DBT Core Skill: Distress Tolerance

Most moms have found themselves in the following scenario…

After having fed and burped your baby, changed them, assessed for any illness or pain, and put them down for a nap- they just will not stop crying? The list of to-dos is piling up and you just want to soothe your little one so that you can have a happy baby that will let you get that one load of laundry done. This is where you feel that rush of anxiety and frustration set in: Your heart rate and temperature go up, your hands and feet may feel tingly, and your mind is instantly in fight or flight mode. This is the time to immediately put down the baby in a safe spot- such as a bassinet or crib- and use the grounding and calming techniques presented through DBT.

What is DBT?

Dialectical Behavior Therapy (DBT) teaches skills and strategies to manage painful emotions and cope with conflicts within relationships. The concept of dialect comes from the idea of accepting one’s thought and behavior pattern with the willingness to change it. The word dialectic refers to the discourse between two or more opposing views on a subject, with the goal of establishing truth and meaning. In DBT, it is the synthesizing of change and acceptance that ultimately lead to the meaningful and desired behavior outcome.

When we think of life with a new baby, there is a spectrum of emotion and stages that work on an ever-evolving continuum. One aspect of us is feeling joy and elation, whereas another aspect may be feeling guilty, fearful, and insecure. For example, many new moms with a history of eating disorders will feel triggered by a lack of control and find themselves back in their disorder as a means of coping. DBT gives you the tools to recognize unhelpful coping mechanisms, practice distress tolerance techniques and be more present in the moment.

There are 4 core skills within DBT that are utilized as the foundation for therapy in treatment of mood and anxiety disorders. This  will article will focus on one of those core skills, Distress Tolerance, and the specific technique of TIPP.

 What is distress tolerance?

Distress tolerance is building skills to handle distress in a healthy way, usually when we find ourselves in a situation where we feel out of control. By managing our own response, we can better build a habitual “go to” that utilizes what DBT refers to as the rational mind over the emotional mind. Once we recognize both parts, we can then access the wise mind. DBT presents tools for assessing how we feel and managing knee-jerk responses through techniques like cost benefit analysis, grounding, radical acceptance, self-soothing and TIPP. Here we will discuss TIPP, what it is and how it can be utilized during moments of distress.

What does TIPP stand for?

TIPP stands for:

Temperature

Intense Exercise

Paced Breathing

Paired Muscle Relaxation

 

How Does TIPP work?

The sequence of events that occur during a distressful moment can be explained in biological terms, when fight or flight causes a nervous system response in the body. When we recognize that what is happening to us is purely natural and we have the ability to calm ourselves down, then the anxiety of these moments will decrease because we now have the proper tools to handle it. Each of these skills are set out in a way that work sequentially, with the ultimate goal being accessing your wise mind and quickly calming down so that you can think rationally and better care for yourself and your baby.

Temperature:

Change your body temperature. Hold onto ice cubes, splash your face with cold water or take a cold shower. This will immediately lower your heart rate and body temperature by accessing your parasympathetic nervous system.

Intense Exercise:

Do an intense exercise to match your intense emotion. This could be running to the end of the street, punching a punching bag, doing push-ups or dancing.

Paired Breathing:

Try Box Breathing: Breathe in for 4 seconds, hold it for 4 seconds, breathe out 4, hold 4. Repeat this until you feel calm.

Progressive Relaxation:

Focusing on 1 muscle group at a time, tighten your muscles as much as possible for 5 seconds, then release and relax. Repeat with other muscle groups for as long as needed.