Distress Tolerance 1

Welcome back! We’re going to be moving on from the Mindfulness module into exploring Distress Tolerance. This module emphasizes managing overwhelming situations without making things worse or adding to the problem. When we’re in crisis, it’s easy to overreact. Life throws a LOT of curveballs and it’s easy to get swept up in our emotion minds, losing sight of our goals and values. This can lead to negative consequences and engaging in self destructive behaviors that we later regret.

It is important to remember that these skills are meant for short-term relief, not as a long-term solution to solving our problems. We’re not meant to push away our emotions entirely, as they can (and will!) resurface later. Distress tolerance skills are meant to serve as a temporary way for us to manage intense emotions and discomfort in order to survive a crisis without further contributing to the problem.

Let’s begin with the TIPP skill. TIPP stands for Temperature –Intense Exercise –Paced breathing and – Progressive muscle relaxation. The TIPP skill is wonderful for those times that you feel completely hijacked by your emotions and are unable to think clearly. Tensions are high, emotions are hot, and it’s easy to lose control. TIPP can help bring you back down to a place where it’s easier to problem solve and restore you back to Wise Mind.

Let’s begin with Temperature. This refers to changing your body temperature to better regulate your emotions. Colder temperatures lower heart rates, which is helpful when you’re trying to return to a less activated state of mind. Think about when you feel anxious or otherwise emotionally overwhelmed. Chances are, your heart rate is through the roof which can make things feel even worse. Splashing your face with cold water, placing an ice pack on the back of your neck, or even taking a walk in the cold weather can slow your heart rate down and lead to overall feelings of calmness. Please check with your doctor if you have any medical conditions that affect your heart rate or blood pressure before attempting to use this skill.

Next is Intense Exercise. High intensity movement can be very effective in “getting it all out” when you’re feeling overwhelmed. Jumping jacks, vigorously shaking your hands and arms, sprinting in place, etc. are all examples of short, intense exercises that can help deescalate and rebalance intense emotions.

Paced breathing is an excellent way to self-soothe intense emotions. A simple way to practice this is by making your exhales longer than your inhales. Some people like to count, which is perfectly fine too! You can count to 4 on the inhale and 6 on the exhale, or some version of that.

Finally, Progressive muscle relaxation is a technique involving tensing and relaxing various muscle groups. You can start with your feet and deliberately tighten them as hard as you can for a couple seconds, then release. Move up to your calves, then your thighs, abdominals, chest, upper back, and neck. See below in the resources section for a YouTube video of the progressive muscle relaxation exercise.

The TIPP skills are very effective ways at managing extreme emotions and can help us regulate when we’re under pressure. Another distress tolerance skill is self-soothing using your 5 senses, sight, sound, taste, touch, and smell.

Sight – Take in what’s around you. Maybe look at something pretty or calming and pay attention
to all the minute details. Look at pictures of people and places you care about and relish in the positive feelings you experience.

Sound – Listen to your favorite music or sing something out loud! Listen to nature sounds around you or pop in a guided meditation.

Taste – Eat your favorite food or drink and really take the time to enjoy it. Treat yourself to some comfort food and really take in the experience. Tip: Peppermint candy is also an effective aid in reducing anxiety!

Touch – Take a long hot bath or shower, pet your dog or cat, get a hug from someone you care about, get a massage, etc.

Smell – Diffuse essential oils (lavender, peppermint, and ylang ylang are especially helpful). Burn smelly candles and pay attention to all the different notes you notice.

Next time we’ll explore other ways of using distraction in a healthy way to manage difficult situations. Please look at the resources below for further information and exercises to practice.

The article is by Alissa Hager, LPC, LCMHC
Palmetto Counseling and Consulting, LLC

Welcome back! To continue our exploration of mindfulness, let’s talk about “Wise Mind”. Wise Mind is a concept taught in DBT that refers to the synthesis between our “rational” mind and “emotion” mind.

Rational mind, also sometimes called “reasonable” mind, is where our logic lives. When we approach situations using our rational mind, we’re focusing on facts rather than feelings. Examples of this might be figuring out a math problem, driving a car, measuring ingredients for a recipe, following a schedule, etc.

Emotion mind is when we’re being driven by our feelings. Logic and facts become distorted when we are in emotionmind and this might result in impulsive decision making or lashing out. Emotion mind isn’t all negative though. We’re in emotion mind when we’re engaging in pleasurable activities like snuggling with a puppy or being overjoyed at good news.

Neither states of mind are inherently good or bad. They’re simply different approaches and ways of conceptualizing situations and experiences.

Wise Mind is where emotion mind and rational mind are balanced. It’s usually a quiet feeling, a sense of inner knowing. Have you ever had a time where you just “knew” something? Maybe it was a quiet nudge in a certain direction that turned out to be in your favor. That’s Wise Mind! Accessing our Wise Mind can be difficult, and you might sometimes feel like you don’t even have a Wise Mind, but you do. We all do. It just might take some practice to discover what it feels like for you. One way to think about Wise Mind is the calm after the storm. Sometimes after a big emotion, we calm down and begin processing things in a different way. You might consider alternative perspectives that you hadn’t been able to before or have different insights into the issue. That’s your Wise Mind talking!

So, how can we practice accessing Wise Mind outside of those moments? The more we practice feeling into what our Wise Minds are, the better we can access it in moments of high intensity. One way to practice is through deep breathing, and focusing on that space between your inhale and your exhale. Take a big, full deep breath in and pause for a second or two. Pay attention to that little pause before exhaling. After you exhale all the way out, center your attention on that space at the bottom of the exhale. How does it feel? Quiet? Weird? Unknown? Lean in to it and keep practicing!

Check out these resources to learn more about Wise Mind. Next article we’ll begin exploring the Distress Tolerance module.

https://dialecticalbehaviortherapy.com/mindfulness/wise-mind/

https://www.mindfulnessmuse.com/dialectical-behavior-therapy/what-is-wise-mind

The article is by Alissa Hager, M.Ed, LPC
Palmetto Counseling and Consulting, LLC