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T.I.P.P. Crisis Survival Strategy from Dialectical Behavior Therapy

If experiencing a panic attack or overwhelming emotions these 4 steps are an easy way to

"hi-jack" your body to calm yourself quickly.


(Warning: Check with your doctor before using these skills because the steps reduce blood pressure significantly.)


If you are experiencing emotion that feels overwhelming to the point of feeling physically overwhelmed, where that is an anxiety attack or panic attack, this is a great place to start to calm your body.


T. - Temperature Change


Imagine diving into cold water and the peace that overcomes your body once in the water. These steps are to help evoke the dive reflex.



  • Cold compress on eyes, or ice water on face.

  • Heart higher than head (bend over, think dive position)

  • Hold breath for 15-30 Seconds.

*Note this is the part that will decrease blood pressure significantly, and will not feel good if body is already calm. Please consult your doctor before trying this step. If you have a heart condition or are pregnant, please choose another way to calm your body.


I. - Intense Exercise

This is the step that helps burn off the cortisol (stress hormone).

If you aren't sure how intense to go, think "almost failure," you want to push your body hard enough that you almost cannot complete the last rep.

Some examples:

  • Push ups

  • Jumping jacks

  • jogging/running

  • hiking


P. - Paced Breathing

Breathing in this way cues your parasympathetic nervous system to take over, which will slow your heart rate.


  • Put one hand on your heart and one hand on your belly.

  • breathe in, expanding your belly, for 4 seconds.

  • hold your breath for 6 seconds

  • and exhale for 8 seconds, feel your belly muscles contract.

  • It is important that your exhale is longer than your inhale, because the exhale is what sends relief to the brain.

  • plan to do this breathing exercise for at least 5 min.


P. - Progressive Muscle Relaxation

This is another way to relieve the built up tension in your body and address the phyiscal part of an emotional crisis.


There are PMR guides on youtube, if you need the accountability and structure.


  • Progressive muscle relaxation is when you methodically go through every body part, tense or clench as hard as you can and then relax.

  • soften your gaze, or close your eyes if you feel safe to do so.

  • Start with your toes. Clench your toes for 10 seconds. Keep breathing. then release.

  • Move to your calves, then thighs, then butt, then abs, then chest, arms, shoulders, neck, jaw, and ending with eyes.

  • Feel free to include or exclude parts of the body as you feel comfortable. Sometimes it is helpful to identify the most tense part of the body and starting there.


I hope this Simple T. I. P. P. is a helpful tool for you next time you experience overwhelming emotions or a panic attack


I hope you can see that you can be in control of your body even when it feels completely overwhelming.


*This does not replace or act as therapy. If in physical crisis and needing assistance, please call 9-1-1 or 9-8-8 for suicide prevention.

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