DBT's TIPP Skill: A Fast Reset When Emotions Are Overwhelming
This has probably happened to you: you have a fight with your partner or get a challenging email at work and a wave of panic comes out of nowhere. It becomes impossible to think clearly, you feel flooded with emotion. When emotions get more intense the thinking brain goes offline. This is tricky because that is often when behaviors become challenging: you say something you later regret, you shut down completely or you do something that you wish you hadn’t.
When you’re flooded with emotions what likely won’t help are words. Hearing “calm down” usually isn’t helpful. Trying to think harder doesn’t usually improve things either. Instead, a helpful strategy is to focus on the body: tools that bypass your thinking mind and work to help slow down your nervous system. DBT (Dialectical Behavior Therapy) offers a great set of tools for doing this called TIPP skills and they can really help in situations like these. I’ll break TIPP skills down and how you can use them but first a little explanation of what’s going on in your nervous system.
Why Emotions Hijack Us
A helpful therapy concept for understanding strong emotional responses is the “window of tolerance.” It is the sweet spot where we might be experiencing positive or negative emotions but they aren’t overwhelming. We can think clearly, make plans, and act in meaningful ways. Think about times where you were stressed or upset but got through it. It may have been really tough but you feel OK with how you handled things.
When we’re outside of the window of tolerance, i.e. we are having difficulty experiencing emotions because they are so intense, our thinking brains go offline and our behavior can become challenging and reactive. Some people shut down or dissociate, while others act out. We’re in survival mode.
When emotional flooding happens your nervous system is becoming highly activated and treats the emotional threat like physical danger: think fight, flight or flee mode. When this happens, trying to talk yourself down often doesn’t work. You can’t reason your way out of a hijacked nervous system. Finding ways to cope that use your breath or your body can be a better strategy. This is where TIPP comes in: change the body first and then the mind (and behavior) can follow.
Breaking Down TIPP
T — temperature
You’re probably familiar with the idea of body reflexes, involuntary things our body does when explosed to a stimulus, i.e. the knee will kick when tapped. One interesting reflex is called the diver response. When you dive into cold water, your body will reflexively start to downregulate your nervous system. Your breathing and heart rate will slow down and your brain will start to calm.
Using the diver response when you are feeling strong emotions is easy: keep a cold pack in the freezer and apply to the face and neck, especially the area around the temples. You can also put your face in a bowl of ice water or take a very cold shower. Even splashing cold water on your face can help trigger this reflex.
Changing temperature with cold is especially helpful with high-insensity emotional states like rage, panic or overwhelming grief. If you find it hard to think straight or feel like you’re not in control, changing body temperature can be a great place to start.
I — intense exercise
The logic behind intense exercise is to burn off the stress hormones (e.g. adrenaline and cortisol) that are intensifying your emotions. Intense exercise can cause physiological changes and lead to a calmer state. 5-10 minutes of intense exercise can really help here and it can be anything that gets your heart rate up fast: jumping jacks, burpees, a sprint around the block, running up stairs, etc. (Make sure to get cleared by your doctor before doing intense exercise).
P — paced breathing
Breathing is a well known technique for slowing down the nervous system but I want to break down why it works and what techniques can work best when emotions are overwhelming. First it can be helpful to consider the two parts of the nervous system, the sympathetic and the parasympathetic. The sympathetic nervous system is designed to activate you. If you see something dangerous it will engage your body to run away, fight, etc. The parasympathetic nervous system is designed to deactivate you. The danger is over, things are OK, you can relax and resume other activities. Breathing can activate both systems.
When we expand and extend our inhalation we activate our sympathetic nervous system (think about how we yawn when sleepy, we are taking in oxygen and trying to wake up). When we expand and extend our exhalation we activate the parasympathetic nervous system. There are a number of breathing techniques that can help with this. A simple one is to inhale for four counts and exhale for six or eight counts. The ratio matters more than specific numbers, the goal is to keep the inhalation comfortable and extend the exhalation.
P — progressive muscle relaxation
Progressive muscle relaxation is a great tool for working with an overwhelmed nervous system. It is very straightforward: you systematically tense and release muscle groups throughout your body. This triggers a relaxation response and brings on a feeling of calm. It can be expecially useful when you feel anxious or a low grade tension that you can’t seem to shake. Here’s how to do it:
Start with your head and work down to your feet.
Tense your facial muscles, hold for five seconds and then release. Notice how this feels before and after you tense.
Move on down to your shoulders, tense these muscles and then release.
Continue with your arms, chest, abdomen, etc. all the way down to your feet.
You can tense large muscle groups like your thighs and small ones like your fingers. Notice how your body and your brain shift as you move through your body tensing and relaxing.
How to Choose the Right Tool in the Moment
Ultimately any of the TIPP skills that help are the ones you should use but some of the skills do work better for some situations. For example, if you are feeling emotional explosivity, completely flooded with emotion and out of control, consider the cold water skill first. Intense exercise is great for when you feel agitated or restless or feel out of control of your body. Relaxation breathing is great for being available anytime and anywhere, especially if you’re in a situation (such as work) where you want to be discreet. Progressive muscle relaxation can really help when your body feels tense and overstimulated.
What TIPP Is Not
TIPP skills are not avoidance of a situation. They are the first step you can take so that you can actually deal with a situation effectively rather than react in a potentially problematic way. Rather than being a substitute for feeling or processing what you’re feeling, TIPP skills are tools to get you regulated enough to feel your emotions without being overwhelmed by them. Once you’ve tried a TIPP skill and you’ve become more regulated you can use other skills (including therapy) to understand what is going on, what happened, and determine what behaviors feel effective. TIPP skills help create some space. Once you feel some sense of calm you can become curious about the part of you that has become so upset and overwhelmed.
Practical Takeaways
To feel prepared for a potentially overwhelming situation I think it is important to try out skills and practice them. Try the TIPP skills when things are OK to see how they feel. It is important to be prepared and ready to use these skills when emotions are overwhelming. Practice relaxation breathing or progressive muscle relaxation to get the hang of it. Keep a cold pack in your freezer in case you need it. You can even think about a recent situation that was overwhelming and plan through what you think you would have needed.
Emotional flooding isn't a sign of weakness or that something is wrong with you. It's your nervous system doing exactly what it's built to do when it perceives overwhelm. The good news is that because these responses are physiological, they respond to physiological tools. TIPP gives you a direct way to work with your body instead of fighting an unwinnable battle with your thoughts. The skill isn't complicated, but it does take practice: try these techniques when you're calm so they're available to you when you're not. Over time, you'll build a felt sense of what coming back into your window of tolerance actually feels like and that's often the first real step toward addressing what's underneath the flooding in the first place.