TIP is all about changing the chemistry of the body very rapidly in order to reduce extreme emotion.  These actions were used when someone at TK was having a panic attack or flashback and their mind was literally not in the present but reliving something from the past.

T – Tip the temperature of your face.  The basic (or mammalian) reflex when submerged in cold water is for the heart rate to decrease and blood flow to increase to the heart and brain.  That’s where life needs to be sustained, and the body and brain react on basic instinct to preserve life.  The same effect can be achieved by putting your face in a bowl of cold water or holding an ice pack to your eyes or cheeks.  At TK residents frequently got cups of ice for other residents in distress and helped guide their hand into it.

I – Intense Exercise. When the body is revved up by emotion, exercising intensely for a short time can expend that energy and help the body and brain calm.

P – Paced breathing. This is a great mindfulness exercise. My info sheet says breathe deeply from the belly and count; inhale on the count of 5 and exhale on the count of 7.  Try to average five to six breaths a minute.  There’s a couple of advantages to this – the heart slows down, hyperventilating stops, the mind focuses on the breathing instead of the problem, and calmness can be restored more easily.  I recently saw a mother use a shortened version of this with her two-year-old.  When he started to whine and cry, she said, “stop; take a deep breath.”  After both of them did a couple times, she said, “now try again without whining.”  And he did!  I wish I’d known to do that with my kids!!

The second skill in the Distress Tolerance Module is Pros and Cons.  This may seem pretty basic, but it’s not when someone is in a desperate crisis situation or in a situation that feels that way.  It was explained in the context of controlling the urge to do something drastic, something addicts and those struggling with anxiety, depression, eating disorders, etc. deal with a lot.  We were encouraged to write it out ahead of time and carry it with us, so when the urge hit, we could pull it out and remind ourselves.

Acting on Crisis Urges. Resisting Crisis Urges.

Here are a couple visuals to help explain it.

This shows a basic chart for general pros and cons of acting on a crisis urge.

The second is a chart to help look at short- and long-term goals in light of tolerating a distressing situation or acting out. (Remember – “One must survive the short-term without making it worse in order to improve the long-term.”) After thinking through these options, it’s easier to say, I’ll do this now so that it doesn’t get worse.  (easy to say; hard to do!)

This last chart shows the pros and cons of changing an emotion.  We are in control of our emotions. Just a reminder – emotion lasts 60-90 seconds; if it continues, it’s because we feed it. Sometimes writing it out can help the mind settle and see the best course.  Sometimes it shows us – at least me – how my emotion may be too long, too intense, or misguided.

Keep in mind, this doesn’t mean the emotion is BAD!  Emotions are just information shared about how our brain and body are reacting to a trigger.  If someone steps on your toe, you may be annoyed.  If someone hits your car, you may be angry.  If someone accidentally throws something of yours away, you may be sad.  These are normal emotions; everyone feels this way at some time.

Back to pros and cons – I’d love to know if this was helpful.  Did you use it to make a decision?  Have you used it before in a distressing situation?

Check out the new List about moving forward…

The first skill in the Distress Tolerance Module is STOP.

S – Stop; do not react.  Just freeze.  Your may be tempted to act, but that would be acting on emotion and impulse instead of mindfully.

T – Take a step back.  Take a break; take a breath.

O – Observe. Notice what’s going on around you.  Notice what others are doing and saying. Tune into your thoughts, feelings, and sensations.

P – Proceed mindfully; act with awareness.  Think about your goals and consider how your actions will line up with them, especially your long-term goals. Use your wise mind, with emotions and reasoning.

This may seem like common sense, but I’ve found that if I’m in a conversation where I react strongly to something said, it’s a valuable tool.  I don’t always think to use it, but when I do, it works!

Many of the Distress Tolerance skills are meant to be internal as a way to regulate moods and responses to the situations we encounter.

I thought this picture was interesting!