For some people who come into the program feeling so overwhelmed by their emotions, TIP skills will be a vital area of practice.
TIP is an acronym that stands for:
T-Temperature change: While many people in dbt use ice (I’ll talk about this later) to get their emotional distress down, others find it more effective to take a warm/hot bath or shower. *DO NOT USE THE ICE TECHNIQUE IF YOU HAVE A HEART CONDITION OR HAVE HAD A HEART ATTACK*.
I-Intense exercise: Running around the block, doing jumping jacks, turning on a song and dancing around for a little while…all of these things can use up some of the energy that is fueling our distress.
Progressive Relaxation: There are many ways of doing progressive relaxation, but in a nutshell, you are going through your body and mindfully relaxing one area at a time. If your distress is very high, you may want to squeeze all the muscles in each area very tightly for a few seconds…and then release. Don’t forget your face! Scrunch it up tightly, and release. Some people don’t feel comfortable or capable of doing the relaxation exercises when they are very keyed up. Some are even `triggered’ by the relaxation response (me!), because it is new and scary. BUT, if I’m not super keyed up to begin with, the progressive relaxation actually works well for me. And it may for you too. Don’t give up on it if it doesn’t work once…try it a few times. You can find guided progressive relaxation video’s on youtube. I’ll check some out tonight and get back to you with some good ones.
Please remember that you don’t need to use all the skills. Some will seems more natural and/or effective for you, and those will likely be your `go-to’ skills. If you really like the `ice’ technique, it’s perfectly fine to use that one.
If you don’t know what the `ice’ technique is, I’ll give you a little overview. If you really want to go for it (and this is not a particularly pleasant thought or experience for most people…until they find that it works;) ), fill a sink with cold water and add some ice. If you don’t have ice, be creative. Add a pack of cold peas…or something ice-y that will lower the temperature of the water even more. If you don’t have a sink, fill a big mixing bowl. Okay, so, you’ve got some frickin’ cold water in a sink, right? Now, you’re going to hold your breath and dunk your face and head in for as long as you can hold your breath. Then come up, exhale, inhale and dunk again. Repeat as many times as you need to until you feel quite a bit calmer. The most I’ve dunked my head is 4 times in one session. It wasn’t a pleasant experience. My face and eyes hurt like hell….but I really was a lot calmer. Now Ice is my go-to TIP skill. (Fortunately, the longer you practice other dbt skills, the less you’ll need to use the TIP skills…but they’re always good to remember)
The ice-dunk simulates the `dive reflex’, which is what would happen if you actually were in freezing cold water and your body needed to conserve its energy to try to survive. In such a situation, your body would essentially start to slow or shut down functions that weren’t absolutely vital for survival. Our anxiety/emotions are not vital, so they get calmed waaaay down. Honestly, as horrible as this skill might be to practice at first, it became the favored skill of most participants in the two active groups I was involved in.
Some people could not, for various reasons, dunk their entire heads in water. They would vigorously rub lots and lots of ice over their face and heads for 15-30 seconds. Others would put ice packs on their heads. Marsha talks about taking bites out of frozen lemons and oranges. I’m not sure how that would correlate scientifically with the dive reflex, but if it works, who cares???
I also know of a dbt therapist who use the `ice water’ technique to calm down before going to sleep.
I guess this gives new meaning to the phrase ‘chill out’!
Ha! On that cheeeezy note, I’ll go and scour youtube for some relaxation cd’s. Again, Jon Kabat-Zinn has a couple of great progressive relaxation cd’s. One is about 20 minutes, the other 45 minutes long. They’re both great, and if you have an MBSR (see last post) teacher near you, call him/her up and see how you might be able to get a copy.