STAIR Narrative Therapy: 5. Distress Tolerance — Moving Towards the Life You Want

Exploring how learning to tolerate difficult feelings can help us pursue meaningful goals, reconnect with positive experiences and create more choice in our lives.

Have you ever avoided doing something important because you knew it would make you anxious, uncomfortable or upset?

Perhaps you would like to develop a new relationship, repair a ruptured one, return to an activity you once enjoyed, pursue a career opportunity or have a difficult conversation. You may know that taking a step forward matters to you, yet find yourself held back by the feelings it brings up.

When we have experienced trauma, avoiding distress can become an understandable way of protecting ourselves. But over time, this protection can sometimes restrict our choices, relationships and opportunities to enjoy life.

In this fifth article in my STAIR Narrative Therapy series, I explore distress tolerance: the ability to experience difficult feelings without automatically responding in ways that may be harmful or prevent us from pursuing what matters to us.

What is distress tolerance?

Distress tolerance is the ability to endure difficult feelings or uncomfortable situations without resorting to unhelpful actions that may harm ourselves or others.

It is something we all use in everyday life. We may tolerate the anxiety of attending an interview, the frustration of a difficult conversation or the uncertainty involved in making an important decision.

This does not mean that distress is pleasant, that we should ignore our feelings or that we must endure every difficult situation.

Rather, distress tolerance involves recognising that uncomfortable feelings are sometimes part of doing something important to us. We can learn to acknowledge those feelings, draw on our coping skills and decide how we want to respond.

Within STAIR, this session brings together the emotional regulation skills explored in the previous sessions and considers how they can support us in working towards personally meaningful goals.

When avoiding distress begins to limit our lives

Avoiding distress is understandable. When something feels frightening, painful or overwhelming, moving away from it can bring immediate relief.

However, if avoidance becomes our main way of coping, it can gradually narrow our lives.

We might avoid social situations because we fear rejection, withdraw from relationships when we begin to feel vulnerable or decline opportunities because we are worried about getting something wrong.

We may also spend considerable time organising our lives around preventing difficult feelings, leaving less energy for the things we would like to do.

For some people who have experienced trauma, this pattern can develop from earlier experiences in which vulnerability, trust or expressing needs led to hurt or disappointment.

Protecting ourselves may once have felt necessary. Yet the same strategies can sometimes prevent us from discovering whether different experiences are now possible.

The aim is not to criticise avoidance or suggest that we should push ourselves into situations that feel unsafe. It is to understand when avoidance is protecting us from genuine harm and when it may be preventing us from pursuing something we value.

That distinction matters.

Distress tolerance with a purpose

An important principle within STAIR is that we are not learning to tolerate distress simply for the sake of it.

We are exploring whether experiencing some discomfort may be worthwhile because it helps us move towards something that matters to us.

For example, someone who wants to build friendships may feel anxious about accepting an invitation. Someone hoping to return to education may worry about failing. Another person may want to become more assertive but fear the discomfort of expressing a different opinion.

These feelings do not necessarily mean the goal is wrong. They may reflect uncertainty, vulnerability or the challenge of doing something unfamiliar.

Distress tolerance can help us consider whether the potential benefits of taking a step forward are important enough to make the discomfort manageable and worthwhile.

It also involves recognising when distress is unnecessary. If a situation is harmful, exploitative or unsafe, the answer may be to change the situation rather than learn to endure it.

We are not aiming to become better at tolerating mistreatment. We are exploring how to make choices that support our own values, wishes and well-being.

Connecting goals with what matters to you

It can be difficult to identify what we want when we have spent a long time concentrating on managing distress or meeting other people’s expectations.

We may know that we want life to feel better without being entirely sure what that would look like in practice.

STAIR encourages people to consider what they would like to be different in their lives and to identify meaningful goals.

These goals will be individual. They might involve developing healthier relationships, returning to study, exploring new interests, improving boundaries or feeling more confident in everyday situations.

A goal does not have to be dramatic to be important.

It might be reconnecting with someone, attending an activity that interests you or taking a small step towards something important you have been putting off.

The emphasis is on identifying what matters to you, rather than pursuing goals simply because someone else thinks you should.

Breaking goals into manageable steps

Sometimes, a goal can feel so large that it becomes overwhelming.

For example, wanting to develop a fulfilling relationship may feel difficult to approach if you are frightened of vulnerability or being hurt again.

Breaking a broader ambition into smaller, more immediate steps can make it easier to consider what feels manageable.

Rather than needing to know how a relationship will develop, you might begin by considering whether you would like to meet someone for a coffee or spend time getting to know them.

The outcome cannot be guaranteed, and the discomfort may not disappear. But the immediate step becomes more specific and easier to evaluate.

This approach allows us to move towards what matters without expecting ourselves to resolve every fear or uncertainty first.

