Workplace Stress & Burnout
Support for general workplace stress and professional burnout affecting healthcare and helping professions.
DBT SKILLS THERAPY
Distress Tolerance Therapy: DBT Skills for Managing Intense Emotions
Last Updated: December 20, 2025 | Expert Reviewed: Jesse Cynamon, RP (CRPO #10979)
Work with a CRPO-registered psychotherapist who understands what it's like when emotions feel overwhelming. Professional support using DBT and ACT approaches for people experiencing intense emotions, emotional overwhelm, and difficulty tolerating distressing situations.
DBT Skills Training
Learn evidence-based distress tolerance techniques including TIPP skills and crisis survival strategies.
$175 / Session
Professional therapy sessions with detailed insurance receipts. Most extended health plans cover.
Flexible Scheduling
Early morning, evening, and weekend appointments available to fit around work and life demands.
Virtual Sessions
Confidential online therapy from anywhere in Ontario. Practice skills in real-world settings.
Is This You?
Small frustrations spiral into overwhelming distress. Criticism cuts so deep you can't function for days. Your emotional responses feel disproportionate, and you find yourself doing things you regret just to escape the intensity of what you're feeling.
Common struggles: Emotional flooding, impulsive reactions to escape discomfort, difficulty "riding out" uncomfortable feelings, crisis-driven coping (substance use, self-harm, angry outbursts), all-or-nothing thinking, and relationship conflicts due to emotional reactivity.
What is Distress Tolerance Therapy?
Distress tolerance therapy teaches practical DBT (Dialectical Behavior Therapy) skills for managing overwhelming emotions without making situations worse. You learn evidence-based techniques to survive crisis moments, tolerate uncomfortable feelings, and make choices aligned with your values even when emotions feel intense.
Core skills you'll learn: TIPP techniques for immediate relief, self-soothing strategies, healthy distraction methods, radical acceptance for unchangeable situations, and crisis survival alternatives to impulsive behaviors.
Most people notice improvements in managing emotional crises within 8-12 weeks of consistent practice.
Jesse Cynamon, RP - Your DBT Skills Therapist
I'm Jesse Cynamon, a Registered Psychotherapist with the College of Registered Psychotherapists of Ontario (CRPO #10979). I work with people struggling with intense emotions, emotional dysregulation, and difficulties tolerating distressing situations using evidence-based DBT and ACT approaches.
Why I Focus on Distress Tolerance
Struggling with intense emotions doesn't mean you're broken or weak. It often means you've experienced difficult situations that didn't teach you healthy ways to manage overwhelming feelings. Distress tolerance skills can be learned at any age, providing practical tools for managing emotional crises without making situations worse through impulsive reactions.
Professional Background
- Registered Psychotherapist with CRPO (#10979)
- Master's degree in counseling psychology
- Specialized training in Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT)
- Experience working with trauma, BPD traits, and emotional dysregulation
Ready to Build Distress Tolerance Skills?
Schedule a 15-minute consultation to discuss how DBT skills can help you manage intense emotions.
Who Struggles with Distress Tolerance?
Difficulties with distress tolerance affect people across many situations and backgrounds. While anyone can struggle with intense emotions at times, certain experiences and conditions make low distress tolerance particularly common.
People with Trauma Histories
- Childhood Trauma: Those who experienced abuse, neglect, or invalidating environments often didn't learn healthy emotion regulation strategies
- Complex PTSD: Repeated trauma can impair your ability to tolerate distressing emotions or situations
- Recent Traumatic Events: Experiencing violence, loss, or life-threatening situations can overwhelm your emotional coping capacity
Mental Health Conditions
- Borderline Personality Disorder (BPD): Emotional dysregulation and low distress tolerance are core features; DBT was specifically developed for BPD treatment
- Anxiety Disorders: Chronic anxiety can reduce your tolerance for additional emotional distress
- Depression: When already emotionally depleted, handling additional stress becomes more difficult
- ADHD: Emotional dysregulation is common in ADHD, affecting distress tolerance capacity
High-Stress Life Situations
- Chronic Stress: Ongoing work pressure, relationship conflict, or financial strain depletes emotional resources
- Major Life Transitions: Divorce, job loss, relocation, or other significant changes can overwhelm coping capacity
- Relationship Instability: Intense, unstable relationships often involve and worsen distress tolerance difficulties
If you're experiencing intense emotional reactions that feel disproportionate to situations, engaging in impulsive behaviors to escape emotional pain, or finding it difficult to tolerate uncomfortable feelings without acting destructively, distress tolerance therapy can help you develop practical skills for managing emotional crises.
Finding Distress Tolerance Support Near You
Searching for "distress tolerance therapy near me" or "therapist for distress tolerance"? Professional support for people experiencing emotional overwhelm and caregivers is accessible through confidential virtual therapy sessions throughout Ontario and beyond.
Many healthcare professionals and caregivers search for "distress tolerance counseling near me" or "burnout therapy for nurses", not realizing that virtual therapy offers maximum privacy (no risk of encountering colleagues) and scheduling flexibility around demanding shift work.
