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  • April Griffin

I am spiralling...Now what? Learn the DBT TIPP skill

Storm brewing
DBT TIPP helps with intense emotions and distress

Have you ever felt stuck in an emotional spiral?  You find yourself ruminating and obsessing over something that is happening or just happened and you can’t shift you’re thinking?  You keep winding back down the same spiral that makes you feel worse and worse inside?

When you are at a 10/10 distress you cannot think your way out of it.  Your brain is in flight/fight mode and you feel uncomfortable energy inside your body.

I have. Many times in my life.  I remember experiencing an intense break-up in my 20’s and being stuck reliving that event and how it happened for months and months.  One of my dear friends at the time reminded me that I used to tell her I felt so frustrated and stuck I had urges to break the plates in the kitchen. I did not follow through on that urge, though I still remember the intensity of those feelings.

When clients I work with come to therapy in a very intense state, feeling like they are falling apart, feeling incredibly anxious or angry and/or feeling as if they cannot move on from something I need to do DBT first aid.  There are lots of grounding/emotion regulation strategies to choose from but some are more effective than others depending on the level of stress.

I often suggest is the DBT TIPP strategy when in extreme emotional distress, which is a very short term strategy to help a 10 go down to a 8/10 or not get worse.

T- temperature.  Change the temperature of your body.  Put your face in a bowl or sink of cold water and hold your breath for as long as your can.  This works to stimulate the dive response which slows your heart rate down- it may take 15-30 seconds to work and is best done in a quiet place without distraction to be effective.  You can also use ice packs on your cheeks and eyes as an alternative- I always keep ice packs in my office for this very reason.

I- Intense Exercise. 

Engage in intense energy, it can be for a short while (1-5 minutes) and that will help expend some of the intense energy that the flight/fight response is sending to your body.  What is intense exercise will vary from person depending on your fitness level, physical health condition, and age.  I recommend trying: jumping jacks, shaking out your body, burpees, mountain climbers, sprints, lifting heavy weights, or a brisk walk.  I will often do these in session with clients to experiment with what works for them.

P- Paced Breathing.

Involves slowing down the pace of your breathing intentionally, breathing in to your belly/abdomen and breathing out more slowly than you are breathing in.  You may need to do this for a longer period of time (3-5 minutes) to see an effect.  

P-Paired Muscle Relaxation.

While breathing into your belly deeply tense your body muscles (not so much as to cause a cramp) in one body part at a time (for example your legs, abs, shoulders, arms, face).  Notice the tension in your body as you tense your muscles.  Release and let go of the tension and breathe out, say the word “release” or “relax” in your mind while you do so.  Notice and pause to experience the release of tension after each time you tense and release.  This exercise is sometimes called “progressive muscle relaxation” and you can find many guided exercises online and in mental health apps.

Very cold water decreases your heart rate rapidly. Intense exercise will increase heart rate. Consult your health care provider before using these skills if you have a heart or medical condition, a lowered base heart rate due to medications, take a beta-blocker, are allergic to cold, or have an eating disorder.

It helps to practice the TIPP skill before needing to use it in very intense emotional states so you are familiar with it.  This will also increase the likelihood you will use it when it is most needed and it is more difficult to think and plan.

Please reach out to us today to sign up for our upcoming Trauma-Informed DBT group or meet with one of our counsellors to learn more DBT skills. We have therapists online and in-person in Vancouver, BC, Canada.

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