Areas › Low mood and hard feelings › Tolerate distress
When a feeling is genuinely unbearable, escaping it is the only regulator you have, so the drinking or the shutting down is doing a job. Build up what you can bear and the job disappears.
It helps to stop asking why you keep reaching for the thing and start asking what state you were in just before you reached. Usually it is a sensation you have no way of riding out. Working on that capacity in small doses does more than any promise made to yourself, because it takes away the reason the escape existed in the first place.
Qur’an and Sunnah
Man never tires of asking for good, but if evil touches him he loses all hope and becomes despondent (Quran 41:49). The verse names the flinch at the first touch of something bad, which is the exact moment the escape gets reached for.
لَّا يَسۡـَٔمُ ٱلۡإِنسَٰنُ مِن دُعَآءِ ٱلۡخَيۡرِ وَإِن مَّسَّهُ ٱلشَّرُّ فَيَـُٔوسࣱ قَنُوطࣱ
Man never tires of asking for good, but if evil touches him he loses all hope and becomes despondent
Qur’an 41:49read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A pilot randomised trial built a treatment for smokers who tend to relapse in the first days, teaching them to tolerate discomfort rather than escape it, and it showed promise. A systematic review of similar skills training for substance use disorder found it feasible and acceptable, with the efficacy evidence still limited and preliminary. The reasoning is sound and the trials are early.
Brown RA, Reed KM, Bloom EL, Minami H, Strong DR, Lejuez CW, Lejuez CW, Kahler CW, Zvolensky MJ, Gifford EV, Hayes SC. (2013). Development and preliminary randomized controlled trial of a distress tolerance treatment for smokers with a history of early lapse.. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco doi
Warner N, Murphy M. (2022). Dialectical behaviour therapy skills training for individuals with substance use disorder: A systematic review.. Drug and alcohol review doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
You only need an exit while the room is unbearable.
When not to
If the escape is alcohol, drugs or self-harm, this is work to do with support rather than alone.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Stop fighting what already is. Accepting a hard reality, without approving of it, ends the extra layer of pain.
A calming skill handed over at the wrong moment reads as your anger is not welcome here. For someone taught as a child that their anger was unacceptable, that is the old prohibition arriving again in kinder clothes.
Before you go anywhere near the hard memory, you need to be able to stay in your own body while something difficult is happening in it. That capacity is part of the work, not a delay before it starts.