Let’s start off again by saying, I am not a doctor. I am NOT a therapist or psychiatrist.
These are the fastest working skills I learned in DBT. I feel like they are some of the most useful, but that feeling is very biased. Since these skills help me get past crisis feelings very quickly, it feels as if they are miracles. They temporarily relieve some of the strongest feelings I can have. Of course, they don’t do anything long term.
My feelings of crisis seem very much like a panic attack, only I don’t necessarily feel afraid. As if approaching rapids, my thoughts begin to get turbulent, the currents faster, tripping over each other in my head in their urgency to get out. My voice gets caught in my throat, and over the loudspeaker I can hear myself becoming an inner dictator, reprimanding my foolishness and my inability to form clear thoughts. You can’t say anything. You’ll only get angry. You’ll only hurt their feelings. You’ll cause a disaster. You deserve what you’re getting. You can’t get out. You can’t get out.
It reminds me of Gandalf at Balin’s Tomb. “The ground shakes. Drums, drums in the deep. We cannot get out. A shadow moves in the dark. We cannot get out. They are coming.” Recast this as the beginnings of crisis, and add the worrying violins to the soundtrack, and you have all the fear and knowing that comes upon you when you realize it’s happening. By that time, it is in some ways too late.
I have come to see that I appear silent, frozen, and terrified, like a hunted rabbit, when this happens. Inside I am raging, inside I am screaming and straining my muscles to lash out and rip myself apart. Anything to regain control of my nerves.
Enter the TIP skills, stage left. T for temperature: run cold water on your hands or splash it on your face, or heck just jump in a shower with your clothes on. I for intense exercise: drop and give ’em twenty, or fifty if you can, anything to get your heart pumping to your own drum. P for progressive relaxation: one by one, relax each muscle in your body.
These skills are pretty awesome. They don’t need to be done in order. They don’t need to each be done. Whichever is sufficient. I find temperature and intense exercise easier and more effective – progressive relaxation, for me, is out of reach. The water needs to be REALLY, really cold. An ice pack, an ice cube pressed against your skin, or just very cold water. Cold enough to gasp, but not frostbite. Intense exercise needs to be really intense, building up lots of heat quickly so that you’re breathing heavily at the end.
Presto. For me, if I can get myself to do these things, the crisis subsides enough to deal with it on a more concrete and manageable level. I am myself again. Exit crisis, pursued by a bear.
I find it really hard to do the exercise sometimes. I’m so angry that I just want to burn into a thousand pieces of ash instead of actively pursue health. Patrick makes me do it, when he’s around. I always feel better after, although sheepish. But when you cannot afford for the crisis to get any worse, and cannot afford to spend time reducing it through mindfulness and acceptance, these are the skills to turn to.