Managing Distress - High Distress Strategies
Managing Distress - High Distress Strategies
Disclaimer: All strategies within this series are derived from Dialectical Behaviour Therapy (DBT), a treatment developed by Marsha Linehan to treat people experiencing significant emotion dysregulation/fluctuations. People with existing medical issues relating to blood pressure/heart should consult a GP before attempting some of these strategies. If you require professional support in a crisis, please call your local Mental Health Triage Team or Emergency Services (000) if you are not safe.
While all strategies work for someone, not all strategies will work for everyone. This occurs for various reasons, including the level of distress you are experiencing at the time that you try to use the skill. The goal of this series of posts (1 of 4) is to help to spread some knowledge about skills, as well as help you to understand which skills are most effective to choose based on how upset/distressed you are at the time.
For periods of high distress or crisis, the most effective strategies focus on changing your body chemistry to reduce feelings of being overwhelmed. These skills work quickly with the aim to bring down the intensity of your emotions as rapidly as possible. When we are highly distressed, we are less able to access the parts of our brain that are involved in problem solving, planning, and logical thinking, therefore it is useful that these strategies require very little thinking.
In DBT, we call these strategies TIPP skills:
Temperature: Dropping your body temperature quickly is typically the strategy my clients have reported in the past to be the most effective for them when managing high distress. You can do this in many ways such as having a cold shower, holding ice to your temples or splashing your face. The colder the option, the quicker it works.
The reason this works is that reducing temperature slows heart rate and many other physical symptoms associated with high distress.
Extra Tip: For the best effect, try to hold your breath while exposing your face to the cold for a short period (this induces something called “the dive reflex” which slows our body systems down more rapidly).
Intense Exercise: While this one may seem counterintuitive at first, bear with me. Intense exercise can be used to increase body activation to a point wherein the natural systems designed to calm the body detect the activation, then kick in to calm the response.
The key to this strategy is that it is about intensity, rather than length of activity primarily. While the best results are usually after 20 minutes, do what you can at high intensity and you are likely to see benefit.
Extra Tip: If you have a medical condition where you tend to get dizzy/faint, I suggest trying the other options rather than this one.
Paced Breathing: When we are distressed, our rate of breathing increases with our increasing heart rate. At university, we did an experiment where we all took very short breaths for 1 minute. I do not recommend deliberately shortening your breathing as a fair amount of students ended up very anxious. While it was a tough way to learn this, increased breathing rate increases anxiety, even if you were not anxious to begin with. Due to this, slowing the breathing rate tends to really help with emotional distress. If you can slow down your “out breath” in particular (do this by blowing air in an exaggerated way out of your mouth) this is the quickest way to calm with breathing.
Extra Tip: It can be useful to count while breathing in, then while breathing out to ensure your “out breath” is longer than your “in breath” by a couple of counts.
Tracing slowly around your fingers with your other hand, while you breathe, can be a good way to pace yourself when distressed.
Image sourced from: https://www.wenatcheeschools.org/safety-security/blog/1629988/starfish-breathing
Progressive Muscle Relaxation: Focus on one muscle group at a time, then tense that muscle, hold for around 5 seconds, then release. If you are in a situation where you are struggling, tensing the same muscle group over and over can be easier than trying to tense different groups. Repeat as many times as you need. This helps the body slow blood pressure/heart rate which then lets our brain know that we are reducing our response, therefore it can stop sending messages of distress to our systems.
Extra Tip: This one is a good option if you are in public and need to be calming down without everyone noticing what you are doing. You can clench fists in your pocket, or underneath the table if you’re sitting. You can also be tensing quad muscles in your legs by pushing down into the floor when sitting.
Hopefully you get something from this and remember that it is important to try things to see if they work or not for you in particular. Don’t lose heart if you try something that doesn’t work, it is often a process of elimination to find the skills that work best for you. Next post will be about distraction and how to use this most effectively for distress.
Josie :)