Distress tolerance skills are evidence-based techniques from Dialectical Behavior Therapy (DBT) designed to help individuals survive crisis moments without making situations worse. These skills fall into two major categories: crisis survival skills for acute distress, and reality acceptance skills for long-term suffering. The key insight: distress tolerance doesn't eliminate pain — it teaches you to bear pain skillfully until you can address the underlying problem or the intensity naturally decreases. Learning when to use crisis survival skills (temporary relief) versus processing emotions (long-term resolution) is critical for effective emotional regulation.