TIPs for Managing Distress

Photo by Zack Melhus on

When we become very activated or overwhelmed by emotion it can be hard to use some of our coping skills. It may also seem like you can’t “calm down” or reduce the intensity of the emotion fast enough. If you experience this, you’re not alone – especially given the emotionally charged time we are living in. I’d like to share some skills from Dialectical Behavior Therapy (DBT) which may help you to rapidly reduce emotion arousal. These skills are known as TIP skills and they are designed to decrease arousal by increasing activity in your parasympathetic nervous system (“rest”) and decrease activity in the sympathetic nervous system (“fight or flight”)

  • Tip the temperature of your face with cold water
  • Intense exercise
  • Paced breathing
  • Paired muscle relaxation

Tip the temperature: just as it says, you change the temperature on your face by using cold water (or ice cubes, frozen peas, etc). This helps to change the chemistry in your body to reduce your heartrate so you can calm down. *If you have any medical conditions that might affect your cardiovascular system, or if you have an allergy to cold items on your skin, you may want to get medical clearance first. 

Intense exercise: engage in some kind of aerobic exercise for at least 20 minutes to help expend some of the stored-up energy. If you can’t exercise for 20 mins, then do whatever feels comfortable for you. Try engaging in an exercise activity that is immediately available to you (so you don’t have to worry about going anywhere). 

Paced breathing: slow down the pace of your breathing (your inhale and exhale). Ideally, you slow down the pace of your breathing down to an average of 6 breaths per minute (if this seems accessible to you). You also want to make the exhale a longer count than the inhale. For example, you can inhale for a count of 3 and exhale for a count of 5. There are also many smartphone apps with paced breathing activities, and you can search YouTube as well. You may want to record yourself counting for the paced breathing, so you have it easily accessible when you need it. 

Paired muscle relaxation:muscle relaxation can be paired with paced breathing! Muscle relaxation involves tensing the muscles (while noticing how it feels in your body during the inhale) and releasing the tension on the exhale. Ideally, you want to increase your awareness of when you tense and when you relax your body. You can do this for as long as you need. 

Notice what your experience is like when you engage in one or more of these TIP skills! 

With deep gratitude


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