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DBT Distress-Tolerance Skill

Pros and Cons

Pros and Cons is a DBT skill for slowing down during a strong urge and looking at what may happen if you act on the urge versus what may happen if you do not.

What Is Pros and Cons?

Strong emotions and urges tend to pull attention toward what will bring relief right now.

In that moment, it can be easy to overlook what happens five minutes, five hours, or five days later.

The DBT Pros and Cons skill helps you pause and look at the bigger picture before acting.

Instead of making only one list, you look at four sides:

  1. The benefits of acting on the urge
  2. The costs of acting on the urge
  3. The benefits of not acting on the urge
  4. The costs of not acting on the urge

Looking at all four matters. Acting on an urge may have a real short-term benefit, such as immediate relief. Not acting may also have a real short-term cost, such as having to tolerate discomfort.

The goal is to see the whole choice clearly rather than pretending one side has no downside.

Try This Now

Do a Four-Sided Check

  1. Name the urge: “Right now I have the urge to ______.”
  2. Ask: “What might I gain if I act on it?”
  3. Ask: “What might it cost me if I act on it?”
  4. Ask: “What might I gain if I do not act on it?”
  5. Ask: “What will be difficult about not acting on it?”
  6. Look at both the immediate consequences and what is likely to matter later.
  7. Ask: “Which choice moves me closer to what I actually want for myself?”

The Four Parts

1. Pros of Acting on the Urge

Be honest about what makes the urge appealing.

Possible short-term benefits might include:

  • Immediate relief
  • Releasing tension
  • Avoiding an uncomfortable situation
  • Feeling in control for a moment
  • Getting reassurance
  • Escaping boredom, anxiety, anger, or sadness

Acknowledging these benefits does not mean you should act on the urge.

It helps explain why the urge is strong.

2. Cons of Acting on the Urge

Consider what may happen afterward.

Ask:

  • How will I feel afterward?
  • Could this make the situation harder?
  • Could it affect another person?
  • Will I need to repair anything?
  • Will the relief last?
  • Does this reinforce a pattern I am trying to change?
  • Will I still be glad I did this tomorrow?

Try to include both immediate and longer-term effects.

3. Pros of Not Acting on the Urge

Consider what you may gain by tolerating the urge without following it.

Possible benefits include:

  • Avoiding consequences you would regret
  • Protecting a relationship
  • Staying aligned with a goal
  • Building confidence that you can handle an urge
  • Giving yourself time to make a clearer decision
  • Breaking an old pattern
  • Feeling proud of how you handled the situation
4. Cons of Not Acting on the Urge

This part is easy to overlook, but it is important.

Not acting on an urge may be uncomfortable.

You may have to:

  • Continue feeling anxious for a while
  • Wait for relief
  • Tolerate uncertainty
  • Feel disappointed
  • Remain angry without immediately expressing it
  • Do something more difficult instead
  • Use coping skills until the urge changes

Naming these costs makes the decision more honest.

You can acknowledge:

“Not acting on this is going to be uncomfortable, and I may still decide it is worth it.”

Think Short-Term and Long-Term

What Happens Right Away?

Strong urges often promise an immediate change:

  • Relief
  • Escape
  • Reassurance
  • Release
  • Comfort

That immediate effect is worth acknowledging.

Then ask what happens after the immediate effect wears off.

What Happens Later?

Imagine yourself later tonight, tomorrow, next week, or farther into the future.

Ask:

  • Will the original problem be better or worse?
  • Will I have created a new problem?
  • How will this affect my goals?
  • How will I feel about the choice?
  • What pattern am I strengthening?

A choice that offers immediate relief can still have a high long-term cost.

Example

Sending an Angry Message

Imagine that you are very angry and have written a message you want to send immediately.

Pros of sending it now:

  • I get to say exactly how angry I am.
  • I may feel immediate relief.
  • I do not have to keep holding the feelings in.

Cons of sending it now:

  • I may say something I do not actually mean.
  • The conflict may escalate.
  • I cannot take the message back once it is sent.
  • I may regret how I communicated.

Pros of waiting:

  • I can decide what I actually want to communicate.
  • I may be able to say it more effectively later.
  • I reduce the chance of making the conflict worse.

Cons of waiting:

  • I have to sit with the anger longer.
  • I may feel like I am not doing anything.
  • Waiting may be uncomfortable.

After looking at all four sides, you might decide:

“I'm still angry and I still want to address this. I'm going to wait until I can decide what I actually want to say.”

