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Distress Tolerance

  • Writer: Deric Hollings
    Deric Hollings
  • Apr 24
  • 6 min read

 

Rational Emotive Behavior Therapy (REBT) uses the ABC model to illustrate that when an undesirable Action occurs and one Believes an unhelpful narrative about the event, it’s one’s unfavorable assumption and not the occurrence itself that causes an unpleasant Consequence.

 

Addressing how people disturb themselves with unhelpful attitudes, the ABC model incorporates Disputation of these unproductive assumptions in order to explore Effective new beliefs. The aim of this tool is to un-disturb oneself.

 

Also, REBT uses the technique of unconditional acceptance (UA) to relieve suffering. This is accomplished through use of unconditional self-acceptance, unconditional other-acceptance, and unconditional life-acceptance. Whereas the ABC model is an abortive tool, UA is preventative.

 

It’s worth noting that these REBT techniques aren’t intended to fully eliminate all unpleasant reactions to undesirable occurrences. Therefore, it’s worth distinguishing between emotional distress and disturbance.

 

To “distress” oneself is to cause to worry or be troubled. Thus, this term colloquially relates to pain or suffering affecting the body, a bodily part, or the mind. However, the American Psychological Association (APA) defines distress thusly:

 

1. the negative stress response, often involving negative affect and physiological reactivity: a type of stress that results from being overwhelmed by demands, losses, or perceived threats. It has a detrimental effect by generating physical and psychological maladaptation and posing serious health risks for individuals. This generally is the intended meaning of the word stress.

 

2. a negative emotional state in which the specific quality of the emotion is unspecified or unidentifiable. For example, stranger anxiety in infants is more properly designated stranger distress because the infant’s negative behavior, typically crying, allows no more specific identification of the emotion.

 

Using the refined psychological description of “distress,” one may conclude that it largely relates to psychologically-maladapted stress or anxiousness. Perhaps most people have routinely experienced this natural and arguably healthy (in limited duration) emotional reaction.

 

Alternatively, to “disturb” oneself is to interfere with or cause disturbance—an interruption of a state of peace, quiet, or calm; an interference with or alteration in a planned, ordered, or usual procedure, state, or habit. Yet, according to the APA, emotional disturbance is defined thusly:

 

[A] fear-, anxiety-, or other emotionally based condition that results in maladaptive behavior—ranging from withdrawal and isolation to acting out and aggression—and adversely affects an individual’s academic and social functioning.

 

Incorporating an REBT framework, emotional disturbance differs from emotional distress in that the former is a behaviorally-maladapted (to include psychologically fueled) experience of a more significant degree than the latter. Whereas distress is natural, disturbance is unnatural.

 

Perhaps an illustrative example to elucidate the point is in order. Imagine there are multiple administrative deadlines inherent in your line of work. Document X is due by close of business today, filing materials Y are due tomorrow, and you have a submission date for file Z in a week.

 

When prioritizing these distinct deadlines (Action), you Believe, “I have to complete all of these tasks quickly and if I don’t, I may face repercussions.” With this distressing attitude, you notice that your heartrate increases, you become nervous, and your head begins to throb (Consequence).

 

Generally speaking, the distorted inference underlying unhelpful narratives of distress is what’s known in REBT literature as low frustration tolerance (LFT). I’ll address this unhelpful matter in a moment. For now, consider a self-disturbing experience in contrast of the above example.

 

When prioritizing distinct work deadlines (Action), you Believe, “I must complete all of these tasks quickly or else I’ll be fired and wind up living in a van down by the river, and that’d be awful!” With this disturbing attitude, you experience fear and a panic attack (Consequence).

 

Distortedly inferred in this narrative of disturbance is LFT. If this irrational belief had a catchphrase it would be something like, “I can’t stand it!” In both the distress and disturbance examples, LFT is inferred. So, you may wonder, why the different outcomes?

 

Bear in mind that it’s natural to experience some degree of stress or anxiousness with a deadline or other time-sensitive element (e.g., extinguishing a fire on your stovetop). Thus, telling yourself that you can’t stand violating an urgent cutoff point isn’t entirely unnatural.

 

Yet, when adding an extreme element to what you tell yourself (e.g., I’ll be fired and wind up living in a van down by the river), you’ll disturb yourself into severe consequences of this belief. Ergo, LFT may exist with either narrative, though disturbance results from a perceived threat.

 

Both the abortive practice of the ABC model and preventative technique of UA are used in advocacy of high frustration tolerance (HFT). If this helpful belief had a tagline it would be something along the lines of, “I can stand it!”

 

Whereas LFT infers inability, HFT supposes ability. When targeting emotional disturbance, I assist people with actively interrogating unhelpful self-narratives. Besides, it may not be in one’s best interests to merely tolerate and accept the unpleasant experience of a panic attack.

 

Alternatively, I try to help people achieve a distress tolerance approach to life. If one has a stringent deadline at work, over which one has no control or little influence, then I’d invite the individual to endure the unpleasantness of stress while diligently completing one’s tasks.

 

If you’re looking for a provider who tries to work to help understand how thinking impacts physical, mental, emotional, and behavioral elements of your life—helping you to sharpen your critical thinking skills, I invite you to reach out today by using the contact widget on my website.

 

As a psychotherapist, I’m pleased to try to help people with an assortment of issues ranging from anger (hostility, rage, and aggression) to relational issues, adjustment matters, trauma experience, justice involvement, attention-deficit hyperactivity disorder, anxiety and depression, and other mood or personality-related matters.

 

At Hollings Therapy, LLC, serving all of Texas, I aim to treat clients with dignity and respect while offering a multi-lensed approach to the practice of psychotherapy and life coaching. My mission includes: Prioritizing the cognitive and emotive needs of clients, an overall reduction in client suffering, and supporting sustainable growth for the clients I serve. Rather than simply trying to help you to feel better, I want to try to help you get better!

 

 

Deric Hollings, LPC, LCSW


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References:

 

APA Dictionary of Psychology. (2018, April 19). Distress. American Psychological Association. Retrieved from https://dictionary.apa.org/distress

APA Dictionary of Psychology. (2018, April 19). Emotional disturbance. American Psychological Association. Retrieved from https://dictionary.apa.org/ https://dictionary.apa.org/emotional-disturbance

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Saturday Night Live. (2013, September 25). Matt Foley: Van Down by the River – SNL [Video]. YouTube. Retrieved from https://youtu.be/Xv2VIEY9-A8?si=dP1sfYrNYLeb-iNW

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