Virtual Therapy for Healthcare Professionals
Whether you're a nurse in Toronto, a physician in Ottawa, a social worker in Hamilton, or a family caregiver anywhere in Ontario, professional distress tolerance support near you is available through secure video sessions.
This matters especially for:
- Shift workers who need appointments outside standard business hours
- Healthcare professionals who value complete confidentiality and privacy
- Caregivers who can't easily leave home due to caregiving responsibilities
- Those in smaller communities where specialized distress tolerance therapists may be limited
Whether you're searching from:
- Greater Toronto Area: Toronto, Mississauga, Brampton, Markham, Vaughan
- Golden Horseshoe: Hamilton, Burlington, St. Catharines, Oakville
- Eastern Ontario: Ottawa, Kingston, Belleville, Peterborough
- Southwestern Ontario: London, Windsor, Kitchener-Waterloo
- Northern Ontario: Sudbury, Thunder Bay, North Bay
Professional distress tolerance therapy near you with flexible scheduling including early morning, evening, and weekend appointments to accommodate healthcare shifts and caregiving responsibilities.
What to Expect - Support Designed for Healthcare Schedules
I understand that healthcare professionals and caregivers have unique scheduling constraints. Therapy needs to work with, not against, your demanding responsibilities.
Flexible Scheduling for Healthcare Workers
- Shift-friendly appointments: Early morning, evening, and weekend sessions available
- Virtual convenience: No commute after a 12-hour shift. therapy from home
- Same-week availability: When distress tolerance is affecting your work, quick access matters
- Consistent scheduling: Regular sessions that accommodate rotating shifts
Complete Professional Confidentiality
Your therapy sessions are completely confidential. Virtual sessions mean no risk of encountering colleagues or patients in waiting rooms. All sessions comply with CRPO privacy standards and healthcare confidentiality requirements.
Insurance and Investment
- Session fee: $175 per 50-minute session
- Insurance accepted: Most healthcare employer plans cover registered psychotherapists
- Detailed receipts: Provided for all major insurers (Manulife, Sun Life, Canada Life, etc.)
- Free consultation: 15-minute call to ensure we're a good fit
Progress Timeline
Many healthcare professionals and caregivers notice improvements in distress tolerance symptoms within the first month of consistent work. Significant progress, including restored empathy capacity, better boundaries, and reduced emotional exhaustion, typically develops within 8-12 weeks of regular sessions.
Distress Tolerance vs Emotional Regulation: Understanding the Difference
| Aspect | Distress Tolerance | Emotional Regulation |
|---|---|---|
| Primary Goal | Survive crisis moments without making situations worse; tolerate intense emotions | Change emotional states; reduce emotional suffering; manage emotions proactively |
| When to Use | During emotional crises, overwhelming moments, when you cannot immediately change a situation | Before crises occur, for ongoing emotional management, to prevent emotional escalation |
| Key Skills | TIPP skills, self-soothing, distraction, radical acceptance, crisis survival strategies | Identifying emotions, opposite action, check the facts, problem solving, building positive experiences |
| Emotional Approach | Accept and tolerate emotions as they are; "ride out" the crisis without reacting | Work to change your emotional response; reduce intensity of emotions; shift emotional states |
| Time Frame | Short-term, in-the-moment strategies for immediate crisis management | Long-term strategies for overall emotional health and preventing crises |
| Example Situation | Partner just broke up with you. Intense pain, can't change it. Use distress tolerance to not send angry texts or self-harm | Notice yourself becoming irritable and overwhelmed. Use emotional regulation to address vulnerability factors before reaching crisis |
| Work Together? | Yes - distress tolerance handles crises that emotional regulation couldn't prevent | Yes - emotional regulation reduces frequency of crises that require distress tolerance |
Both distress tolerance and emotional regulation are essential DBT skill sets. Distress tolerance is for crisis management ("getting through the moment"), while emotional regulation is for long-term emotional health ("preventing future crises"). You need both for effective emotion management.
Evidence-Based Approaches for Distress Tolerance
I use therapeutic approaches with research support for distress tolerance, secondary traumatic stress, and professional burnout in helping roles.
Acceptance and Commitment Therapy (ACT)
ACT helps people experiencing emotional overwhelm and caregivers develop psychological flexibility—the ability to stay present with difficult emotions (both your own and others') while still taking action aligned with your professional values.
- Values reconnection: Understanding why you chose caring work and reconnecting with that purpose
- Acceptance skills: Reducing struggle with unavoidable aspects of helping work
- Defusion techniques: Creating distance from intrusive thoughts about patients' trauma
- Self-compassion: Addressing the guilt and shame that often accompanies distress tolerance
Cognitive Behavioral Techniques
CBT strategies help identify and modify thought patterns that contribute to distress tolerance while developing practical coping skills for managing emotional exhaustion.
