The popular version overpromises. What reliably changes isn’t how much distress you can hold before you break — it’s whether you meet it by avoiding or by allowing.
Distress tolerance is the capacity to stay present and keep functioning under high stress and strong emotion, without being overwhelmed into reactivity or shutdown. It’s a real, measurable individual difference,1 but the evidence that you can simply raise your capacity to withstand distress, like adding weight to a bar, is thin: self-reported tolerance shifts with practice while behavioral persistence is harder to move, and the two barely track each other.2 What reliably changes is your relationship to distress — avoidance versus allowing.
The reflex under distress is to get rid of it, and that reflex backfires. Experiential avoidance — trying to escape or suppress unwanted internal states — is broadly linked to harm rather than relief,3 while psychological flexibility is a fundamental feature of health.4 Suppressing a thought tends to make it rebound.5 Accepting a difficult emotion produces lower physiological arousal and faster recovery than suppressing it — though, tellingly, it doesn’t make the moment itself feel less distressing.6
Acceptance, then, is not a technique for feeling better now. It is what lets the system settle afterward — and what frees attention for the task in front of you.
Willingness isn’t resignation and it isn’t liking it. It’s dropping the struggle against what’s already here, so you can act on what matters.
Allow rather than avoid, steady the body without erasing the feeling, and meet suffering without being pulled under.
Choose willingness over avoidanceAllow a distressing state to be present without fighting it: “There is fear, and it can be here while I do this.”7 Catch the avoidance move — suppression, distraction, numbing — since suppression amplifies what you pushed away.5
Steady the body without fighting the feelingExtended-exhale breathing brings arousal down while the situation and the feeling remain.8 Grounding redirects attention and supports willingness — honestly, a practice for staying present, not a proven in-the-moment fix.
Meet suffering through common humanityThe risk in sustained exposure to others’ pain isn’t “compassion fatigue.” It’s empathic distress — absorbing another’s pain until it becomes your own.910 Compassion is a different process and doesn’t wear out the same way; it can even be trained.11 The guard is common humanity: suffering is shared, not special. Stay with it without becoming it.12
The claims this guide rests on, and where to go deeper. The full model lives across all five pillars.
Simons, J. S., & Gaher, R. M. (2005). The Distress Tolerance Scale. Motivation and Emotion, 29(2), 83–102.
McHugh, R. K., et al. (2011). Shared variance among self-report and behavioral measures of distress intolerance. Cognitive Therapy and Research, 35(3), 266–275.
Hayes, S. C., et al. (1996). Experiential avoidance and behavioral disorders. Journal of Consulting and Clinical Psychology, 64(6), 1152–1168.
Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30(7), 865–878.
Wegner, D. M., et al. (1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53(1), 5–13.
Campbell-Sills, L., et al. (2006). Effects of suppression and acceptance on emotional responses. Behaviour Research and Therapy, 44(9), 1251–1263.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy (2nd ed.). Guilford Press.
Balban, M. Y., et al. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine, 4(1), 100895.
Singer, T., & Klimecki, O. M. (2014). Empathy and compassion. Current Biology, 24(18), R875–R878.
Klimecki, O., & Singer, T. (2012). Empathic distress fatigue rather than compassion fatigue? In Pathological Altruism (pp. 368–383). Oxford University Press.
Klimecki, O. M., et al. (2013). Functional neural plasticity and associated changes in positive affect after compassion training. Cerebral Cortex, 23(7), 1552–1561.
Neff, K. D. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85–101.
“Compassion fatigue” is imprecise: the depleting state is empathic distress, distinct from compassion (which can be trained). Firefighter avoidance–PTSD links are preliminary and cross-sectional. Part of The Trauma Competent Model™, Richard Goerling’s operationalized trauma-informed model.
Go Deeper
Where to take this further
Book ·Joan Halifax — Standing at the Edge (2018)
Empathic distress as an “edge state” — where a strength tips into harm.
Read ·Singer & Klimecki — Empathy and Compassion (2014)
The neuroscience separating compassion from empathic distress.
Read ·Inner Range Lab — innerrangelab.org
The rest of the pillars and the writing behind them. innerrangelab.org