When Pros and Cons Can Help

  • When you want to react immediately during an argument
  • When you feel a strong urge to avoid something
  • When you are tempted to make an impulsive decision
  • When you want immediate reassurance
  • When you feel pulled toward a behavior you are trying to change
  • When emotional relief now may create consequences later
  • When you know what you want in the moment but are unsure whether it fits your larger goals

Exercises & Applications

Write the Four Boxes

Divide a piece of paper or note into four sections:

  1. Pros of acting on the urge
  2. Cons of acting on the urge
  3. Pros of not acting on the urge
  4. Cons of not acting on the urge

Write at least one item in each section.

Seeing the choices in front of you can be easier than trying to hold everything in your head while emotions are high.

Mark Short-Term vs. Long-Term

Next to each item, mark whether the consequence is mostly:

  • Immediate
  • Short-term
  • Long-term

This can reveal situations where most of the benefits happen immediately but most of the costs arrive later.

Ask “What Happens Next?”

For each possible choice, ask:

“And then what?”

Keep following the likely chain forward.

For example:

“I cancel because I'm anxious.”

Then what?

“My anxiety drops.”

Then what?

“I miss something I wanted to do.”

Then what?

“Avoiding it may make the next time feel even harder.”

Following the chain helps you look beyond the first consequence.

Read Your List During the Urge

If you deal with the same type of urge repeatedly, make the Pros and Cons list while you are relatively calm.

Save it somewhere easy to find.

When the urge returns, read the list instead of trying to recreate the reasoning while distressed.

Imagine Tomorrow

Picture yourself tomorrow after each possible choice.

Ask:

“Which version of tomorrow would I rather wake up to?”

This can help bring longer-term priorities back into a decision that currently feels urgent.

Common Difficulties

Only Listing Reasons Not to Act

It may be tempting to make the list prove the answer you think you are supposed to choose.

Try to honestly acknowledge the appeal of acting on the urge.

If there were no perceived benefit, the urge would probably not be so compelling.

Understanding that benefit can also help you find another way to meet the same need.

Pretending Not Acting Has No Cost

Choosing not to act may require tolerating real discomfort.

Acknowledge that honestly.

Instead of:

“There is no reason to do this.”

you may find:

“There is a reason I want to do this. I just don't think the overall cost is worth it.”

Making the List While Too Overwhelmed

When emotions are extremely intense, carefully evaluating four sets of consequences may be difficult.

Use another distress-tolerance skill first if needed.

For example:

  • TIPP
  • STOP
  • Grounding
  • Delay the Urge
  • Distraction

Then return to Pros and Cons when you have enough space to think.

Overthinking the Decision

Pros and Cons should help clarify a choice, not create endless analysis.

Once the important consequences are clear, ask:

“Do I have enough information to choose?”

If so, move from analysis to action.

What Comes After Pros and Cons?

Once you decide not to follow an urge, you may still need help getting through it.

Depending on the situation, you might:

  • Surf the urge while it rises and falls
  • Delay acting for a set amount of time
  • Change your environment
  • Use ACCEPTS or another distraction
  • Use TIPP if your body is highly activated
  • Reach out to someone supportive
  • Use Problem Solving if there is an underlying problem you can change

Pros and Cons vs. Cost-Benefit Analysis

These skills are related, but this page focuses on the DBT version of Pros and Cons.

DBT Pros and Cons is especially useful during distress or a strong urge. It compares acting on the urge with resisting it.

Cost-Benefit Analysis can be used more broadly when comparing choices, habits, plans, or possible decisions.

Related Skills

  • Urge Surfing — observing an urge without automatically acting on it.
  • Delay the Urge — giving yourself time before deciding whether to act.
  • STOP — pausing before an automatic or impulsive response.
  • ACCEPTS — redirecting attention while getting through a difficult period.
  • Problem Solving — addressing a real, changeable problem after the immediate urge becomes manageable.
  • Wise Mind — considering both emotion and reason when deciding what response fits the situation.
  • Cost-Benefit Analysis — comparing the broader advantages and disadvantages of different choices.

Tips for Practice

  • Be honest about both sides instead of trying to force the list toward a predetermined answer.
  • Include both immediate and longer-term consequences.
  • Remember that not acting on an urge can have real short-term costs, including discomfort.
  • Make important lists ahead of time when possible, rather than waiting until the urge is strongest.
  • Keep the list somewhere you can find it easily.
  • Ask which choice supports what you want beyond the immediate moment.
  • Once the choice is clear, use another coping skill to help carry it out if needed.