We’ve spent quite a bit of time getting into our heads recently, so today we are going to talk about three skills that focus on the body. We’re going to break down the TIP skills—and yes, it is an acronym!
TIP skills target our body chemistry to reduce the feeling of overwhelm and other forms of high emotional arousal. The skills work quickly, often within seconds to minutes, for those of you looking for more instant gratification. These skills are easy to use and don’t require a lot of thinking, which is important when you’re in a highly stressful situation.
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One caution that I give my patients about TIP skills is that they’re not designed to solve problems; they’re designed to bring down your emotional arousal so you can then think clearly and then solve problems. I’ve had several patients actually be surprised that the skills worked, and they have become go-to skills for many of them.
I like these skills for when you are near a breakdown point and need to get your emotional arousal down fast. Other times when the TIP skills are useful include when you’re in a crisis and have high urges to engage in destructive behaviors, when you’re not able to process information correct, when you’re caught up in an emotional and can’t get out or when there’s a problem demanding your attention but you’re too overwhelmed to think clearly.
When looking at skills like TIP, the expectation shouldn’t be to drop from maximum intensity to zero. Instead, you’re looking for any change in your emotional experience. So, you might start at 100 and see yourself drop to an 80, which is still high but better than where you started. Others may notice that their overwhelm is steadily increasing but stops increasing after the use of a skill. I tell my patients all the time that sometimes our skill usage isn’t about feeling good, but rather it’s about keeping things from getting worse. TIP skills are short-acting, so they may be the first in a combination of other skills.
You might be thinking, but Dr. Johnson, how do these skills work? The TIP skills are designed to activate your body’s physiological nervous system for decreasing arousal. Your nervous system is composed of two parts: the sympathetic and parasympathetic systems.
The sympathetic system is the one that revs you up. It’s responsible for your fight or flight response and increases arousal. The parasympathetic system tries to keep things balanced. It helps with increasing emotion regulation, which is associated with decreases in emotional arousal. The TIP skills are all about activating your parasympathetic nervous system. With that in mind, let’s break down each of these three skills!
T is for Temperature
The first TIP skill is tipping the temperature. You do this by submerging your face in cold water or placing cold packs on your face while holding your breath. This induces the human dive reflex, which in turn sets off the parasympathetic system and reduces physiological and emotional arousal very quickly. The dive response, which could take up to 30 seconds to activate by using this skill, occurs when your brain thinks it’s underwater. In these situations, your brain will slow your heart rate, reduce blood flow to nonessential organs and redirect blood to your brain and heart. This response helps regulate your emotions and is helpful when you have strong, distressing emotions or have urges to engage in dangerous or destructive behaviors.
The most common method that my patients have used is dipping their full face into cold water and holding their breath for anywhere from 30-60 seconds. This should be sufficient enough to start the diving response; however, some patients may hold their breath for longer if they are comfortable doing so. Be careful not to make the water below 50 degrees. This temperature should be enough to engage the diving response.
The second most common method is to fill a Ziplock bag with cold water and place it over your eyes and upper cheeks. The third most common method is splashing cold water on your face. We’ve all seen this in the movies. Standing, bending over and holding your breath while using these two methods will often increase the effect.
A quick caution: Before using temperature to regulate your emotions, I suggest that you get the a-OK from your medical doctor. Using cold water in this way can reduce your heart rate rapidly, so those with heart disorders, low heart rate due to medications, eating disorders or other medical problems may want to use temperature only under the permission of their medical doctor.
I is for Intense Exercise
The second TIP skill is intense aerobic exercise for 20 to 30 minutes. Intense exercise of any kind for 20 to 30 minutes or so can have a rapid effect on mood, decreasing negative moods and ruminative thoughts and increasing positive moods after completing the exercise.
It’s important not to judge the exercise; whatever you would consider to be intense by your fitness level works. That could range from walking briskly to doing backflips.
There is research to support that anxiety can reduce significantly if your heart rate gets to 70% of your maximum based on your age. Additionally, getting your heart rate to between 55% and 70% has been shown to increase positive emotions with more lasting effects when the exercise gets your heart rate to 70% intensity.
Now you’re beginning to realize why I begrudgingly promote exercise so often! I don’t personally enjoy it, but I do enjoy the effects it has on the mind and body! Use exercise when you are engaging in non-stop rumination, experiencing extreme agitation, when you’re angry or anytime you need a mood boost. Exercise is great in the morning, but you can use it at any time of day that you’ve found useful in the past.
P is for Paced Breathing and Progressive Muscle Relaxation
Generally, the heart beats faster during in-breaths and slows down during out-breaths.
This change in heart rate is influenced by the sympathetic nervous system activating upon breathing in and the parasympathetic nervous system activating upon breathing out. Consequently, paced breathing can cause changes in your nervous system similar to those of the diving reflex. By slowing down your breathing to five to six breaths per minute, it can reduce emotional arousal by activating the parasympathetic nervous system.
To give a concrete example, one paced breathing method is known as 4-7-8 breathing. In this exercise, you will inhale for a count of four seconds, hold your breath for a count of seven seconds and exhale for a count of eight seconds. This is a different way of breathing for most, so you may want to limit it to a few cycles at first and expand as you get more efficient at deep breathing.
P also stands for progressive muscle relaxation. You can perform this skill alone, but most people will pair it with paced breathing as well.
In this exercise, you tense and release various muscle groups. This can be a short exercise, or you can literally go from the tips of your toes to the top of your head! The strategy is to tense muscle groups, noticing the sensation of tension while breathing in, and then relax them by letting go of the tension, noticing the sensations as the muscle tension gradually goes down. The goal is to increase awareness of both stress and relaxation in the body.
Most of us carry a lot of tension in our bodies; I’m notorious for having tight shoulders. This exercise can be helpful for letting it all go. Generally speaking, you would tense your muscles on the in-breath, and on the out-breath, repeat the word “relax” to yourself as you let the tension melt away. I’ll walk you through a brief example.
For this example, we will focus on two areas, your hands and shoulders. You will want to tense for 5-10 seconds and release for 5-10 seconds. Breathe in as you make a tight fist. Then breathe out while in a soothing internal voice saying the word “relax” as you let all the tension fall in your hands. In regard to your shoulders, it’s the same steps; however, you will pull your shoulders all the way up to your ears and hold them for 5-10 seconds, then let your shoulders gradually relax on the out-breath.
All content here is for informational purposes only. This content does not replace the professional judgment of your own mental health provider. Please consult a licensed mental health professional for all individual questions and issues.
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