We all experience emotions. Emotions are an important part of being human, and are essential to our
survival. As humans we are designed to feel a whole range of emotions, some of which may be comfortable
to us, and others may be uncomfortable.
Most people dislike feeling uncomfortable. There are many different ways that humans can feel
uncomfortable…we can be hot, cold, tired, in pain, hungry, unwell, and the list could go on. The type of
discomfort we will be talking about in these modules is emotional discomfort, or what is often called
distress. We may not like it, but experiencing uncomfortable emotions is a natural part of life.
However, there is a difference between disliking unpleasant emotions, but nevertheless accepting that they
are an inevitable part of life and hence riding through them, versus experiencing unpleasant emotions as
unbearable and needing to get rid of them. Some people tell us that they “can’t face”, “can’t bear”, “can’t
stand”, or “can’t tolerate” emotional distress. Being intolerant of experiencing emotional discomfort can
actually breed a whole bunch of problems, as it interferes with living a fulfilling life, and can make worse any
emotional discomfort we might be experiencing. If difficulty facing your feelings or tolerating distress
sounds like you, then read on to learn ways to overcome this pattern.
What Is Distress Intolerance?
There are many different definitions of distress intolerance. What we mean by distress intolerance is a
perceived inability to fully experience unpleasant, aversive or uncomfortable emotions, and is
accompanied by a desperate need to escape the uncomfortable emotions. Difficulties tolerating
distress are often linked to a fear of experiencing negative emotion. Often distress intolerance centres on
high intensity emotional experiences, that is, when the emotion is ‘hot’, strong and powerful (e.g., intense
despair after an argument with a loved one, or intense fear whilst giving a speech).
However, it could also occur for lower intensity emotions (e.g., nervousness about an upcoming medical
examination, sadness when remembering a past relationship break-up). It is not the intensity of the
emotion itself, but how much you fear it, how unpleasant it feels to you, how unbearable it seems, and how
much you want to get away from it, that determines if you are intolerant of distress.
There are varying types of negative emotions that could potentially be distressing for people. We thought
it might be helpful to categorise these emotions into the following 3 clusters:
This group includes emotions that reflect sadness at varying degrees of intensity. This would include
disappointment, hurt, despair, guilt, shame, sadness, depression, grief, misery, etc. These emotions
can be accompanied by either low physiological arousal (e.g., low energy, fatigue, heaviness) or
heightened physiological arousal (e.g., intense crying, restlessness), thoughts of hopelessness, loss,
regret and inadequacy, and the urge to hide away from life.
This group includes emotions that reflect anger at varying degrees of intensity. This would include
irritation, agitation, frustration, disgust, jealousy, anger, rage, hatred, etc. These emotions are
usually accompanied by high physiological arousal (e.g., tension, increased heart rate, feeling sweaty
or hot, etc), thoughts of unfairness, injustice and wrong doing, and the urge to lash out in some way.
This group includes emotions that reflect fear at varying degrees of intensity. This would include
nervousness, anxiety, dread, fear, panic, terror, etc. These emotions are usually accompanied by
high physiological arousal (e.g., increased heart rate, increased breathing, tension, sweating, shaking,
butterflies in stomach, etc), thoughts of threat, vulnerability and helplessness, and the urge to avoid
• Psychotherapy • Research • Training
Module 1: Understanding Distress Intolerance