What to do when you're too upset to think straight
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What is the main topic discussed in this episode?
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Distress is inevitable. Pain is an inevitable part of life. And so much of what we do are attempts to avoid distress and pain. We drink when we're anxious or we lash out at people when we're angry. Those behaviors are the result of not knowing how to tolerate what feels intolerable in that moment, which is that emotional experience.
You're listening to Life Kit. I'm Mariel Segarra. And you just heard from Shireen Rizvi. She's a professor of psychiatry and behavioral sciences at Montefiore Einstein. She co-wrote a book called Real Skills for Real Life, and it's filled with distress tolerance skills that come from dialectical behavior therapy. That's a form of therapy that helps people understand the connections between their thoughts, their behaviors, and their emotions. She says according to this framework, in moments of distress, we have these two options.
We could try to change the situation that's causing us distress, but sometimes we can't just remove the problem or solve the problem. And so in those moments, we have to learn how to accept the distress and respond in a more effective way. What do you think people get wrong about coping with distress? I think first thing that people get wrong is thinking that I have to get rid of it right away. Their first impulse and instinct is to do something to make it stop. And I think the second thing that people get wrong is the idea that I need to do something to make it go away because otherwise it will last forever.
Yeah.
And so one thing that we want people to learn is that actually whatever it is you're feeling, no matter how intense, no matter how awful it feels in this moment, it will pass.
What is distress tolerance and why does it matter when emotions feel overwhelming?
On this episode of Life Kit, research-backed skills to help you tolerate distress. And these skills can make sense in a lot of different situations. When you're stuck in traffic, when you got in a fight with your partner, when your teenager is rude to you, and when you're dealing with big life events like illness or death. Okay, so the first distress tolerance tool we're going to talk about here from the book is something called TIP. It's an acronym, T-I-P. And it actually stands for four distinct skills that you can use in moments when you're so distressed that you just can't think straight. You say in the book, these are not skills to help you solve the problem, right?
Yes, exactly. And the idea is these are skills to help you go from, let's say, a 100 on a scale of 0 to 100 to an 80. And then when you're at an 80, you might be able to flip through the pages and find something else to do.
Okay, so TIP is an acronym. It stands for T-I-P. T is temperature. What does that mean?
Yeah, temperature is actually one of my favorite skills. This is going to sound really weird, but it's making your body think that you have just dived into extremely cold water. And the reason we do that is because there's such a thing called the mammalian dive reflex, which is a reflex that all mammals have that when we are submerged in cold water, it's it increases the likelihood of survival. And the reflex does things like slows down your heart rate, slows down your respiratory rate. Those are things that we also often need when we're in high degrees of distress and are physiologically aroused. So the way that we practice this skill is to get a large kitchen bowl, fill it with very cold water with some ice cubes in it so that it's pretty cold.
You take a deep breath and then you plunge your face, your eyes and your temples in particular, into the water while holding your breath. Wow. and staying there for as long as possible. For most people, I have to say it is incredible in terms of how well it works for people in terms of getting that arousal to go down.
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Chapters
4 chapters
1
What is the main topic discussed in this episode?
0:00–2:23
2
What is distress tolerance and why does it matter when emotions feel overwhelming?
2:23–7:45
3
What are the two options DBT suggests when you're in a moment of intense distress?
7:45–18:04
4
How does the TIP skill (Temperature) lower your heart rate using the mammalian dive reflex?
18:04–25:49
Speakers
7 identifiedMore from Life Kit
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