Distress Tolerance in DBT: Tools for Managing Trauma Responses
Trauma triggers can show up unexpectedly, through sounds, emotions, memories, or stress. When this happens, the nervous system may react as if danger is happening right now.
Dialectical Behavior Therapy (DBT) offers distress tolerance skills that help regulate the body and mind in the moment. These tools help you move through emotional waves.
This week’s Trauma Education Series highlights three DBT tools that can transform how you handle trauma triggers: TIP skills, self-soothing, and healthy distraction.
TIP Skills: Resetting the Body When Trauma Takes Over
TIP skills; Temperature, Intense Exercise, Paced Breathing, and Paired Muscle Relaxation, are fast and body-based strategies that help interrupt the stress response. TIP skills help shift the body back toward a grounded state.
T : Temperature Change
Cooling the face stimulates the dive reflex, and slows heart rate.
Splashing cold water on your face
Holding an ice pack to your cheeks
I: Intense Exercise
Short bursts of movement help release energy.
30–60 seconds of brisk walking, squats, or jumping jacks
Shaking the arms or legs
P: Paced Breathing
Slow, rhythmic breathing signals safety to the nervous system.
Inhale for 4 seconds
Exhale for 6–8 seconds
Repeat for 1–2 minutes
P: Paired Muscle Relaxation
Tense a muscle group while inhaling, then release with a long exhale. This helps the body settle after a trigger. TIP bypasses the thinking mind and calms the nervous system.
Self-Soothing: Using Your Five Senses to Re-Anchor
These practices invite comfort, safety, and grounding through simple sensory experiences.
Sight
Watch your favorite show
Sound
Soft music
Nature sounds
Smell
Essential oils
Fresh air from an open window
Taste
A warm drink
Favourite snack
Touch
A weighted blanket
Holding a warm mug
Trauma can disconnect you from your body. Self-soothing restores safety through simple sensory input.
Distraction vs. Avoidance: Knowing the Difference
Many people fear that using distraction means they’re avoiding the trauma or “pushing it down.” DBT offers a helpful distinction:
Healthy Distraction
Short-term and intentional
Helps reduce emotional intensity
Helps you return once regulated
Think of it as “putting the pain on a shelf” until your mind and body are ready to handle it.
Examples:
Counting backwards from 100
Doing a quick puzzle
Calling a friend
Avoidance
Long-term
Often increases fear or anxiety over time
Avoidance feels like running from danger; healthy distraction feels like temporarily stepping out of the storm.
A Sample Plan for a Trauma Trigger
Check-In: Notice the early signs; tight chest, racing thoughts, flashback sensations.
Use TIP: Do 30 seconds of intense exercise + a cold compress.
Self-Soothe: Sip tea or play grounding music.
Distraction: Watch a short comforting show or text a friend.
Return When Ready: Later when grounded, reflect on what happened.
This approach helps you feel more empowered.
Next Steps
Trauma triggers don’t mean you’re going backward, they’re a normal part of healing DBT’s distress tolerance skills that give you tools to stay present and safe during moments that once felt unmanageable. This week, try practicing one TIP skill, one grounding technique, and one healthy distraction strategy.
At Healing Voices Psychotherapy, our DBT-trained therapists provide supportive care to help you develop effective regulation skills. Book a free 15-minute consultation today with one of our registered psychotherapists.