- Thought restructuring: Addressing beliefs about professional responsibility and perfectionism
- Boundary development: Learning to separate others' pain from your own emotional experience
- Stress recovery: Techniques for processing difficult shifts or caregiving days
- Meaning-making: Finding sustainable purpose in helping work despite exposure to suffering
Trauma-Informed Approaches
When distress tolerance includes secondary traumatic stress symptoms, we use trauma-informed techniques to process vicarious trauma while maintaining your ability to work effectively in your caring role.
Frequently Asked Questions About Distress Tolerance
What is distress tolerance?
Distress tolerance is the ability to experience and withstand negative emotional states without engaging in impulsive or harmful behaviors. It's a key component of Dialectical Behavior Therapy (DBT) that helps people manage intense emotions, crisis situations, and overwhelming feelings without making the situation worse. Low distress tolerance means small stressors trigger major reactions and difficulty "riding out" uncomfortable feelings.
What is the difference between distress tolerance and emotional regulation?
Distress tolerance focuses on surviving crisis moments and tolerating intense emotions without making things worse, while emotional regulation involves changing your emotional state and reducing emotional suffering over time. Distress tolerance is for crisis management ("getting through this moment"), emotional regulation is for long-term emotional health ("preventing future crises"). Both are important DBT skill sets that work together.
Can therapy help with distress tolerance?
Yes, therapy (particularly DBT and ACT) provides structured training in distress tolerance skills. You learn practical techniques for managing overwhelming emotions, tolerating uncomfortable situations, and building capacity to handle stress without impulsive reactions. Most clients notice improvements in emotional regulation within 8-12 weeks of consistent practice.
What are the symptoms of poor distress tolerance?
Common symptoms include emotional flooding (feeling completely overwhelmed by emotions), impulsive reactions to distress, all-or-nothing thinking during crisis moments, difficulty "riding out" uncomfortable feelings, engaging in harmful behaviors to escape emotions (substance use, self-harm, angry outbursts), relationship conflicts due to emotional reactivity, and feeling like small stressors trigger major emotional breakdowns.
Who struggles with distress tolerance?
Low distress tolerance is particularly common in people with trauma histories, Borderline Personality Disorder (BPD), anxiety disorders, depression, ADHD, and those experiencing chronic stress. Anyone who experiences intense emotions that feel overwhelming or engages in impulsive behaviors to escape emotional pain may benefit from learning distress tolerance skills through DBT therapy.
How long does therapy for distress tolerance take?
Many people notice improvements in managing emotional crises within 8-12 weeks of consistent DBT skills practice. Building strong distress tolerance typically takes 3-6 months of regular therapy and daily skills practice. Timeline varies based on severity of emotional dysregulation, trauma history, and consistency of skills practice between sessions.
Is virtual therapy effective for distress tolerance?
Yes, virtual therapy is highly effective for learning distress tolerance skills. Virtual sessions allow you to practice techniques in your own environment, access therapy from anywhere in Ontario, and maintain privacy. Research shows virtual DBT skills training provides equal benefit to in-person therapy for emotional regulation and crisis management.
Can I continue work/school while learning distress tolerance?
Yes, most people continue their normal activities while learning distress tolerance skills in therapy. The goal is building skills you can use in real-life situations, not withdrawing from life. Therapy provides tools for managing emotions while maintaining work, relationships, and daily responsibilities. Some people find it helpful to reduce commitments temporarily during initial skills building.
What is distress tolerance treatment?
Distress tolerance treatment typically involves Dialectical Behavior Therapy (DBT) skills training focused on managing emotional crises, building capacity to tolerate uncomfortable emotions, reducing impulsive behaviors, and developing crisis survival strategies. Treatment includes TIPP skills, self-soothing techniques, distraction methods, radical acceptance, and practical tools for surviving overwhelming moments without making situations worse.
Does insurance cover therapy for distress tolerance?
Most extended health plans in Ontario cover Registered Psychotherapist services. Many healthcare employers provide comprehensive mental health benefits. Sessions are $175, with detailed receipts provided for insurance reimbursement. Some employee assistance programs (EAPs) may also provide coverage.
5 Steps to Start Distress Tolerance Therapy
1
Reach Out
Contact via phone, email, or online booking. This first step can feel difficult when you're emotionally depleted—that's completely understandable. There's no pressure, just a conversation about how therapy might help you continue in your caring role.
2
Free 15-Minute Consultation
We'll have a brief, confidential conversation about what you're experiencing, your work environment, and how therapy could support you. This is your opportunity to ask about approaches, scheduling, and confidentiality.
3
Schedule First Session
Book your first 50-minute session at a time that works around your schedule—early morning before shifts, evening after work, or weekends. Virtual sessions from the privacy of your home.
4
Assessment and Understanding
Your first session focuses on understanding your experience of distress tolerance—what triggered it, how it's affecting your work and personal life, and what you've tried before. Together, we develop a treatment plan that honors your professional goals and personal well-being.
5
Begin Recovery
Start developing practical tools for managing distress tolerance while continuing in your caring role. Most healthcare professionals attend weekly sessions initially, with progress typically noticed within 6-8 weeks of consistent work.
You don't have to carry the emotional weight of caring alone. Professional support is available.
Call (416) 306-2157 Schedule 15-Min Call