Distress Tolerance skills: Learning how to calm myself when things feel out of control
“How to use ‘TIPP’ to reduce distress, aid emotional regulation and soothe the nervous system. ”
Why is this important?
Learning how to use tools to regulate emotions helps to soothe our nervous system, ease anxiety and allow us to feel back in control of our bodies. Having a skills ‘toolbox’ gives us a sense of control when experiencing feelings of distress and anxiety.
TIPP is one of my favourite tools and I continue to use aspects of this myself on a regular basis. TIPP is an acronym for TEMPERATURE, INTENSE EXERCISE, PACED BREATHING & PAIRED MUSCLE RELAXATION. This explains different tools to reduce the physical and psychology symptoms of anxiety, panic attacks and emotional dysregulation. The aim is use these skills to ground ourselves when we feel out of control. TIPP is a technique taught in Dialectical Behaviour Therapy (DBT) and are what DBT recommends to survive a crisis. The idea is to use these skills when you need them and continue to practice overtime.
Read more about each skill below:
the skills - TIPP
Temperature
Use things around you to change the temperature of your body. Examples: Splash cold water on your face, Hold an ice cube in the palm of your hand or to your chest, Let the car Air Conditioner blow on your face, Take a cold shower, Have a cold/icy drink.
Intense Movement or Exercise
Do intense exercise or body movements to match the intensity of your emotions. Examples: Sprint to the end of the street, Star jumps, Do push ups, Shake your limbs.
Paced Breathing
Breathing exercises help to regulate our nervous system. Example: Box Breathing (inhale 4 seconds, exhale 4 seconds, inhale 4 seconds, exhale 4 seconds, repeat).
Paired Muscle Relaxation
This tool is used by tightening and relaxing muscles to encourage relaxation. Starting at your feet, squeeze the muscles and hold them tight for 5 seconds, then release and relax. Repeat this by slowing adding muscle groups moving up your body. Finish after you are squeezed your muscles and held your muscles over your whole body for 5 seconds. Release, relax and breathe deeply.
How does this work?
Using TIPP helps to regulate when feeling intense emotions or dysregulation. For example: anxiety, panic dissociation and anger. Using these skills works to ground you and bring your brain back to feeling ‘safe’ by reducing psychological and physiological symptoms of distress. It is important to note using these skills takes practice and rehearsal to master. More than one skills can be used to aid the regulation.
Having experience in using these skills has helped me during times when my anxiety has felt out of control. Skills like this help us become more in tune with our bodies and our emotional responses which is one aspect towards improving psychological wellbeing. Try them all to find out what works for you and this will help you to build your own toolbox for crisis situations when you feel out of control.
Adapted from Linehan, M., M., (2014). DBT Training Manual. New York, NY: The Guilford Press.