Considering the benefits and costs

Not every difficult situation is worth tolerating, and not every goal requires us to experience significant distress.

STAIR introduces the importance of considering the potential advantages and disadvantages of pursuing a goal when discomfort is involved.

This involves thinking about what the goal could offer, what difficulties might arise and whether the expected discomfort is necessary and worthwhile.

For example, pursuing a professional opportunity might involve anxiety about being assessed or uncertainty about the outcome. The potential benefits could include developing skills, increasing confidence or moving towards work that feels meaningful.

Considering both sides can help someone make a more informed decision, rather than automatically avoiding the opportunity because it feels uncomfortable.

It can also help identify ways to manage foreseeable difficulties and recognise when a different route towards the same goal might be more appropriate.

This is not about convincing ourselves to pursue something at any cost. It is about making thoughtful choices that reflect our own priorities and circumstances.

Learning to experience feelings without immediately reacting

Distress does not always arise when we are pursuing a specific goal. Sometimes, difficult emotions appear unexpectedly during everyday life.

We might feel frustrated while waiting, anxious after an uncomfortable interaction or sad without immediately understanding why.

Our first instinct may be to make the feeling disappear as quickly as possible.

However, not every difficult emotion needs to be fixed immediately. Sometimes, we can acknowledge what we are feeling, recognise that it is uncomfortable and allow it to be present without acting impulsively.

This does not mean liking the feeling or pretending it does not matter.

It means recognising that an emotion can be experienced without automatically determining what we do next.

Within STAIR, this includes learning to observe emotions with greater acceptance and understanding that feelings can change over time.

The intention is to develop confidence in our ability to experience discomfort while choosing how we respond, rather than feeling compelled to escape every difficult feeling.

Why positive feelings matter too

Distress tolerance is not only about managing difficult emotions. It is also about making room for positive experiences.

When we become focused on preventing distress, we can unintentionally limit opportunities for enjoyment, curiosity, connection and excitement.

For some people, particularly those whose earlier experiences made vulnerability feel unsafe, moving towards positive experiences can feel unfamiliar or frightening.

Getting closer to another person, trying a new activity or pursuing an ambition may bring pleasure alongside anxiety.

Learning to notice positive feelings can help us recognise what interests us, what feels meaningful and what we might like to explore further.

Enjoyment can provide information about our preferences and help sustain motivation towards a goal, particularly when the process also involves challenges.

A fulfilling life is not one without difficult feelings. It is one in which difficult feelings do not have to prevent us from experiencing everything else.

Bringing the skills together

The fifth STAIR session builds on the skills explored in the previous sessions, including awareness of our emotions, body-based coping strategies and ways of working with thoughts and behaviour.

Different situations may call for different combinations of skills.

Someone preparing for a difficult conversation might use focused breathing to manage physical tension, consider a more balanced perspective on their worries and seek support while planning how to communicate.

Another person may need to acknowledge anxiety, take a manageable step towards a personal goal and make time for activities that support their well-being.

There is no single combination that works for everyone. The aim is to recognise which skills are relevant to our needs and to develop greater flexibility in how we use them.

This process takes practice, reflection and, where appropriate, therapeutic support.

A final thought

Learning to tolerate distress is not about becoming endlessly resilient or expecting ourselves to cope with every difficult situation.

It is about recognising that some discomfort is part of change, while also understanding that we do not have to endure distress that serves no useful purpose.

We can begin to distinguish between situations that require protection and those in which we may choose to tolerate uncertainty in pursuit of something meaningful.

We can identify what matters to us, consider the potential benefits and difficulties, and take steps that feel realistic and appropriate.

You do not have to wait until you feel completely confident or free from anxiety before moving towards something that matters to you. Sometimes, change begins when you decide that what you hope to gain is worth taking one manageable step forward.

In the next article in my STAIR series, I will begin exploring interpersonal relationships and how the emotional regulation skills developed so far can support the way we communicate, connect and navigate difficulties with other people.

---

About the author

Lisa Harris is a psychotherapist, clinical supervisor and consultant, and a Qualified Traumatologist. Her work explores trauma, emotional well-being and the ways therapeutic relationships can support understanding, choice and change.

This article is for educational purposes. It introduces themes explored within STAIR and is not a substitute for individual assessment, therapy or participation in a structured treatment programme. Distress tolerance should never be interpreted as a requirement to endure abuse, coercion or unsafe circumstances.

STAIR is one of several trauma treatment approaches Lisa is trained to offer.

Further reading: Cloitre, M., Cohen, L. R., Ortigo, K. M., Jackson, C. and Koenen, K. C. (2020). Treating Survivors of Childhood Abuse and Interpersonal Trauma: STAIR Narrative Therapy (2nd ed.). The Guilford Press.