TIP Skills

TIP Skills

Happy Sunday, y’all! Like last weekend, I took this weekend to do some self-care, mostly hanging out with the puppy and cleaning the apartment. Wednesday through Friday, and even parts of this weekend, I really struggled with my anxiety. There are different ways my anxiety manifests. Sometimes it’s like I can’t breathe or I get really light-headed. Other times, I feel like I’m losing control of my surroundings. In moments like these, my anxiety is more visible to others. I’ll start to tap my feet, fidget with my fingers, grind my teeth, scratch myself, ect.

I wouldn’t say that my anxiety has specific triggers, but rather, when I’m anxious there are certain situations I experience more difficulty handling. It’s like a chicken before the egg situation. In the last two years, group gatherings have become difficult for me. When there’s so many people to talk to, I can’t figure out where to focus my attention. I hear everyone all at once, which feels like I can’t really hear anyone. Enclosed areas tend to make this experience worse because it’s so noisy. The entire experience can be super overwhelming for me. Noise in general is something I really struggle with. Everything from children crying to the sound of someone’s bracelet scraping across the table- it can be pervasive.

This section I’m currently in for Dialectical Behavior Therapy (DBT) is dedicated to distress tolerance. The goal is simple: survive “crisis situations” without making them worse. A crisis situation doesn’t need to be outwardly obvious. It can be a situation that throws you into a bout of rage or a moment of extreme anxiety. Any feeling or situation that may cause you to say or do something that you’ll regret, can realistically be classified as a crisis situation.

This week, I’ve been working on incorporating “TIP Skills” into my regular routine. TIP stands for:

T: Tip the temperature
I: Intense Exercise
P: Paced Breathing
P: Paired Muscle Relaxation

Tip the temperature is the skill I’ve done the most work with this week. On both Thursday and Friday, I used ice packs help lower my anxiety. Basically, if you hold an ice pack on your face for 15-30 seconds while holding your breath, you’ll trigger the dive response. Your heart slows down, blood flow to nonessential organs is reduced, and blood flow is redirected to the brain and heart. This should help better regulate emotions.

Intense exercise is also supposed to help calm down your body when it is revved up by emotion. I haven’t done a ton of work with this skill this week, since I haven’t really had time to get to the gym. I’ve been walking my puppy- only on concrete, since she has 2/3 of her shots. It’s becoming a really enjoyable activity for me. I’m not sure if it feels calming because exercise releases endorphins, or if it’s because walking her forces me to be mindful. Probably a little bit of both.

I did a lot of work with paced breathing before I learned about TIP skills, and I’m still continuing to work on it. My DBT talked about breathing in sets of four (inhale 4 seconds, hold 4 seconds, exhale 4 seconds, hold 4 seconds, repeat..). So far, this exercise leaves me feeling more anxious since I’m trying to time my breathing and count at the same time- but I’ll keep working on it. I use longer breathing patterns to help me come out of a panic attack. The difference here is that I don’t feel the pressure of counting how many seconds I’m inhaling and exhaling- I’m just allowing myself to take deep breaths.

Paired muscle relaxation, to me, is similar to many mindfulness exercises. The idea is to notice different parts of your body, and the tension you feel in those parts, and to physically let go of that tension. For example, while breathing slowly, ball up your fists. When you release your fists, exhale and mentally tell yourself to relax. You can repeat this by pulling your shoulders up to your ears, holding your stomach tightly, and more. I find these exercises really helpful because I carry a lot of my emotion, whether that be anger, anxiety, or stress, in my body. I grind my teeth so badly at night that I wake up with horrendous headaches. I’ve been struggling with a lot of back and shoulder pain. Paired muscle relaxation helps release some of this stress.

Not all of these skills will work for everyone, but they are all worth trying out. So take a deep breath, and try one out.

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