, the meeting you can't leave, the hour before results. Your thumb is on your phone before you've decided anything, and part of you wonders whether calm people are just built differently.
Is Distress Tolerance a Trait or a Skill?
Both, going by the studies. Distress tolerance is your ability to put up with negative emotional states, and psychologists often measure it with a questionnaire.
The best known is the Distress Tolerance Scale, built in two studies of 642 and 823 people. Scores were stable over six months, which looks trait-like. People who scored lower were more likely to say they used substances to cope, and low scores predicted later alcohol problems in men.
Stable on its own doesn't mean fixed. A 2023 review of 106 papers found that self-reported distress intolerance falls with treatment, across different kinds of therapy. Mindfulness and acceptance-based approaches appeared to sit at the core of most of the treatments that worked.
Two trials in China tested this directly. One enrolled 347 adults with at least moderate distress, 86.5% of them women. The other enrolled 170 patients with anxiety disorders or depression. In both, an eight-week group mindfulness program raised distress tolerance scores, and the comparison groups barely moved.
So a low tolerance for discomfort tends to stay put if nothing changes. It can move with structured practice, like an eight-week mindfulness course or therapy.
Why Is Sitting With Your Own Thoughts So Hard?
Doing nothing is uncomfortable for most people, not just you. In 11 studies published in 2014, participants typically did not enjoy spending 6 to 15 minutes alone in a room with nothing but their thoughts. Many were college students, but one study recruited adults aged 18 to 77 at a farmer's market and a church, with similar results.
The best known study added a button. Lab volunteers first tried and rated an electric shock, and the analysis only counted those who said they'd pay to avoid another one. Left alone for 15 minutes, 12 of 18 men and 6 of 24 women shocked themselves at least once.
One sex difference turned up in both. On the questionnaire, women rated their distress tolerance lower than men in both studies. In the shock study, women were less likely to shock themselves (6 of 24, against 12 of 18 men).
The authors attributed that gap to men's higher sensation-seeking. These were different people doing different tests, so together they can't tell you which sex copes better.
Why Escaping a Feeling Keeps It Around
Escaping works in the moment, which is why it's so hard to stop. Psychologists call the habit experiential avoidance. A 1996 paper framed many mental health problems as unhealthy efforts to escape and avoid emotions, thoughts, memories and other private experiences.
Acceptance and commitment therapy (ACT) targets that avoidance. A review of 20 meta-analyses covering 12,477 people found ACT efficacious for every condition examined, including anxiety, depression, substance use and pain. It beat waitlists and usual care, but it didn't outperform CBT.
Avoidance also explains why insight alone rarely settles things. Knowing why you're anxious and still not being able to stop it covers how exposure therapy uses the opposite move.
When Should You Not Sit With Discomfort?
When the feeling points at something you can fix, or something that could hurt you. In Marsha Linehan's DBT handouts, crisis survival skills are for when you cannot make things better right away. The same handout says not to use them for everyday problems.
So the first question isn't how to tolerate it. It's "can this be made better right now, and is it safe to wait?"
| Usually worth sitting with | A signal to act on |
|---|
| The urge to check whether they've replied | A partner who threatens you, controls your money or phone, or hurts you |
| Restlessness in a waiting room or a long meeting | Chest pressure, pain spreading to your arm, jaw or back, or shortness of breath |
| Nerves before a talk you've prepared for | A sense that you're unsafe where you are right now |
| Grief, or a decision that can't be undone | A bill, email or conversation that has a next step today |
| Wanting to fix a friend's bad mood | A new symptom that keeps coming back or getting worse |
Heart symptoms deserve a line of their own. Mayo Clinic says women, older adults and people with diabetes may get symptoms that seem unrelated to a heart attack. Examples include nausea or a very brief pain in the neck or back. If you think it could be your heart, call 911 or your local emergency number, even if you also have anxiety.
Sitting with it is also the wrong tool for a relationship that's harming you. If you're being controlled, threatened or hurt, the National Domestic Violence Hotline is free and open 24/7 at 800-799-7233, or text START to 88788. In Canada, call 911 if you're in danger. If you're in immediate danger in the US, call 911.
In the UK, call 999 in danger; if you can't speak on a mobile, press 55. In England, the abuse helpline is 0808 2000 247, and GOV.UK lists the other UK helplines.
Signs of a toxic relationship covers how to leave safely.
How to Practice Sitting With Discomfort
Practice on the milder items in the left column, like the reply urge or waiting-room restlessness. Big feelings such as grief are a bad place to start.
- Pick a window. Two minutes is enough. Agree with yourself that you won't text, scroll, snack or fix anything until it's up.
- Stop first. Borrow the first step of Linehan's STOP skill, a crisis skill: "Stop! Freeze!" then "Take a step back from the situation." Put the phone face down.
- Name it exactly. "Embarrassed about the missed deadline" gives you more to work with than "stressed."
- Find it in your body. A tight jaw, a hot face, a fluttery stomach. Watch whether it changes over the two minutes.
- Then choose. Borrow STOP's next step too, and ask which actions will make things better or worse. Sometimes the answer is still to send the text.
The goal isn't to stop feeling it. Cleveland Clinic describes DBT's distress tolerance skills as managing hard moments without responding with harmful behaviors. Doing nothing harmful for two minutes counts.
When a feeling is too big for two quiet minutes, use something faster first. How to calm anxiety fast goes through what works in a few minutes, and nervous system regulation looks at what the trials show. Tolerating a feeling is one part of emotional resilience, not all of it.
When to Get Help
See a doctor or a therapist if distress is stopping you from working, sleeping or seeing people. Get help, too, if you're relying on alcohol, food, spending or self-harm to get through feelings, or if panic attacks keep coming back.
DBT was designed for people who experience emotions very intensely. Cleveland Clinic says it's a common treatment for borderline personality disorder. It's also used for self-harm, suicidal behavior, PTSD, substance use disorder, binge eating disorder, bulimia, depression and anxiety. Ask a doctor or therapist whether a DBT or ACT program is available near you.
If you're thinking about harming yourself, call or text 988 any time in the US or Canada. In the US that's the 988 Suicide & Crisis Lifeline, and in Canada it's the 9-8-8 Suicide Crisis Helpline. If your life is at risk or you can't keep yourself safe, call 911 or go to the nearest ER.
In the UK and Ireland, call Samaritans free on 116 123, any time, or 999 in a UK emergency. Elsewhere, call your local emergency number.
Frequently Asked Questions
How Long Does It Take to Build Distress Tolerance?
In the two mindfulness trials, scores rose over an eight-week program, and one trial saw a difference from the first week. Full DBT is longer. Cleveland Clinic says treatment usually takes at least six months to a year.
Are Women Worse at Tolerating Distress Than Men?
Women rated themselves lower on the Distress Tolerance Scale in both of its original studies. In the 2014 shock study, women were less likely than men to give themselves a shock during 15 minutes alone with their thoughts. The authors linked that to sensation-seeking, and neither study shows women are worse at tolerating distress.
Is Sitting With Discomfort the Same as Putting Up With Things?
No. Tolerating a feeling is different from tolerating a situation that's harming you. DBT's crisis skills are for pain that can't be fixed right away. If the situation can be changed or you're unsafe, act on it.
This article is for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making changes to your health routine.
