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DBT TIPP Skills


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DBT TIPP Skills by Kinga Burjan

General Coping Skills: DBT TIPP Skills

Today’s short video is to break down what TIPP skills are as per DBT therapy, Dialectical Behavioral Therapy (DBT). So this type of therapy allows us to access skills in the here and now when we’re feeling the stress. So that’s where we’re going to focus on today.

What you can do to help lower your heart rate, to calm your mind, to calm your body during intense moments of distress. But just know that these exercises are really good to practice when you’re not feeling distressed so that when you get distressed, you already have that habit and that experience of practicing these habits. So it’s not new. So my recommendation and as a DBT recommendation, it is to practice beforehand. And then when you need it, it’s going to work more effectively for you.

So overall, when we get anxious, stressed, upset or emotionally activated, it’s normal for our body to go into a flight fight or freeze response. And when this happens, our heart rate starts pumping excessively. When we’re accessing the temperature part of TIPP skills, we are doing something drastic to change the temperature. So an example of this would be dunking your face in cold water or using an ice cube and holding it until it melts, focusing on that cold sensation.

This strategy can be particularly good for individuals who might have a history of self-harm. When you hold the ice, it actually hurts. Focus on the pain in the sensation of that. This also releases endorphins into the body, which will calm you.

If holding the ice is not as effective for you, then the other thing you could do is carefully put the ice in your mouth and focus on the sensation of it melting. But be careful to do this if you experience involuntary movements or hyperventilation as you might choke. Another option, if that feels too extreme for you, is just to go outside in a cold temperature. This can also bring you a sense of calm.

The next part of TIPP skills is I, intense exercise. Intense exercise gets your heart rate up and can also help shock the body into a sense of reset. Focusing on exercise not only releases those feel-good neurotransmitters like dopamine and serotonin, but it also allows excess mental energy to be directed into something. So it’s not getting built up inside you anymore. And therefore we have less mental energy to go toward overthinking and perhaps getting in the spiral of negative thoughts. Any intense exercise you could run on the spot do a workout video, anything that gets your heart rate up.

The next part of TIPP skills is P, paced breathing, so when you take a moment to allow your body and mind to focus on the breath, this can help calm the nervous system and help you regain a sense of control over your bodily responses. It can also allow your mind to return to the present moment.

Practicing mindfulness. An option for this is the four seven four breathing method. So this involves breathing into four counts, holding the breath for four counts and exhaling for four counts.

And the final P, of the TIPP skills is Progressive Muscle Relaxation. This requires the tensing and releasing of each muscle group starting at the toes and then working your way up the body. This exercise allows for mindful relaxation of each body part, as well as creating that space around any tension you might be holding and consciously giving your body permission to let go. When you clench for about five seconds, it helps allow your body to release the tension when you let go.

So those are the four tips skills, but just know overall, if you have a hard time staying the present moment or experience, perhaps some dissociation or out-of-body experience, but a good strategy is to go through the five senses.

This is a really good grounding technique where you name five things of each sense. So, for example, if you are feeling that way, you can look around and name five things that you see so mean. I see the sky. I see a door. I see a lamp. I see a desk. I see a plant. And then you name five things that you hear, touch, smell and feel. And if you can’t get to five, don’t worry. The whole point is to get you grounded and back into your body with the five senses. So remember that these skills are all preventative, the TIPP skills in the moment, we may be upset and stressed and we might not have that energy to remember our skills.

Therefore, the more we practice it and use it when we’re not distressed, the easier it’s going to be to access it when we are in a state of distress and more effective over time. So I encourage you even to try out one of the TIPP skills for practice and see how your body responds. And as all of these healthy habits, it’s one little change at a time that makes that positive difference over time and you are worth it.

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